The Trump administration’s plan to lower US drug costs through two new pricing models is prompting legal concerns from the ...

He explained that there is no provision in GLOBE or GUARD that changes what plans, hospitals or pharmacists pay for prescription drugs, and there is no mechanism for shifting the any savings to ...

Anthropic is bringing Claude for healthcare, following a similar move by OpenAI for ChatGPT. In a blog post , Anthropic explained that Claude is expanding into Healthcare, and it's testing new ...

Medicare offers help for caregivers of dementia patients but getting the word out has not been easy. People who work in ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. On December 23, the Centers for Medicare and Medicaid ...

The Association for Community Affiliated Plans (ACAP) has proposed five demonstration programs to leverage Dual-Eligible Special Needs Plans (D-SNPs) to improve the quality and accessibility of ...

The Centers for Medicare & Medicaid Services (CMS) announced on December 23 a new voluntary test of a model designed to enable Medicare Part D plans and state Medicaid agencies to cover GLP-1 ...

CMS has been trying to scale value-based care for decades with mixed results — but the agency’s newly announced ACCESS model could represent a more meaningful step toward aligning payment with ...

The Trump administration is proposing significant changes to the metrics used to the calculate the Medicare Advantage star ratings. As part of the Contract Year 2027 MA and Part D proposed rule, the ...

CMS is launching a five-year Prior Authorization Demonstration for certain ambulatory surgical center (ASC) services beginning December 15, 2025, in 10 states, including Georgia, Florida, Tennessee, ...

WASHINGTON – Reps. Dan Meuser and Mariannette Miller-Meeks are spearheading a sign-on letter asking CMS Administrator Dr. Mehmet Oz to prevent flawed provisions for a new round of the competitive ...

The Review Choice Demonstration (RCD) was a home health boogeyman when the program was announced in 2018, with industry stakeholders fearing it would cause major disruptions. Fast forward some years ...