All posts tagged: Medicare

Medicare to launch weight loss drug option in July with copay  : NPR

Medicare to launch weight loss drug option in July with $50 copay  : NPR

Published by Sam Flores

Weight management medications, including Wegovy, Zepbound and Foundayo, will be available to eligible Medicare beneficiaries with a $50 copay starting in July. Universal Images Group/Getty Images hide caption toggle caption Universal Images Group/Getty Images Starting in July, Medicare beneficiaries may be able to get a GLP-1 prescription for weight loss for $50 a month. It’s a notable shift for Medicare, which has long been barred from covering weight loss treatments. The drugs, such as Wegovy and Zepbound, are effective but can be expensive without insurance coverage. They’re available in injection or pill form. Even with discounts, current cash prices typically range from $149 to $699 per month. About half of GLP-1 users say these drugs were difficult for them to afford, according to KFF polling. A quarter said they were “very difficult” to afford. But the new Medicare benefit comes with caveats, particularly around clinical guidelines and what happens when the short-term program ends. What is this program? The initiative, announced by the Centers for Medicare & Medicaid Services, or CMS, is a short-term pilot …

Immigrant seniors lose Medicare coverage despite paying into it : NPR

Immigrant seniors lose Medicare coverage despite paying into it : NPR

Published by Sam Flores

Rosa María Carranza attends a protest supporting the temporary protected status program outside the Phillip Burton Federal Building and U.S. Courthouse in San Francisco on Nov. 18, 2025. Carranza, a resident of neighboring Oakland, worries she could lose her legal status and risk indefinite detention or deportation. Hiram Alejandro Durán/El Tímpano hide caption toggle caption Hiram Alejandro Durán/El Tímpano OAKLAND, Calif. — Rosa María Carranza leaned forward to hold a 3-year-old’s back as the girl climbed a rock in the forested hills of northeast Oakland. Dressed in hiking gear and beaded necklaces, Carranza, 67, maneuvered between trees and children on a sunny morning in December. “Hold onto that branch,” she said in Spanish. “You can do it, my love!” Carranza, a child development professional who grew up swinging through trees and swimming in rivers in El Salvador, said she feels at home in the forest at the outdoor preschool she co-founded. She has worked with children and teens as a caregiver and educator for more than three decades, long enough to know when to lean …

CBS News Investigation Uncovers Massive Medicare Hospice Fraud In L.A. County

CBS News Investigation Uncovers Massive Medicare Hospice Fraud In L.A. County

Published by Jenni Sidey

Authored by Bryan Hyde via American Greatness, An investigation by CBS News has discovered massive Medicare fraud at more than 700 out of 1,800 licensed hospice providers in Los Angeles County. The scam utilizes stolen Medicare numbers to fraudulently enroll healthy seniors in hospice with fake terminal diagnoses, billing Medicare an average of $29,000 per patient without delivering care, to the tune of hundreds of millions of taxpayer dollars. CALIFORNIA HOSPICE FRAUD: There’s a stretch in Los Angeles with 500 registered hospice companies within just three miles of each other. And 89 in a single building. But when we visited, we found empty offices, piled-up mail, and phone lines dead. Watch CBS News’ exclusive… pic.twitter.com/ydb8v0RqxE — CBS News (@CBSNews) March 10, 2026 About 31 percent of hospice and home health companies in the U.S. are registered in L.A. County but when investigators visited the addresses listed, they found no clinics, patients or healthcare workers. Instead they found multiple red flags, including multiple hospices in one building, high rates of terminally ill patients later discharged alive, excessive billing, …

Seniors Hit With Billions In Extra Premiums From Medicare Overpayments: Report

Seniors Hit With Billions In Extra Premiums From Medicare Overpayments: Report

Published by Jenni Sidey

Private insurers are padding their pockets with billions in alleged overpayments from Medicare Advantage, and hardworking American seniors are footing the bill through higher Part B premiums, according to a congressional report obtained by the Wall Street Journal. The report, issued by the bipartisan Joint Economic Committee, shows that controversial practices, such as adding extra diagnoses to trigger larger government reimbursements, drove up Medicare Part B premiums by $13.4 billion in 2025 alone. That amounts to roughly 10% higher costs, or more than $200 extra annually, for the average senior on a fixed Social Security income. The impact extends beyond enrollees in Medicare Advantage plans. Traditional Medicare beneficiaries are also paying higher premiums to help subsidize the private plans’ gains. Rep. David Schweikert (R-AZ), who chairs the committee, said in a statement to the Journal, “Extra spending on Medicare Advantage is not just coming out of the federal government’s budget, a portion of this comes out of you.” Politicians scream at each other over scraps while Medicare Advantage spits out $84B in overpayments in a …

Medicaid Undone | Adam Gaffney

Medicaid Undone | Adam Gaffney

Published by José Betancourt

One year ago President Donald Trump promised to “love and cherish” Medicaid. Alas, his affection for the public insurance program was short-lived. The so-called One Big Beautiful Bill Act (OBBA) he signed into law on July 4—the most sweeping health care legislation since Barack Obama’s 2010 Affordable Care Act (ACA)—slashes about $1 trillion in federal health care spending, mostly from Medicaid, over the coming decade. The spending reductions fund tax cuts for the wealthy and a surge in spending on immigration enforcement. As an ICU physician at a safety-net hospital system that largely serves publicly insured, low-income communities north of Boston, I may see some of the effects of the law’s cuts firsthand. Around half of our system’s gross patient revenue comes from Medicaid, which covers more than 70 million Americans. What these cuts will mean for hospitals like mine is uncertain: some providers could face severe financial strain or even closure if Medicaid revenues plunge. But for Medicaid enrollees themselves, there is little doubt that the cuts will translate into inadequate care, increased debt, …

BBC GP says Tesco Clubcard data could help detect cancer early

BBC GP says Tesco Clubcard data could help detect cancer early

Published by Sam Flores

Scientists are analysing shopping data to identify early signs of 10 different types of cancer (Image: Getty ) BBC Morning Live’s resident GP, Dr Oscar Duke, has revealed the latest findings from a study designed to potentially help people spot early warning signs of cancer through their purchasing patterns. The medical expert discussed the recent developments during today’s programme (February 11), presented by Neil Jones and Helen Skelton. Dr Oscar explored the research, spearheaded by Imperial College, now in its second phase, to establish whether loyalty card information from retailers such as Boots and Tesco could be used to identify potential “cancer red flags”. Scientists suggest that consumer behaviour recorded in loyalty card data, including that from Boots and Tesco, may help detect cancer earlier. The research involves nearly 3,000 participants to determine whether purchasing patterns can serve as an early warning for 10 different forms of cancer. Previous work by the same team found that an increase in purchasing painkillers and indigestion remedies could suggest early indicators of ovarian cancer. The scientists will now …

Medicare launches pilot program using AI to approve or deny treatment claims

Medicare launches pilot program using AI to approve or deny treatment claims

Published by Daniella Wilson

Sign up to our free Living Well email for advice on living a happier, healthier and longer life Live your life healthier and happier with our free weekly Living Well newsletter Live your life healthier and happier with our free weekly Living Well newsletter Medicare has launched a six-year pilot program that could eventually transform access to health care for some of the millions of people across the U.S. who rely on it for their health insurance coverage. Traditional Medicare is a government-administered insurance plan for people over 65 or with disabilities. About half of the 67 million Americans insured through Medicare have this coverage. The rest have Medicare Advantage plans administered by private companies. The pilot program, dubbed the Wasteful and Inappropriate Service Reduction Model, is an experimental program that began to affect people enrolled in traditional Medicare from six states in January 2026. During this pilot, medical providers must apply for permission, or prior authorization, before giving 14 kinds of health procedures and devices. The program uses artificial intelligence software to identify treatment …

Trump Administration Announces 15 New Drugs for Medicare Price Negotiation Program

Trump Administration Announces 15 New Drugs for Medicare Price Negotiation Program

Published by Sam Flores

The drugs selected include some of the medications on which Medicare spends the most money. That means the deals negotiated this year have the potential to deliver significant savings to taxpayers when they go into effect in 2028. “For too long, seniors and taxpayers have paid the price for skyrocketing prescription drug costs,” Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz said in a statement Tuesday. “Under President Trump’s leadership, CMS is taking strong action to target the most expensive drugs in Medicare, negotiate fair prices, and make sure the system works for patients — not special interests.” The federal government had until Feb. 1 to announce its list of 15 drugs. The negotiations take place under a 2022 law that allows Medicare to haggle over the price it pays on the most popular and expensive prescription drugs used by older Americans. The government already has negotiated prices for 25 prescription drugs covered by Medicare, including the massively popular GLP-1 weight-loss and diabetes drugs Ozempic, Rybelsus and Wegovy. This year’s negotiations mark the …