News
Latest news, analysis, and updates.
CMS to Add COPD, Substance Use Care to ACCESS Model in 2027
CMS plans to add COPD, substance use disorder and tobacco cessation to its ACCESS payment model in 2027. Here's what it means for Medicare beneficiaries.
September 17, 2026
KFF Video Breaks Down What Insurers' Premium Cut Buys
KFF's Larry Levitt examines insurer overhead and profit in Medicare and private plans, and what a Medicare-for-all system would change for beneficiaries.
September 15, 2026
UnitedHealthcare CFO Predicts Strong 2027 Medicare Advantage
UnitedHealthcare's CFO says the insurer will be very competitive in Medicare Advantage for 2027 as it works to keep MA plans profitable.
September 13, 2026
CMS Raises Bar for 2027 Medicare Advantage Star Ratings
CMS's draft 2027 Medicare Advantage Star Ratings cut points are stricter, which could affect bonus payments and plan benefits ahead of AEP.
September 11, 2026
Mass General Brigham Drops Dana-Farber From MA Network
MGB's Medicare Advantage plan dropped Dana-Farber Cancer Institute from its network as the two Boston systems wind down their partnership in 2026.
September 9, 2026
HaloMD's No Surprises Act Savings Claim Draws Doubt
HaloMD says the No Surprises Act cut out-of-network ER spending by over $1 billion, but independent researchers question its study methodology.
September 7, 2026
UnitedHealthcare Cuts Prior Authorization on 1,700 Codes
UnitedHealthcare will drop prior authorization for about 1,700 codes starting October 2026. Here's what it means for Medicare Advantage enrollees.
September 5, 2026
OIG Audit: Medicare Paid Millions for Ineligible Drugs
An HHS OIG audit found Medicare spent hundreds of millions on ineligible drugs due to CMS oversight gaps. Here's what it means for your Part D costs.
September 3, 2026
Florida AG Sues Drug Middlemen Prime, Express Scripts
Florida's AG sues PBMs Prime Therapeutics and Express Scripts over alleged pharmacy price fixing. What it could mean for Medicare drug plan costs.
September 1, 2026
No Surprises Act Dispute Costs Hit $22B: Medicare Impact
Georgetown research finds No Surprises Act dispute resolution has added $22B in costs. Here's what it means for Medicare and MA plan shoppers.
August 30, 2026
Villages Health Settlement Raises Medicare Questions
A $542 million Villages Health settlement highlights why Medicare Advantage members should review bills, records, and plan choices.
August 28, 2026
Medicare's New GLP-1 Discount Program Has a Catch
Medicare's new GLP-1 Bridge program offers weight-loss drugs for as little as $50 a month, but some sick patients don't qualify for the discount.
August 26, 2026
Medicare Cataract Cuts Push Patients Toward Pricey Lasers
Medicare pays less for cataract surgery, and more eye doctors now offer laser upgrades patients pay extra for. Here's what Medicare beneficiaries should know.
August 24, 2026
Medicare Payment Cuts Are Reshaping Cataract Surgery Costs
Medicare reimbursement for cataract surgery has declined, and more ophthalmologists now offer laser-assisted procedures as an out-of-pocket upgrade. Here's what beneficiaries should know.
August 22, 2026
Providence Health Plan Closing: What Medicare Members Should Know
Providence Health Plan is closing after a Medicare Advantage rescue deal collapsed. Here's what affected members need to know about enrollment options.
August 20, 2026
Why Discharge Timing Now Shapes MA Star Ratings
MA plans are focusing on the first 24 hours after hospital discharge to raise CMS star ratings, here's what that shift means for Medicare enrollees.
August 18, 2026
When Hospice Care Ends: What Medicare Enrollees Need to Know
Some hospice patients improve and lose eligibility. Here's how Medicare's hospice discharge and appeal rules work, and what beneficiaries should do next.
August 16, 2026
Hospice Discharge: When Patients Improve, Not Decline
Some hospice patients improve and lose eligibility. Learn how Medicare's hospice benefit works, why discharges happen, and how to appeal.
August 14, 2026
Medicare's $13B MA Bonus Program: What It Means for You
Medicare will spend $13 billion on MA quality bonuses in 2026, with 68% of enrollees in bonus-eligible plans. Here's what it means for your coverage.
August 12, 2026
Sentara-Anthem Contract Fight Threatens VA Medicare
Sentara plans to end Anthem contracts in Virginia, threatening network access for about 380,000 patients, including Medicare enrollees.
August 9, 2026
Sentara-Anthem Split Could Affect Medicare Choices
Sentara says it is moving to end Anthem contracts in Virginia. Learn what a possible network change could mean for Medicare members.
August 7, 2026
Complete Health Pays $14M Over MA Billing Allegations
Complete Health agreed to pay $14M to resolve DOJ allegations of inflated Medicare Advantage diagnosis coding. Here's what it means for MA enrollees.
August 5, 2026
CMS Ends Part D Premium Stabilization Demo for 2027
CMS says it will end the Part D Premium Stabilization Demonstration after 2026, and a researcher warns some enrollees could face higher 2027 premiums.
July 30, 2026
Hospital Prices Drive Health Costs, But Stay Off Radar
Hospitals drove 40% of U.S. health spending growth from 2022-2024, yet drug prices dominate policy debates. Here's what Medicare enrollees should know.
July 17, 2026
Zero-Premium Drug Plans: When $8 Costs You Coverage
Thousands of Medicare Part D enrollees were dropped for missing small new premiums. Here's what happened, who's at risk, and what to do now.
July 7, 2026
Medicare Prior Auth Still Blocks Lifesaving Drugs
A Missouri woman's hospitalization after a Medicare Advantage prior auth denial shows why industry reform pledges haven't fully protected patients.
June 29, 2026
PBM Lobby Sues Illinois Over Drug Affordability Law
PCMA filed its second state lawsuit in one week over PBM reform laws. Here's what the Illinois case means for Medicare Part D drug costs in 2026.
June 21, 2026
Congress Moves Against Medicare AI Prior Authorization
House committee votes to block Medicare's AI prior authorization pilot amid concerns about care delays for seniors. What this means for beneficiaries.
June 11, 2026
CMS Delays Elevance Medicare Advantage Sanctions
CMS delays Elevance Medicare Advantage sanctions until July after progress on data fixes. What this means for your plan coverage.
June 3, 2026