Starting Jan. 1, 2025, millions of Americans who get their prescription drugs through Medicare could get a major financial break when a $2,000 out-of-pocket spending cap on medications goes into ...

The Centers for Medicare & Medicaid Services (CMS) revealed several updates to the ACO REACH program in 2026, though the ...

The agency said it would increase the number of MA plan audits and complete its backlog of reviews by investing in technology ...

Under the Medicare Drug Price Negotiation Program, the HHS secretary negotiates directly with manufacturers on the prices ...

The order is based on a "most favored nation" pricing model, which is similar to a policy Trump pushed in his first ...

For example, brokers and agents may receive ... In the final rule, CMS projects a $726 cap on new Medicare Advantage enrollments and a $313 cap on renewals for the coming plan year, but the ...

Medicare and Medicaid program integrity audits are a highly cost-effective strategy to reduce federal healthcare program expenditures. For example, prior reports have found that certain hospital ...

The Centers for Medicare & Medicaid Services (CMS ... The following steps show an example of how to use the PFS lookup tool. Go to the PFS lookup tool overview and click the “Begin Search ...

Plus, insights from Marcia Mantell. Medicare beneficiaries will see several key changes in 2026 as the Centers for Medicare & Medicaid Services continues to implement Inflation Reduction Act (IRA ...