Tag: Medicare

Eliminating Waste, Fraud, and Abuse in Medicaid My Administration has been relentlessly committed to rooting out waste, fraud, and abuse in Government programs to preserve and protect them for those who rely most on them. The Medicaid program was designed to be a program to compassionately provide taxpayer dollars to healthcare providers who offer care to the most vulnerable Americans. To keep payments reasonable, billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare. The State and Federal Governments jointly shared this cost burden to ensure those of lesser means did not go untreated. Under the Biden Administration, States and healthcare providers were permitted to game the system. For example, States “taxed” healthcare providers, but sent the same money back to them in the form of a “Medicaid payment,” which automatically unlocked for healthcare providers an additional “burden-sharing” payment from the Federal Government. Through this gimmick, the State could avoid contributing money toward Medicaid services, meaning the State no longer had a reason to be prudent in the amount of reimbursement provided. Instead of paying Medicare rates, many States that utilize these arrangements now pay the same healthcare providers almost three times the Medicare amount, a practice encouraged by the Biden Administration. These State Directed Payments have rapidly accelerated, quadrupling in magnitude over the last 4 years and reaching 0 billion in 2024 alone. This trajectory threatens the Federal Treasury and Medicaid’s long-term stability, and the imbalance between Medicaid and Medicare patients threatens to jeopardize access to care for our seniors. I pledged to protect and improve these important Government healthcare programs for those that rely on them. Seniors on Medicare and Medicaid recipients both deserve access to quality care in a system free from the fraud, waste, and abuse, that enriches the unscrupulous and jeopardizes the programs themselves. We will take action to continue to love and cherish the Medicare and Medicaid programs to ensure they are preserved for those who need them most. The Secretary of Health and Human Services shall therefore take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law. This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. DONALD J. TRUMP

Eliminating Waste, Fraud, and Abuse in Medicaid My Administration has been relentlessly committed to rooting out waste, fraud, and abuse in Government programs to preserve and protect them for those who rely most on them. The Medicaid program was designed to be a program to compassionately provide taxpayer dollars to healthcare providers who offer care to the most vulnerable Americans. To keep payments reasonable, billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare. The State and Federal Governments jointly shared this cost burden to ensure those of lesser means did not go untreated. Under the Biden Administration, States and healthcare providers were permitted to game the system. For example, States “taxed” healthcare providers, but sent the same money back to them in the form of a “Medicaid payment,” which automatically unlocked for healthcare providers an additional “burden-sharing” payment from the Federal Government. Through this gimmick, the State could avoid contributing money toward Medicaid services, meaning the State no longer had a reason to be prudent in the amount of reimbursement provided. Instead of paying Medicare rates, many States that utilize these arrangements now pay the same healthcare providers almost three times the Medicare amount, a practice encouraged by the Biden Administration. These State Directed Payments have rapidly accelerated, quadrupling in magnitude over the last 4 years and reaching $110 billion in 2024 alone. This trajectory threatens the Federal Treasury and Medicaid’s long-term stability, and the imbalance between Medicaid and Medicare patients threatens to jeopardize access to care for our seniors. I pledged to protect and improve these important Government healthcare programs for those that rely on them. Seniors on Medicare and Medicaid recipients both deserve access to quality care in a system free from the fraud, waste, and abuse, that enriches the unscrupulous and jeopardizes the programs themselves. We will take action to continue to love and cherish the Medicare and Medicaid programs to ensure they are preserved for those who need them most. The Secretary of Health and Human Services shall therefore take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law. This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. DONALD J. TRUMP

MEMORANDUM FOR THE SECRETARY OF HEALTH AND HUMAN SERVICES THE ADMINISTRATORS OF THE CENTERS FOR MEDICARE AND MEDICAID…

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Medicare seeks lower prices for drugs, including Ozempic : Shots

Medicare seeks lower prices for drugs, including Ozempic : Shots

Medicare has started price negotiations for 15 medicines, including the diabetes drug Ozempic. Mario Tama/Getty Images hide caption…

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Amazon, A Small Pharmacy Player, Seeks To Dent CVS And Walgreens Medicare Share

Amazon, A Small Pharmacy Player, Seeks To Dent CVS And Walgreens Medicare Share

Amazon Pharmacy Enhances Services for Seniors with Medicare Coverage Amazon Pharmacy is making strides to attract more seniors…

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Delaying Medicare enrollment. What to know

Delaying Medicare enrollment. What to know

As you approach the age of 65, the decision of when to enroll in Medicare can be a…

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What Medicare doesn’t pay for becomes hefty debt for millions of seniors

What Medicare doesn’t pay for becomes hefty debt for millions of seniors

Connie Morton, a resident of Colonial Beach, Va., faced a devastating loss when her husband passed away last…

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What Health Systems That Are ‘Losing On Medicare Advantage’ Can Do

What Health Systems That Are ‘Losing On Medicare Advantage’ Can Do

Medicare Advantage is often seen as a challenging program, with providers expressing frustrations over inadequate payments and financial…

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The Medicare Advantage Reset? How UnitedHealth Got Squeezed And What Comes Next

The Medicare Advantage Reset? How UnitedHealth Got Squeezed And What Comes Next

“We remain committed to our strategy of driving quality outcomes and reducing healthcare costs through our integrated model,”…

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UnitedHealth faces Medicare Advantage challenges rivals have overcome

UnitedHealth faces Medicare Advantage challenges rivals have overcome

UnitedHealth Group, a behemoth in the health insurance and services industry, has recently faced some financial challenges that…

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Democrats target Medicare Advantage, not Medicaid cuts, in Trump budget

Democrats target Medicare Advantage, not Medicaid cuts, in Trump budget

In the ongoing debate over healthcare spending, Democrats are urging Republicans to focus on cutting wasteful spending in…

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Here’s How Trump And Oz Can Fix Medicare

Here’s How Trump And Oz Can Fix Medicare

Dr. Mehmet Oz Takes Aim at Medicare Administrative Contractors to Improve Healthcare With Dr. Mehmet Oz now at…

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Humana Reports .2 Billion Profit As Medicare Costs Fall Within Expectations

Humana Reports $1.2 Billion Profit As Medicare Costs Fall Within Expectations

Humana's Profits Soar to $1.2 Billion in First Quarter Humana recently announced a significant milestone in its financial…

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Tariffs, Medicare Advantage, Elevance’s expansion

Tariffs, Medicare Advantage, Elevance’s expansion

Breaking down tariffs on surgical robots and devices The global economy has been shaken in recent weeks by…

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