North Carolina State

Columbus, OH

Fortune

People very limited financial resources may qualify for Medicaid to help pay for health costs not covered by Medicare. Health care expenses often increase as people age, due to more health challenges and care needs. According to the Centers for Medicare & Medicaid Services, U.S. adults ages 65 and over...

Who is eligible for both Medicare and Medicaid?

Trisha Byers left behind one crucial item when she moved to North Carolina last year to be closer to her family after suffering a brain injury: health insurance. In Massachusetts, Byers, 39, was enrolled in Medicaid, the government health program that covers low-income people. But she was ineligible in North Carolina, which had not yet expanded Medicaid coverage under the Affordable Care Act. She said she racked up thousands of dollars in unpaid emergency room bills while uninsured for several months after her move.

Amid Medicaid ‘Unwinding,’ Many States Wind Up Expanding

Mississippi State

Arkansas Advocate

For Roderick Givens, a radiation oncologist, the expansion of Medicaid isn’t just a policy issue. He practices medicine in a rural area in the Mississippi Delta and he sees daily how Medicaid coverage could help his uninsured patients. “I can’t tell you the number of patients who I see who come in with advanced disease, […]

The politics holding back Medicaid expansion in some Southern states

The proportion of allergists accepting Medicaid in the US varied significantly among and within states. Objective: To determine the geographic variability of Medicaid acceptance among allergists in the US. Study Design: Geospatial analysis predicted Medicaid acceptance across space, and a multivariable regression identified area-level population demographic variables associated with acceptance.

Geographic Variability of Medicaid Acceptance Among Allergists in the US

HealthPartners, a prominent healthcare provider, has announced plans to withdraw from the Medicare Advantage plan offered by UnitedHealthcare starting in 2025. This decision will affect approximately 30,000 patients and marks a considerable shift in the relationship between the two healthcare giants. A potential coverage gap is anticipated for the affected...

HealthPartners to exit UnitedHealthcare’s Medicare plan in 2025

UnitedHealthcare will launch a national program Oct. 1 for physicians to override traditional prior authorization requirements. The gold card program, which applies to commercial, individual exchange and Medicare Advantage plans, allows certain physician practices to not submit prior authorization requests for “certain medical, behavioral and mental health services,” according to a fact sheet released by the company.

UnitedHealth institutes gold card program to address prior authorization concerns

Humana CFO Susan Diamond told investors on Wednesday that the insurer is likely to lose a "few hundred thousand members" as it adjusts to ongoing pressures in the Medicare Advantage space. On its earnings call Thursday morning, CEO Jim Rechtin said that Humana identified as it built 2025 MA bids...

Humana braces to lose a 'few hundred thousand' members in 2025

Ohio State

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contributor

The Lantern

On Tuesday, licensed Ohio dispensaries began legally selling non-medical marijuana to consumers; however, the drug’s possession, growth and/or usage are still prohibited on Ohio State’s campus. Credit: Jefferee Woo/Tampa Bay Times/TNS [Original caption: Four citizen-led petitions with proposals to update Dallas’ charter hit the 20,000 valid signature threshold to make it on the Nov. 5 election ballot, including one that would ban police officers from arresting or citing people carrying less than four ounces of marijuana.] As of Tuesday, students 21 and older can now legally purchase marijuana in Ohio.

Dispensary sales of recreational marijuana began Tuesday; possession and usage still prohibited on Ohio State’s campus

Under the new prescription drug law and for the first time in history, Medicare has negotiated lower prices for 10 medications that are among the costliest and most used in its prescription drug program (Part D). Every year going forward, the federal program will select additional drugs to negotiate. The...

Medicare Announces First 10 Negotiated Drug Prices

Your article was successfully shared with the contacts you provided. Americans need affordable, quality health care, but many are hard put to find good care at a price they can afford, according to a recent report from the personal finance website WalletHub. The average annual health care outlay for Americans...

12 Worst States for Health Care: 2024

Bucks County Beacon

Conservatives have done the United States a huge favor by explaining in detail what they’ll try to do if Donald Trump is reelected. Project 2025 , a “presidential transition project” of the Heritage Foundation, helpfully lays out how a group of former Trump officials would like to transform the country into a right-wing dystopia where the rich thrive and the rest of us die aspiring to be rich.

Project 2025’s Plan to Gut Medicare and Medicaid

“Private Medicare plans now cover more than half of Medicare beneficiaries, but how well they actually serve people differs from county to county,” Maya Goldman writes over at Axios. “Medicare enrollees living in communities of color and with high rates of poverty had less access to top-rated Medicare Advantage plans last year than those living in wealthier places that are majority white. These disparities could contribute to unequal health outcomes for seniors across the country as Medicare Advantage enrollment grows, particularly among seniors from diverse and low-income backgrounds. The geographic quality differences in Medicare availability drive home the longstanding point that where someone lives in America can determine the caliber of their health care options. ‘Nobody can really easily move to another location to get the health care services they need,’ said Jeannie Fuglesten Biniek, associate director of KFF’s program on Medicare policy. ‘It’s even harder for people who are Medicare beneficiaries.’ … Medicare Advantage plans offered in more disadvantaged counties were less likely to be rated 4.5 stars or higher, according to research published last week in JAMA Network Open.” Maya Goldman, “Medicare Advantage’s geographic disparities,” Axios.

Medicare Advantage worse in some places

Colorado State

David Heitz

A bill quietly introduced this spring in the Colorado legislature to decriminalize the possession of drug paraphernalia obtained by harm reductionists has become law. As low-key as the legislation was introduced, the bill was signed into law without fanfare June 6. It garnered little to no media attention.

Colorado legalizes needles, pipes for meth and crack if obtained by harm reduction group

In the first round of direct price negotiations between Medicare and drug manufacturers, prices for 10 expensive and commonly used drugs saw price cuts between 38 percent to 79 percent compared to their 2023 list prices, the White House and the US Department of Health and Human Services (HHS) announced Thursday. The new negotiated prices will take effect on January 1, 2026.

Medicare drug price negotiations: 10 list prices drop between 38% to 79%

Jacksonville, FL

Jacksonville Today

A historic marker could be erected to honor the victims of the racist mass shooting at the Dollar General store in Jacksonville’s New Town neighborhood nearly a year ago. If approved by the Jacksonville City Council, a marker would be installed at Kings Road and Canal Street on Aug. 25, a day before the first anniversary of the shooting, when a white gunman took the lives of three Black people.

Memorial considered to honor Dollar General victims

Kiplinger

If you're delayed taking Medicare because you have employer coverage, changes ahead may disqualify your plan.

Medicare Upgrades Could Disqualify Your Private Plan

Your article was successfully shared with the contacts you provided. Executives of CVS Health, the company that owns Aetna, are giving early hints about why Medicare plan menus may shoot to the top of financial professionals’ priority lists this fall. Tom Cowhey, the CVS chief financial officer, warned securities...

Aetna May Let Medicare Plan Enrollment Fall 10% in 2025

“If my mother needs to move into a nursing home, what are the eligibility requirements to get Medicaid coverage?” –Caretaking Son. Dear Caretaking, the rules and requirements for Medicaid eligibility for nursing home care are complicated and will vary according to the state your mother lives in. With that said, here’s a general, simplified rundown of what it takes to qualify.

Paying for Nursing Home Care with Medicaid

Medicare Advantage insurers fully or partially denied 7.4% of prior authorization requests in 2022, an increase compared to the previous three years, according to an analysis by health policy research firm KFF. Only 10% of patients appealed the denials in 2022, possibly because beneficiaries didn’t know about the appeals process...

Medicare Advantage prior authorization denials increased in 2022: KFF

Getting seniors enrolled into the right Medicare plan is typically an inefficient process that many older patients find confusing and frustrating, spending hours on the phone with human call center agents. Startup Fair Square Medicare is using advancements with generative AI to build AI-based voice agents to screen seniors for...

Fair Square Medicare rolls out AI voice agents to help enroll seniors into insurance plans

NewsBreak

Amid Medicaid's 'unwinding,' many states work to expand health care access

Trisha Byers left behind one crucial item when she moved to North Carolina last year to be closer to her family after suffering a brain injury:...

Amid Medicaid's 'unwinding,' many states work to expand health care access

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