Author: Elizabeth Blessing
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Medicare adds at-home support options for heart failure, COPD, and substance-use care
Beginning April 1, 2027, people with Original Medicare who have heart failure, chronic obstructive pulmonary disease, a substance use disorder or nicotine dependence will be able to sign up for technology-supported care at home through Medicare’s ACCESS Model. The Centers for Medicare & Medicaid Services announced the expansion on September 15, 2026. Participating organizations may…
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Social Security cuts certified earnings statement fee to $79 from $96 on October 1
The Social Security Administration will charge $79 for certified yearly earnings totals on requests it receives on or after October 1, 2026, down from $96 under the schedule it set in 2024. The change appears in a Federal Register notice published September 21, which lowers the base charge for Form SSA-7050 earnings information from $61…
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New Medicare lab rates are projected to save taxpayers $1 billion every year
Medicare plans to cut what it pays laboratories for most blood tests, urinalysis and other diagnostic tests starting in 2027, a change the Centers for Medicare & Medicaid Services projects will save taxpayers about $1 billion a year. CMS released preliminary 2027 rates on September 21, 2026, and said its data show Medicare has been…
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CBO projects Social Security retirement fund exhaustion in fiscal year 2032
The Congressional Budget Office projects that Social Security’s Old-Age and Survivors Insurance Trust Fund, which pays retirement and survivor benefits, will be exhausted in fiscal year 2032. The estimate comes from CBO’s 2026 Long-Term Projections for Social Security, released September 17, 2026, which also finds that the gap between the program’s outlays and revenues generally…
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DOJ’s proposed Pinnacle settlement would bar use of rivals’ private rent data
The Justice Department has filed a proposed consent decree that would bar Pinnacle Property Management Services, one of the largest apartment managers in the United States, from using rent-pricing software fed by competitors’ private data. The September 4, 2026 filing in federal court in North Carolina would also stop Pinnacle from sharing sensitive rent information…
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Social Security office visitors wait six minutes with appointments and 26 without
Visitors who book an appointment at a Social Security field office now wait about six minutes on average before being seen, while those who walk in without one wait about 26 minutes, according to the Social Security Administration’s latest performance data. The figures cover fiscal year 2026 through July, a period in which nearly 25…
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Conflicting CMS guidance cost Medicare $380 million for unused organs
Medicare paid transplant hospitals an estimated $380 million from 2017 through 2022 to acquire organs that were never transplanted into Medicare patients, because long-standing CMS guidance conflicts with a federal law barring the program from subsidizing care for people it does not cover, the HHS Office of Inspector General found. The audit, issued September 1,…
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Medicare Part D auditors found five over-the-counter drugs billed as prescriptions
Medicare Part D drug plans paid pharmacies $587.7 million from 2021 through 2023 for five drugs that should no longer have been covered, because their brand-name versions had already become available over the counter, federal auditors found. The HHS Office of Inspector General, in an audit issued August 31, 2026, traced nearly all of the…
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Humana rejected recommendations to review 212 additional enrollee-years
Humana has rejected all four recommendations in a new federal audit of its HumanaChoice Medicare Advantage contract, including a call to review 212 additional enrollee-years of diagnosis codes that auditors flagged as possible data-entry errors. The HHS Office of Inspector General, which issued the audit of contract H5216 on September 10, 2026, found that medical…
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HHS auditors found 183 of 250 UnitedHealthcare enrollee-years had unsupported diagnoses
Federal auditors found that medical records did not support the diagnosis codes UnitedHealthcare of Wisconsin submitted to Medicare in 183 of 250 sampled enrollee-years, and estimated the insurer was overpaid at least $46.9 million for 2020 and 2021. The HHS Office of Inspector General issued the audit of Medicare Advantage contract H5253 on September 10,…