Medicare Cancer Drug Costs Not Linked to Clinical Value

TOPLINE: A new analysis suggests that Medicare spending on anticancer drugs is not based on a drug’s clinical value, highlighting “a misalignment between drug pricing and the clinical benefits they offer.” METHODOLOGY: Medicare typically accepts the drug …

EnforceMintz — Medicare Advantage and Part D Programs to Remain in the Enforcement Spotlight in 2025

As government scrutiny and enforcement targeting the Medicare Advantage (Medicare Part C) program continued in 2024, the industry’s response to agency actions escalated. Last year also resulted in the first sizable Part D False Claims Act settlement. Year …

MedPAC recommends tying Medicare physician reimbursement to Medicare Economic Index

Primary care physicians could get a financial boost if Congress were to base Medicare reimbursement on the Medicare Economic Index and add payments to doctors treating low-income beneficiaries. The Medicare Payment Advisory Commission (MedPAC) voted Jan. …

MedPAC recommends to Congress Medicare 2026 payment updates for inpatient, outpatient services

The Medicare Payment Advisory Commission today voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount plus 1% for 2026 and reiterated its recommendation to distribute an …

Navigating Medicare maze? Let Jill Becker be your compass for confident coverage choices

January 15, 2025 — Navigating the Medicare process can feel like a maze for seniors and their loved ones. But there is help available to guide you on through the process. Jill Becker Insurance for Seniors offers personalized services to ensure seniors feel …

Prescription drug cap may save Medicare enrollees thousands: Report

An analysis of the Inflation Reduction Act of 2022 found that a majority of Medicare Part D enrollees will see lower total out-of-pocket costs in 2025.  The law's new $2,000 out-of-pocket spending cap for prescription drugs is expected to save most …

ZoomCare to accept Medicare and Medicare Advantage

MedPAC recommends to Congress Medicare 2026 payment updates for inpatient, outpatient services

The Medicare Payment Advisory Commission today voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount plus 1% for 2026 and reiterated its recommendation to distribute an …

Iowa healthcare workers settle in telemedicine fraud case involving false Medicare claims

DES MOINES, Iowa — Two Iowa healthcare workers have agreed to pay settlements after being accused of submitting false claims to Medicare as part of a telemedicine scheme, federal officials said. Nurse practitioner Cori Lempiainen will pay $150,000 for …

Betrayal In Small-Town Texas: $70M Medicare Scam Conviction

Fredricksburg, Texas is best known for its sleepy lifestyle and picturesque tourist activities while quietly sitting among Texas Hill Country with 1/3 of their population well into retirement age. One doctor who is over 60 himself, will now be spending …