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Medicare & Medicaid
Eligibility, parts A‑D, Advantage, dual eligibility, and state program changes.
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The School Bus Driver Shortage Gave a 62-Year-Old With $260,000 Saved What His Nest Egg Couldn't: Health Insurance Until Medicare
35+ min ago (672+ words) For pre-Medicare retirees, the gap between 62 and 65 can quietly swallow a shocking portion of a nest egg before a single lifestyle expense hits. One overlooked job category is quietly solving that problem for thousands of early retirees. A 62-year-old with…...
Report: Medical Service Costs in California Comp Rising With Payments, Utilization
1+ hour, 50+ min ago (251+ words) Medical service costs in California workers’ compensation rose 5% last year on the back of growth in both average payments and utilization, a new report shows. The Workers’ Compensation Insurance Rating Bureau of California released its Medical Service Cost Trends report,…...
Local retiree advocate warns Villagers to check mail for Medicare plan cancellations
2+ hour, 50+ min ago (20+ words) With Medicare open enrollment fast approaching, a local retiree advocate is warning Villagers to pay close attention to their mail....
Shapiro admin rules for Medicaid recipients spark lawsuit from people with disabilities
3+ hour, 50+ min ago (1656+ words) By Ed Mahon For Spotlight PA A placard outside the Pennsylvania Health & Human Services building in Harrisburg. HARRISBURG — Earlier this year, some Pennsylvanians with disabilities and their families won a major victory. Commonwealth Court struck down two rules that affected…...
Michigan Man Indicted in Alleged $4.75M Medicare Psychotherapy Fraud
6+ hour, 50+ min ago (272+ words) A federal grand jury in the Eastern District of Michigan returned an indictment charging Emory Matthews, 62, of Farmington Hills, Michigan, with conspiring to bill Medicare for psychotherapy services that were never provided to patients of an adult day care center…...
Epsilon Health Raises $27.6 Million to Solve America’s Growing Radiologist Shortage
1+ week, 3+ day ago (735+ words) Epsilon Health (“Epsilon”), the AI-native radiology practice reinventing how radiology is delivered, today emerged from stealth with $27.6 million in funding led by AlleyCorp, with participation from... SAN FRANCISCO--(BUSINESS WIRE)--Sep 10, 2026-- Epsilon Health (âEpsilonâ), the AI-native radiology practice reinventing…...
Medicare Part D Plans Paid $562 Million for Generic Voltaren. A Doctor's Prescription Still Doesn't Make an OTC Drug Part D-Eligible
10+ hour, 18+ min ago (709+ words) A doctor's prescription cleared millions of pharmacy claims through Medicare Part D for a drug the program was never legally allowed to cover, and the bill that follows could land on beneficiaries with no warning and no open enrollment fix…...
Top Trump Official Drops Blockbuster Announcement - 'They're Going to Prison' - Federal Bust Exposes Massive Health Care Fraud
10+ hour, 37+ min ago (495+ words) A sprawling federal investigation has uncovered a nationwide threat that may have placed thousands of improperly trained workers inside hospitals, nursing homes and clinics across the United States. Although the people who allegedly built the operation are now behind bars,…...
Beyond Review Volume: What Healthcare Payers Now Expect From Managed Care and Utilization Management Consulting
18+ hour, 38+ min ago (447+ words) This shift reflects a broader change in how payers view consulting. Where engagements once focused primarily on filling gaps, many organizations now expect a consulting partner to strengthen the underlying operating model so improvements persist after the engagement ends. Why…...
Patients who fight health insurance denials often win
19+ hour, 50+ min ago (1240+ words) Few patients appeal when insurers decline to pay for their care. Many don’t even know they can. But new data show that when they do, they frequently win — in some plans, nine out of 10 times. Insurers disclosed this data on…...