Author: Elizabeth Blessing
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Medicaid will cover only one month of bills from before an application, starting January 1
Starting with Medicaid applications filed on or after January 1, 2027, the program will stop covering most of the medical bills a person racked up before they got around to applying. For decades, Medicaid could reach back and pay for care going back three months before an application, as long as the person qualified during…
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Nobody verifies the contractors who inspect the nation’s nursing homes
The federal government relies on outside contractors, not just state employees, to inspect a growing share of the nation’s roughly 15,000 nursing homes, and a new federal audit found that nobody is checking whether those contractors actually meet the government’s own standards. The finding matters to any family with a parent in a nursing home,…
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A Virginia health system leaves UnitedHealthcare’s Advantage network on October 1
Valley Health System, the largest hospital network serving the northern Shenandoah Valley out of Winchester, Virginia, is going out of network for UnitedHealthcare Medicare Advantage members on October 1, 2026. The break comes after UnitedHealthcare rejected Valley Health’s proposal to renew their contract, and it lands roughly two weeks before the Medicare Annual Enrollment Period…
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Nursing home payments rise 2.4 percent on October 1
Medicare will pay skilled nursing facilities 2.4 percent more starting October 1, 2026, the first day of the federal government’s 2027 fiscal year, under a final rule the Centers for Medicare & Medicaid Services published this summer. The increase is not a proposal still open for debate — CMS has already finalized it — and…
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Medicare says it has been paying 16 percent more than private insurers for lab work
Medicare has been paying laboratories roughly 16 percent more than private insurers pay for the same clinical tests, according to the agency’s own comparison of its payment data against private-sector rates. The Centers for Medicare & Medicaid Services released that finding on September 21, 2026, alongside preliminary 2027 lab payment rates designed to close most…
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Medicare is ending the program that has held standalone drug plan premiums down
The Centers for Medicare & Medicaid Services has confirmed it will shut down the Part D Premium Stabilization Demonstration at the end of this year, ending a two-year-old arrangement that used extra federal subsidy payments to keep standalone prescription drug plan premiums from spiking after the Inflation Reduction Act redesigned the Part D benefit. The…
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Medicare’s new chronic care tracks open in 2027 and Advantage members cannot use them
The Centers for Medicare & Medicaid Services is adding four new disease-management tracks to a program that already reaches three out of four people on Medicare, with heart failure, chronic obstructive pulmonary disease, substance use disorders and tobacco cessation joining the lineup starting in spring 2027. The expansion arrives with a restriction the agency states…
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Social Security sent about 10,540 people a tax form with the wrong benefit total
Every January, Social Security mails beneficiaries a Form SSA-1099 reporting exactly how much the agency paid them the previous year, the figure used to work out how much of that money, if any, counts as taxable income. “Effective systems and clear guidance are important to ensuring payments are processed correctly,” Michelle L. Anderson, the Social…
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A missed filing date cost one family $10,276 in children’s Social Security benefits
A child had been collecting Supplemental Security Income since 1994 when his father qualified for Social Security retirement benefits in January 2006 — but the father’s application never named the child, and nobody flagged that the boy might also be owed a check on his father’s record. Four months later, in May 2006, the Social…
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Social Security never asked the Treasury to pull back money paid after death in about 5,921 cases
About 5,921 times over an eight-year stretch, the Social Security Administration paid a benefit into a deceased person’s bank account and never sent the paperwork asking the U.S. Treasury to get the money back. That estimate comes from a new evaluation by the agency’s Office of the Inspector General, which checked how consistently SSA uses…