Medicare and Medicaid are losing billions of dollars annually as international criminal networks exploit gaps in digital security and business registration laws. According to a Post investigation, hackers and foreign syndicates use AI voice bots, stolen patient data, and shell companies to bypass federal oversight, with improper payments across the programs estimated at $186 billion … Read more
Patients under the care of general internists who score in the top quartile of the American Board of Internal Medicine’s (ABIM) Longitudinal Knowledge Assessment (LKA®) are nearly 8% less likely to receive low-value healthcare services than those treated by lower-scoring physicians, according to a study published in JAMA Internal Medicine. These findings, based on data … Read more
Medicare prescriptions for the anti-obesity medication Wegovy surged 598% in the six months following a federal policy shift that allowed coverage for heart disease prevention. Despite this increase, new research from the USC Schaeffer Center for Health Policy & Economics reveals that less than 1% of the estimated 3.6 million eligible beneficiaries have accessed the … Read more
Senator Ron Wyden (D-OR) and 14 Democratic co-sponsors are introducing legislation today to establish a $5,000 annual out-of-pocket spending cap for beneficiaries in traditional Medicare. The proposal seeks to address the lack of protection against catastrophic medical costs in the original program, though the bill faces long-term legislative hurdles in the current Congress. Why does … Read more
Kinney Drugs will launch the Medicare GLP-1 Bridge Program next Wednesday, providing eligible Medicare Part D patients access to weight-loss medications like Wegovy, Zepbound, and Fundayo for a $50 monthly copay through 2027. According to Shannon Miller, vice president of healthcare operations at Kinney Drugs, the pilot program aims to bridge the coverage gap for … Read more
The federal government’s pilot program testing artificial intelligence-driven prior authorization in Medicare, known as the Wasteful and Inappropriate Service Reduction Model (WISeR), has triggered significant patient and provider backlash in six states. According to reports from KFF Health News, the program, launched in January 2025, requires preapproval for 13 specific medical services, leading to reports … Read more
Senate Democrats released a policy blueprint on Tuesday aimed at expanding federal government authority to negotiate prescription drug prices. The proposal, spearheaded by Sen. Ron Wyden (D-Ore.), seeks to build on the Inflation Reduction Act by broadening the scope of Medicare price negotiations and introducing stricter penalties for pharmaceutical companies accused of price gouging, according … Read more
Medically tailored meals—nutrient-dense, dietitian-designed food prescribed as clinical therapy—reduce hospitalizations by 31 percent and emergency room visits by 20 percent for Medicaid patients, according to research published in Nature Medicine. These interventions, which generated an average of $3,433 in per-person healthcare savings, are increasingly viewed as a viable strategy to lower the $5 trillion spent … Read more
Nine South African Police Service (SAPS) officers have been suspended following allegations they helped secure a controversial R228 million contract for Medicare24, a company linked to businessman Vusimuzi “Cat” Matlala. Police spokesperson Brigadier Athlenda Mathe confirmed the suspensions on Friday, stating that the officers all served on the bid evaluation committee. Why were the police … Read more
Medicare beneficiaries face significant changes in 2026, including adjustments to Part D out-of-pocket maximums, updates to prescription payment plans, and a reduction in available Medicare Advantage options. Staying informed on these shifts is essential for seniors managing their healthcare budgets and retirement financial planning. What Are the 2026 Changes to Medicare Part D? Medicare Part … Read more