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Results for " medicare " 622 found 🔀 AI-powered Shuffle

The Health Care Crisis and How to Fix It

Democrats have glommed onto proposals such as the impractical Medicare for All and the inadequate public option. There’s a better way.

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Sep 4 • 5:00 AM EDT • Health • washingtonmonthly.com
Democrats eye expanded Medicare coverage if they take U.S. House

Reversing Medicaid cuts and restoring ACA subsidies top the list, but Democrats are also talking about lowering the age of eligibility for Medicare benefits.

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Sep 3 • 4:22 PM EDT • Business • washingtonpost.com
Democrats eye expanded Medicare coverage if they take U.S. House

Reversing Medicaid cuts and restoring ACA subsidies top the list, but Democrats are also talking about lowering the age of eligibility for Medicare benefits.

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Sep 3 • 4:22 PM EDT • Health • washingtonpost.com
Changes to Medicare’s quality payment program may disadvantage radiologists

CMS is moving to new MIPS Value Pathways, or MVPs, which are specialty-specific measures intended to replace traditional ones, experts write in JACR.

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Sep 3 • 2:20 AM EDT • Business • radiologybusiness.com
MyChart Medicare phishing scam raises concern among Philadelphia health systems

Pa. Attorney General David Sunday is urging residents to beware of unsolicited free offers and rewards.

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Sep 2 • 6:30 AM EDT • Health • inquirer.com
New research: For lower costs without worse outcomes, vertically integrate healthy health systems with certain health plans

Hospital-operated Medicare Advantage plans can help streamline post-hospitalization care of discharged inpatients while cutting episode-of-care costs and maintaining good patient outcomes.

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Sep 1 • 7:29 PM EDT • Health • healthexec.com
CHI St. Vincent & CommonSpirit Health opt out of AR Blue Cross Blue Shield networks

CHI St. Vincent has opted out of the healthcare provider networks of Arkansas Blue Cross and Blue Shield and its associated health plans (Arkansas Blue Medicare

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Sep 1 • 10:52 AM EDT • Health • katv.com
WATCH: Trump says 'Medicare for All' doesn't work

The president was asked about Democratic candidates who want to use Medicare to provide universal access to health care — and he said his approach to have confidential drug pricing deals was superior.

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Aug 31 • 5:15 PM EDT • Politics • pbs.org
Home health, hospice deal-making on track to soar in 2027, report predicts

Despite concerns that a federal Medicare moratorium is stifling home health and hospice growth, a new analysis predicts merger and acquisition activity in the home health and hospice sector could be poised for a strong rebound in 2027.

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Aug 31 • 1:03 AM EDT • Health • mcknightshomecare.com
Study: Rural, dual-eligible patients less likely to receive timely home health rehab

Medicare patients who were rural and dually eligible for Medicare and Medicaid were less likely to receive home health rehabilitation services within 48 hours of discharge from the hospital, according to an August study published in the Journal of the American Medical Directors Association.

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Aug 31 • 12:37 AM EDT • Health • mcknightshomecare.com
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Medicare's pilot GLP-1 discount program has a catch. Some sick patients don't qualify

Medicare launched a pilot program that could streamline the process to get GLP-1s, with some seniors paying just $50 a month. But many people with the most serious illnesses won't get that discount.

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Aug 30 • 5:00 AM EDT • Health • npr.org
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Kiggans, CMS Administrator Oz Discuss Healthcare Affordability, Access in Coastal Virginia

VIRGINIA BEACH, VA — Today, Congresswoman Jen Kiggans (VA-02) welcomed Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz...

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Aug 28 • 3:57 PM EDT • Health • kiggans.house.gov
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AHA recommends changes to home health payments, provider enrollment provisions in CY 2027 proposed rule

The AHA provided comments to the Centers for Medicare & Medicaid Services Aug. 28 on its calendar year 2027 home health prospective payment system proposed rule, focusing on two specific concerns.

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Aug 28 • 10:24 AM EDT • Health • aha.org
Florida health system settles Medicare Advantage fraud claims for $542M

In a statement, the U.S. Department of Justice confirmed that Villages Health System self-reported the upcoding and fully cooperated with an investigation. The incidents occurred between 2020 and 2024.

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Aug 28 • 7:53 AM EDT • Health • healthexec.com
Radiologists urge CMS to quash proposal that would slash pay for 2nd services delivered in same visit

Outlined in the 2027 proposed physician fee schedule, Medicare wants to pay 50% of full price in certain scenarios where patients visit an office and receive a second service on the same day.

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Aug 28 • 2:24 AM EDT • Business • radiologybusiness.com
CMS plans launch event for ACCESS, the Medicare chronic care pilot

In this edition of STAT Health Tech: CMS plans a launch event for Medicare chronic care pilot, and what the Meta settlement means for health AI.

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Aug 27 • 1:21 PM EDT • Health • statnews.com
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Monogram Health to pay $2.4M to settle Medicare Advantage upcoding allegations

The Justice Department told Healthcare Dive that Monogram, a home health company, overcharged Medicare through contracts with Cigna and Humana by inflating diagnostic codes.

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Aug 26 • 5:12 AM EDT • Health • healthcaredive.com
DOJ settles lawsuit with Medicare Advantage homecare company for $2M

Tennessee-based Monogram Health was accused of upcoding claims in violation of the False Claims Act. The company does not admit to wrongdoing.

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Aug 26 • 4:38 AM EDT • Health • healthexec.com
‘Medicare for All’ means Medicare for none

Merrill Matthews argues that Sen. Bernie Sanders’ “Medicare for All” proposal deceptively seeks to replace the highly-rated existing Medicare program with a centralized, governmen…

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Aug 25 • 8:00 AM EDT • Health • thehill.com
Health systems warn of coordinated phishing targeting Epic’s patient portal

It isn’t clear how many scammers are involved in the effort, but health systems across the country are warning their patients to ignore fake messages, many of which offer a “reward” in the form of a “MyChart Medicare Kit.”

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Aug 25 • 1:29 AM EDT • Health • healthexec.com
Cityblock to Acquire Homeward Health, Secures $116M Series E

Cityblock Health plans to acquire rural healthcare provider Homeward Health and has raised $116 million to expand its value-based care model to rural and Medicare Advantage populations.

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Aug 23 • 10:11 AM EDT • Health • medcitynews.com
Full interview: Sen. Markey on primary, age in politics and more

Here’s the full @Issue interview with Sen. Ed Markey ahead of his primary election against challenger Rep. Seth Moulton. Markey and Matt Prichard discuss his priorities for another term in office, his response to criticism over aging members of Congress staying in power, Republicans’ criticisms of socialism going back to Social Security and Medicare.

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Aug 23 • 8:30 AM EDT • Politics • nbcboston.com
Readers Write: Women’s sports and trans athletes, health care, Medicare Advantage

So conservatives support women athletes, huh?

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Aug 22 • 2:28 PM EDT • Health • startribune.com
Healthcare startup Devoted Health could be valued at $25 billion

Devoted Health, co-founded by Ed and Todd Park, is raising a round that might value it at $25B, spotlighting the booming Medicare Advantage sector.

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Aug 21 • 3:58 PM EDT • Health • businessinsider.com
Healthcare startup Devoted Health could be valued at $25 billion

Devoted Health, co-founded by Ed and Todd Park, is raising a round that might value it at $25B, spotlighting the booming Medicare Advantage sector.

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Aug 21 • 3:58 PM EDT • Business • businessinsider.com
Why this year’s Medicare-for-all debate is different

Democrats never resolved their health care war, but they may have found a way around it.

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Aug 21 • 6:00 AM EDT • Health • vox.com
Democrats in NH’s 1st District race push competing visions for health care reform

From Medicare for All, to a public option, to an all-of-the-above strategy, health care emerged as a key campaign issue this week.

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Aug 21 • 5:00 AM EDT • Health • nhpr.org
New York’s physician shortage is creating a health care crisis

Congress must act to stabilize Medicare payments to help encourage more physicians to establish practices in high-need communities.

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Aug 19 • 10:45 AM EDT • Health • rochesterbeacon.com
Providence Health Plan to close completely after Medicare Advantage deal falls through

The regional health plan was in talks with an unnamed national insurer to keep its MA plans afloat. But the agreement sputtered “despite significant effort on all sides,” a Providence spokesperson said.

healthcaredive.com logo
Aug 19 • 8:28 AM EDT • Health • healthcaredive.com
Columbia event to focus on Medicare and mental health coverage

The community was invited to a free conversation about Medicare and mental health Tuesday at the Trinity Educational Community Center.

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Aug 18 • 11:32 PM EDT • Health • wistv.com
Costco plots major expansion into senior healthcare with Medicare partnership

In a first-of-its-kind venture, Costco is partnering with SCAN Health Plan on senior-focused insurance products that could include pharmacy, vision and hearing benefits.

foxbusiness.com logo
Aug 18 • 10:01 PM EDT • Health • foxbusiness.com
Latest phishing scam targets Medicare patients, University Health warns
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Aug 18 • 8:59 PM EDT • Health • ksat.com
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Costco strikes first comprehensive Medicare plan partnership with SCAN Health Plan

Costco announced a partnership withSCAN Health Plan to provide medical care to Costco members.SCAN Health Plan and Costco Wholesale Corporation announced an en

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Aug 18 • 7:11 PM EDT • Health • kmph.com
Providence to end Medicare Advantage plans after deal with national insurer fails

Roughly 55,000 Oregonians will need to find new Medicare coverage next year after Providence's proposed sale collapsed.

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Aug 18 • 6:01 PM EDT • Health • oregonlive.com
ASPE Report on WFTCL Impacts on Health Care Costs

The report analyzes state directed payments and provider tax provisions on Medicaid, Medicare, and commercial coverage spending.

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Aug 18 • 3:53 PM EDT • Health • essentialhospitals.org
CMS announces QualTech event focusing on innovative technology to improve health outcomes

The Centers for Medicare & Medicaid Services yesterday announced the launch of QualTech, a new event created to identify innovative technology that improves health outcomes. CMS is seeking participants from U.S-based teams, academic institutions, nonprofit organizations, private sector companies, industry associations and other stakeholders to propose technology solutions in advance of the event.

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Aug 18 • 11:00 AM EDT • Health • aha.org
Medicare Calls it a Bridge Program

And a lot of seniors hope it takes them to better health.

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Aug 18 • 8:00 AM EDT • Health • conehealth.com
UnitedHealth shareholders sue company over ‘corporate governance failures on a historic scale’

The lawsuit was filed by two major institutional investors who blame company leadership for the 2024 breach on Change Healthcare and accuse executives of facilitating alleged Medicare billing fraud.

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Aug 18 • 6:58 AM EDT • Health • healthexec.com
Medicare works to speed up coverage for ‘breakthrough’ radiology devices

The federal payment program for seniors recently released a new fact sheet with details about its Regulatory Alignment for Predictable and Immediate Device, or RAPID, coverage pathway.

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Aug 17 • 5:43 PM EDT • Business • radiologybusiness.com
Sauer: Mass. must get ahead of health care fraud

If policymakers drag their feet, Medicare Advantage’s waste, fraud, and abuse problems could erode public trust, drive up taxpayer costs, and threaten the long-term viability of the program.

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Aug 17 • 3:43 AM EDT • Health • bostonherald.com
Where healthcare could sway voters, Democratic canvassers ramp up an old tactic: talking to people

In Wisconsin, voters weigh candidates who backed cuts to Medicare and Medicaid, and those who want to expand it

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Aug 15 • 6:00 AM EDT • Health • theguardian.com
Medicare approves new technology add-on payment for inpatient radiology AI solution

The federal insurance program for seniors will pay a maximum of $137.53 per case for Aidoc's CARE (Clinical AI Reasoning Engine) Multi-Triage CT Body tool.

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Aug 14 • 5:56 PM EDT • Business • radiologybusiness.com
As It Walks Toward Its Doom, Providence Health Plan Gets More Bad News

In change of plans, the Portland-based health insurance company say it would be closing down its Medicare Advantage line too after negotiations with a national big insurance company failed.

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Aug 13 • 9:27 PM EDT • Health • wweek.com
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Group sues AMA seeking transparency over Medicare billing codes

PatientRightsAdvocate.org says it wants to republish the proprietary billing codes that guide billions of dollars in health care payments.

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Aug 13 • 10:45 AM EDT • Health • washingtonpost.com
An investigation into Commure, and Medicare's new-tech incentives for AI devices

In this edition of STAT Health Tech: a deep dive into General Catalyst-backed Commure, and Medicare's tech incentives for AI devices.

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Aug 13 • 8:29 AM EDT • Health • statnews.com
Cityblock Health Expands in North Carolina to Support Nearly 20,000 Dual-Eligible and Medicare Advantage Members

/PRNewswire/ -- Today, Cityblock Health announced a program to bring comprehensive, accessible care to almost 20,000 Medicare Advantage and dual-eligible...

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Aug 13 • 7:59 AM EDT • Health • prnewswire.com
An Overview of State-Directed Payments and Medicaid Provider Taxes: History and Potential Effects of the Working Families and Tax Cut Legislation on Health Care Costs

Health care provider taxes and state-directed payment policies in the Working Families and Tax Cut legislation are expected to reduce non-Medicaid prices by up to 3.5 percent in markets with provider taxes and reduce spending on Medicaid, commercial and Medicare coverage. Our spending estimates indicate that there will be an additional $29 billion in federal savings on Medicare and commercial coverage for each $100 billion that federal Medicaid spending is reduced.KEY POINTS

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Aug 12 • 8:00 AM EDT • Health • aspe.hhs.gov
Whoop CEO Will Ahmed on Medicare expansion: 'We're excited about where the business is going'

Whoop CEO Will Ahmed discusses the wearable technology company's expansion into CMS Medicare, reaching over 3 million members, and launching natural cycles integration on 'Mornings with Maria' with Maria Bartiromo.

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Aug 12 • 7:20 AM EDT • Business • foxbusiness.com
Congressmen propose expanding Medicare reimbursement for radiologist assistants

Reps. John Joyce, MD, R-Pa., and Mike Thompson, D-Calif., recently reintroduced the latest iteration of the Medicare Access to Radiology Care Act, also known as MARCA.

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Aug 12 • 2:20 AM EDT • Business • radiologybusiness.com
Health insurers are dumping Medicare Advantage plans. Here’s how many seniors could be affected.

Older adults could be scrambling for new health coverage next year, especially in rural markets that have fewer insurance choices.

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Aug 11 • 2:02 PM EDT • Health • marketwatch.com
The U.S. Healthcare System is Already Mostly Socialized

Now that Abdul El-Sayed is the Democratic nominee for Michigan’s open Senate seat, the outcome of this crucial race will depend mainly on two things: Whether Republicans succeed in demonizing El-Sayed because he’s brown and a Muslim, and whether they succeed in demonizing him as a left-wing radical. I will defer for the now the question of whether bigotry will be effective this year, although I will address it another day. What I want to address instead is El-Sayed’s signature issue — healthcare. Yes, El-Sayed advocates Medicare for All, a position the usual suspects denounce as “socialism.” I will get to the politics of his stance soon. Today, however, I want to talk about the substance. We should be clear that El-Sayed doesn’t even call himself a socialist. On the contrary, he explicitly disavows the label, saying “I’m a capitalist who just knows about capitalism”. In fact, as I explained in a previous post, the policies that El-Sayed advocates qualify him as a social democrat, not a socialist. Still, El-Sayed advocates a system under which the government would pay almost all medical expenses. Isn’t that socialism? Well, if that is the criterion then much of U.S. healthcare is already socialist. In fact, the government’s role is so large that U.S. healthcare is better described as partially privatized socialism than as anything resembling a free market. Let’s start with the raw numbers on health insurance, which pays the bulk of Americans’ medical expenses. Americans receive health insurance either from private companies or from public programs, overwhelmingly Medicare and Medicaid. Here’s what the breakdown of coverage and spending between private and public looked like in 2024: While a majority of Americans with health insurance get it from private companies, well over 100 million of us are covered by government programs instead. And these government programs pay more total dollars for medical bills than the private insurers do. Why do government programs that cover a minority of the population account for a majority of health insurers’ outlays? Mainly because Medicare covers seniors, and we’re expensive. Also, while Medicaid covers many younger Americans, disabled and elderly beneficiaries account for most of its spending. Even by the raw numbers, then, U.S. health insurance looks as much public as private. But that understates the government’s role: Private health insurance in the U.S. is both highly regulated and heavily subsidized. This is obviously true for the insurance coverage purchased by tens of millions of Americans through the exchanges established by the Affordable Care Act. But employment-based health insurance, which covers 161 million Americans, is far more of a government creation than most people realize. For employment-based insurance exists largely because of huge implicit government subsidies that come with major strings attached. Here’s how that works. If your employer pays you $10,000, that’s taxable income. But if your employer pays $10,000 toward a company health insurance plan that meets certain criteria, it isn’t taxable. That’s a huge effective subsidy, running at more than $300 billion a year. Take that subsidy into account, along with the more than $100 billion per year spent subsidizing policies purchased under the ACA, as well as the outlays on Medicare and Medicaid, and net effect is that the government pays for more than two-thirds of Americans’ health insurance. Granted, there are strings attached. Roughly speaking, employment-based health plans can’t discriminate based on medical history — that is, they can’t deny coverage to employees with pre-existing conditions — and they also can’t offer the plans only to highly compensated employees — a health plan that is only for the C-suite is considered taxable income. So given the restrictions of the federal tax code, employer-based health insurance is a lot like Obamacare, which also prohibits discrimination based on medical history and provides subsidies to make insurance affordable to lower-paid workers. The fact is that virtually all of private healthcare insurance is already well under some form of government control through regulation and tax subsidies. How should we think about this system? First of all, is Medicare socialist? Don’t tell anyone, but the way Medicare operates — it covers every senior’s medical expenses, whatever they turn out to be, while being funded by taxes that depend on one’s income — could be summarized by the old Marxist slogan “From each according to his ability, to each according to his need.” And back in 1961, when Ronald Reagan was the face of a last-ditch effort by the American Medical Association to block the creation of Medicare, he denounced Medicare as “socialized medicine” and warned that it would destroy our freedom. In reality, American freedom survived until Jan. 20, 2025, while Medicare is immensely popular, with an 82 percent favorable rating in the most recent KFF survey. Medicaid, government health insurance for lower-income Americans, comes in at 73 percent. This is in sharp contrast to public views about private insurers, who are widely disliked if not hated and accused of denying essential care. Furthermore, if Medicare is socialism, then the whole U.S. health insurance system, with the government paying most of the bills and placing conditions on private insurers, is almost equally socialist. If you insist on calling any program the government pays for and regulates socialist, then U.S. healthcare would best be described as a partially privatized form of socialism. And one must ask, what is the point of the part that is privatized? Do private insurers add anything positive? Or are they simply parasites, skimming off money that could have been paying for care? The case for viewing insurers as parasites is strong. Many Medicare benefits are now delivered via Medicare Advantage, that is, plans paid for by the government but run through insurance companies. MedPAC, an independent advisory commission, estimates that last year Medicare Advantage plans were overpaid by $84 billion, thanks to practices such as “upcoding,” in which patients’ health problems are overstated to get larger sums from Medicare. Assessing the waste from employer-based insurance is harder, but most evidence suggests that private insurers have substantially higher administrative costs than Medicare does. Furthermore, the complexity of private insurance, with multiple payers all trying to deny care when they can, is a huge burden both on providers — doctors, nurses, and hospitals — and on patients. What do private insurers offer to compensate for these costs? One must go through intellectual contortions to avoid the conclusion that they are, in fact, parasites. Which brings me back to El-Sayed. In supporting Medicare for All, he’s basically calling for an end to the partial, parasitic privatization of a healthcare system that is already hugely dependent on public funding. When one looks at it that way, it’s not at all a radical proposal. Admittedly, the political lift requires overcoming the opposition to higher taxes to pay for Medicare for All. Political realism rather than economics was the reason I and many other progressives supported Obamacare, with all its complexities, rather than demanding an immediate move to Medicare for All. But the political calculus may very well have shifted since the 2000s, as Americans are fed up with a system of unaffordable premiums, rampant claim denials, and byzantine claim administration. Moreover, funding healthcare insurance through taxation would allow for a much more progressive distribution of the cost. That is, compared to the present system, middle-income households would pay less as high-income households would pay more. And the U.S. would stop wasting large sums on pointless administrative costs. So let’s be clear: El-Sayed’s healthcare platform is perfectly reasonable on the merits of cost, fairness and health efficacy. And with private insurers never more hated, while millions of Americans are losing their health insurance, 2026 may be its time. MUSICAL CODA

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Aug 11 • 6:33 AM EDT • Health • paulkrugman.substack.com
Dr. Ramon Tallaj reflects on the family doctor, faith, and health equity

Dr. Ramon Tallaj is chairman of the board and founder of SOMOS Community Care. “SOMOS,” which means “we are” in Spanish, is a physician-led network of 2,600 healthcare providers serving over 850,000 Medicaid and Medicare beneficiaries in New York City’s immigrant communities. Tallaj reflects on the impact of the COVID-19 pandemic, the importance of the family doctor, and how faith has played a large role in his life and work.

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Aug 10 • 8:00 PM EDT • Health • oikoumene.org
Health Brief: Is Minnesota ready for Medicare-for-all?

Plus: Trump’s new effort to upend childhood vaccines

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Aug 10 • 5:52 PM EDT • Health • washingtonpost.com
Members of Congress seek to stabilize radiologist pay in Medicare program

A broad coalition of doc groups has endorsed the measure, including the AMA, American College of Radiology and the American Society for Radiation Oncology.

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Aug 10 • 7:22 AM EDT • Business • radiologybusiness.com
MetroPlusHealth Achieves 4-Star Medicare Advantage Rating

MetroPlusHealth, New York City’s high quality, affordable health plan, announced today that its Medicare Advantage plans have been awarded a 4-Star rating

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Aug 7 • 10:49 AM EDT • Health • nychealthandhospitals.org
Dr. Abdul El-Sayed on Historic Michigan Win: “People Are Sick and Tired of This Politics of Hatred”

We speak with Dr. Abdul El-Sayed after his victory in Michigan’s primary race for U.S. Senate sent shockwaves through the Democratic Party. El-Sayed, a former public health official, ran a progressive campaign focused on affordability, Medicare for All, getting money out of politics, and opposing Israel’s genocide in Gaza. He defeated Congressmember Haley Stevens, who was backed by tens of millions in outside spending including by AIPAC, the powerful pro-Israel lobby group. “In an era where many of us can’t afford basic things like groceries or rent or healthcare, the idea that your government is sending your tax dollars to buy bombs and tanks for foreign governments seems anathema,” El-Sayed says. “That money could be spent to fix your potholes, rebuild your kid’s school.” El-Sayed says his focus now is on beating Republican nominee Mike Rogers, whom he calls a “bootlicker for Trumpism,” and to present a positive vision for his party that can lead into the next Democratic presidential administration.

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Aug 7 • 8:00 AM EDT • Politics • democracynow.org
Rural Health Transformation Program Reporting

August 5, 2026 Mehmet Oz, AdministratorCenters for Medicare & Medicaid ServicesDepartment of Health and Human ServicesAttention: CMS-10949P.O. Box 8010Baltimore, MD 21244-8010 RE: Rural Health Transformation Program Reporting Dear Administrator Oz: The Bipartisan Policy Center appreciates the opportunity to comment on CMS’s proposed Rural Health Transformation Program (RHTP) reporting requirements (file code CMS-10949). The work the … Continued

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Aug 6 • 9:39 AM EDT • Health • bipartisanpolicy.org
Medicare pushes ACCESS but doesn't tell patients what providers offer it

In this edition: Progress report on ACCESS, Medicare's chronic care pilot, and health regulators courting industry on AI regulation.

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Aug 6 • 8:54 AM EDT • Health • statnews.com
Medicare cuts to impact 1.3M N.Y. seniors

New York Gov. Kathy Hochul is slamming the Trump administration’s new Medicare cuts.

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Aug 5 • 7:47 PM EDT • Politics • spectrumlocalnews.com
Advocates celebrate as California's first cardiac ablation is performed in ASC

Medicare is looking to reduce healthcare costs, and EPs believe outpatient procedures are more convenient for patients.

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Aug 5 • 5:07 PM EDT • Business • cardiovascularbusiness.com
AHA urges CMS to prioritize hospitals, providers with Rural Health Transformation Program funding

The AHA Aug. 5 provided comments to the Centers for Medicare & Medicaid Services on the distribution of funding for the Rural Health Transformation Program. The program will fund $50 billion to rural providers from fiscal year 2026 to FY 2030.

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Aug 5 • 11:17 AM EDT • Health • aha.org
Progressive Abdul El-Sayed wins Michigan's Democratic primary for Senate

El-Sayed, an epidemiologist, backs Medicare for all and decries corporate money in politics. He beat Rep. Haley Stevens, whose supporters said she would have had a better chance in the fall.

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Aug 5 • 9:54 AM EDT • Politics • npr.org
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Complete Health to pay $14M to settle Medicare Advantage fraud allegations

The value-based primary care provider submitted false diagnosis codes to the CMS for three years, inflating its reimbursement by millions of dollars, according to the DOJ.

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Aug 5 • 6:34 AM EDT • Health • healthcaredive.com
Senate Democrats Release Memo On Reforms To Make Health Insurance More Affordable

The debate between Medicare for All and Medicare by Choice advocates, both of whom seek better affordability, is shaping up to be an interesting one in the coming years.

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Aug 4 • 4:10 PM EDT • Health • forbes.com
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Senators Markey, Merkley Reintroduce Legislation to Protect Healthcare for Americans Who Cannot Afford Bail

Bill Text (PDF) Washington, D.C. – Senator Edward J. Markey (D-Mass.), a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and Senator Jeff Merkley (D-Ore.) today reintroduced the Equity in Pretrial Health Coverage Act, legislation that would protect the continuity of federal health benefits under Medicaid, Medicare, Children’s Health Insurance Program (CHIP), and Veterans Affairs for Americans who […]

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Aug 4 • 2:35 PM EDT • Health • merkley.senate.gov
If Not AOC, Then Who?

What do we do if Alexandria Ocasio-Cortez decides not to run for president in 2028? It makes sense that many leftists are currently focused on calling on her to take the plunge. But the absence of a Plan B, or even much discussion about one, is worrisome. The US Left can’t afford to sit out the 2028 Democratic primary. Doing so in 2024 was a disaster: our abstention self-marginalized anti-billionaire politics from the national conversation and thereby gave space for Harris to pivot to the “center” (i.e. the policy preferences of corporate donors, establishment hacks, and AIPAC). Abstaining again in 2028 would be especially counterproductive since democratic socialists now have so much wind in our sails after our big electoral wins in NYC and across the country. It’s time to deepen our momentum, organization, and profile — not to retreat to the margins during America’s single most important political battle. Even more urgently, keeping Trump’s heir out of the White House may depend on whether leftists and the party’s unprecedentedly disenchanted base can force the Democrats in 2028 to take meaningful steps towards a very angry electorate and away from the corporate-consultant blob that has helped get us into this mess. If AOC (or Abdul El-Sayed) decides to run, we should enthusiastically go all in — DSA, fighting unions, progressive organizations, anybody who wants to see a better country and world. But, as far as I can tell from the outside, there’s a real chance that she doesn’t run. And we can’t just wait and see where she lands before discussing alternatives, since AOC’s decision might not come for quite a while, giving us little time to scramble at the last minute for an alternative. So we should start working now on getting a Plan B into motion, and recruiting a good candidate for the role. Here’s one idea. A Worker Candidate — Healthcare Not Warfare 2028 Run a union worker Leftists don’t need to always run experienced, well-known socialist politicians for high-profile contests. Lula, the current president of Brazil, began his political career as a metalworker militant who ran for governor of São Paulo in 1982. Especially in an era of institutional distrust, it’s possible to lean hard into making a virtue out of a working-class comrade’s distance from traditional politics. Experience abroad shows this clearly. Rachel Kéké — an immigrant hotel housekeeper — ran as the candidate of the leftist La France Insoumise for the National Assembly in 2022, defeating a former minister in the Macron government. The Belgian Workers’ Party in 2024 won its first Flemish seat in the European Parliament by running Rudi Kennes, a three-decade veteran of the Opel Antwerp auto factory. And the South Korean left in 2024 elected auto factory militant Yoon Jong-oh to the National Assembly. If a tiny French Trotskyist organization could make such a big splash in 2002 and 2007 by running a well-spoken postal worker cadre for office — the LCR’s Olivier Besancenot received about 1.5 million first-round votes — it’s not far-fetched to expect that a much larger organization like DSA, together with a broader coalition of the willing, could run this playbook to much greater effect. This is especially the case now that almost everything DSA does immediately becomes a national news story. We don’t need someone famous. We just need a charismatic, well-vetted comrade who works in a relatable working-class occupation — e.g. a nurse, or a worker in auto or construction, or at Amazon. Ideally, they have a compelling personal story or have been part of a significant strike or organizing campaign, but even those criteria don’t necessarily have to be deal-breakers. The main lesson of the Graham Platner fiasco isn’t that we should never run outsiders for office (the momentum he generated proves the exact opposite), but that they need proper vetting and roots in democratic membership organizations like DSA or a union. In any case, there are plenty of ways to signal working-class authenticity without resorting to Platner’s or Fetterman’s performative macho white dude affect. Better to have someone of any gender or race who is actually working class, with firm socialist politics, who can speak from experience about the day-to-day realities of trying to make it in America. There are surely at least a dozen such worker leaders in our movement nationwide; we just need to sit down and convince one that their personal sacrifice for the greater good (i.e. running for president) will be worth it. If we don’t have a frontrunner with a clear path to victory like AOC (or El-Sayed, were he to win Michigan), it’s better to embrace someone whose decision to run in itself tells an important story about US politics: workers have been iced out of our political system and are now fighting hard to break back in. The novelty factor, in itself, would generate press. And it would help democratic socialists signal to the American public that our movement’s defining characteristic is that we represent workers vs. bosses, not that we’re “the furthest left” force in American politics — a framework that suggests we’re extremists and that helps our opponents isolate us from non-college-educated voters by highlighting extremely minoritarian (and misguided) stances included in DSA’s platform like prison abolition. We don’t get many opportunities to speak to tens of millions of Americans; we need to use these opportunities to broaden our appeal beyond those already in our orbit. Run to polarize the 2028 primary and general election around “Medicare for All” and “End All Aid to Israel” Why should democratic socialists use our scarce time and volunteer energy to run in a race we’re unlikely to win? Running in the 2028 primary will not only recruit us scores of members (imagine having a DSA member intervening in eleven nationally televised primary debates!), but — more importantly — it has the potential to be a decisive leap forward towards an America that finally starts meeting the needs of working people instead of HMO and AIPAC billionaire donors. Polarizing litmus tests are good, actually — as long as they’re fought for around popular demands in a thoughtful and strategic way. Democratic socialists have an opportunity and responsibility to make the 2028 primary about two of the most widely and deeply felt issues of our moment: domestically, America’s unaffordable, family-breaking private healthcare system; internationally, America’s bankrolling of the genocidal Israeli government. A candidacy relentlessly demanding Medicare for All and No Aid to Israel would pose a sharp question to the American public, the Democratic Party, and other 2028 contenders: Why can’t working-class Americans afford their healthcare bills at the same time that our government is spending at least $3.8 billion yearly to fund an Israeli regime eager to keep dragging us and the world into more forever wars? Our candidate can agitate around a clear message: I’m running to give voice to all those working-class Americans who are struggling to get by. No matter what state you live in, who you voted for in 2024, or your background, it’s just plain common sense that we should make healthcare more affordable instead of spending billions to enable the Israeli government’s crimes against humanity. Every American who agrees with me when I say ‘Medicare for All — Not a Dime for Israel’ should make their voice heard through our campaign. Racking up a high number of votes for this agenda is a crucial way to show the Democratic Party and the country as a whole that we can’t keep supporting a life-destroying status quo in our healthcare system and in the Middle East. If we want to defeat Trump’s handpicked crony this coming November, we need to speak to ordinary people’s frustrations with the status quo — we can’t keep running the same tired establishment playbook and expecting a different result. For those highly engaged voters (or skeptical media pundits) who raise concerns about wasting votes, the candidate can take the time to explain why this isn’t the case: It's true I'm a long shot. But Zohran showed anything can happen — and voting for me is a pragmatic decision, not a wasted vote. In a heavily divided primary with a large number of candidates and a very discredited establishment, my campaign and the democratic socialist movement I’m part of are positioned to be the balance of power if we can get a large enough number of voters to loudly demand Healthcare Not Warfare. Since there’s a high chance no candidate will get to 50% in the 2028 primaries, the Democrats could very well be heading towards a brokered convention, where a disciplined, principled current committed to breaking from corporate donors can play an outsized role in making sure whoever ends up with the nomination raises the banner of single-payer healthcare and cutting aid to Israel. How exactly could running this sort of primary campaign be translated into actual leverage? The candidate replies: I’m aiming to win the nomination, but if I don’t achieve that goal, my delegates and I will pledge our support in the primary only for a candidate who agrees in the general election to call for ending US aid to Israel and establishing Medicare for All at home. These are both winning planks for November against the Republicans, and the only reason I can see that other candidates haven’t yet raised these is that they’re still more scared of the donor class than they are of the people. That needs to change. If Democratic leaders want young people, workers, and those sick of the status quo to show up in big numbers this November, they need to meet us halfway. In this way, whether or not we win the nomination, democratic socialists could still play a decisive role in 2028. The approach outlined here is similar to what radical left parties periodically do in parliamentary democracies like Denmark or Sweden when they find themselves as a junior partner electorally: they dictate to center-left allies what their terms would be for enabling, from the outside, the formation of a new government. Running a Healthcare Not Warfare candidate will make it significantly more likely that the 2028 Democratic candidate stands with ordinary people instead of donors on these two pivotal planks — a shift that will, in turn, make it easier to achieve the existentially important task of defeating MAGA’s heir in November. Look at how much popular traction the Uncommitted movement got with a similar strategy in 2024 with so little on-the-ground organization — surely we can go much further with a working-class candidate, a much bigger DSA, and a Democratic Party base that has turned against Israel, billionaires, and the hacks in the party who prop them up. Objections and Responses There are quite a few objections to this proposal, many of which are very reasonable. Let me briefly address each here. Socialists shouldn’t waste their scarce time and resources on a candidate unlikely to win. This is a good rule in general, but there are important exceptions, and presidential elections are the main one. There’s no other political contest that gets anything like this level of attention and engagement in the US, so if you want to be a serious force in nationwide politics, you basically can’t afford not to have a candidate. Far from being an overall drain on our resources, running a dynamic 2028 campaign would likely result in a major net increase in members and capacity. In that spirit, the very pragmatic Milwaukee sewer socialists — who mostly ran to win at home in Wisconsin — supported Eugene Debs’s propagandistic presidential campaigns, which they correctly saw as a crucial means of recruiting to the Socialist Party. And now that the (post-1972) Democratic Party gives more weight to voters than party operatives in determining its presidential nomination, it’s become feasible to run as a socialist in primaries without risking a split in the vote against the Republicans in November. We should just support Ro Khanna, who also supports M4A and ending aid to Israel. I like Ro Khanna and would enthusiastically vote and canvass for him for president were he to get the nomination. But there’s a real chance that Khanna’s bid for office doesn’t catch on; he lacks the grassroots organizational apparatus of DSA, and, because he’s not really of the Left or labor (despite his current very good positions), he’s unlikely to generate the type of buy-in and enthusiasm that a DSA candidate would. Moreover, Khanna would be running as an individual, not as someone emerging from and building an organized movement — his campaign would not likely focus on building sustained power from below, nor would it likely polarize the 2028 primary around M4A and Israel aid. Also, and not inconsequentially, the poor electoral results for Tom Steyer and Saikat Chakrabarti this spring suggest that there’s perhaps not much of a popular appetite in the Democrats’ base to support multi-millionaire class traitors. Much better, then, to run a democratic socialist worker. If by Super Tuesday it’s clear that our campaign has captured the main left lane in the primary, Khanna should drop out and endorse us; conversely, if he’s managed to capture this lane, DSA could at that point transform its Healthcare Not Warfare campaign into an independent campaign to elect Ro Khanna focused on winning (and holding him accountable to) those two critical planks. An openness to consolidating an anti-corporate candidate by Super Tuesday is a necessary component of the strategy I’m proposing, because otherwise we risk splitting the primary votes (per DNC rules, you need at least 15% to get any delegates to convention). We should convince Shawn Fain or Sara Nelson to run for president instead. I agree it’d be great if either ran for president, but my impression is that there’s basically no chance that will happen in 2028, because both are firmly focused on their union leadership duties (and, in the case of Fain, beating back a federal witch-hunt). This plan could have DSA end up endorsing a non-socialist, non-DSAer for president. That’s against our principles. It’s a myth, and bad politics, that socialists can’t ever support candidates who aren’t members of their organization and/or who don’t call themselves socialists. Bernie, after all, was not a DSAer. And socialists abroad regularly make tactical decisions about if and when supporting a non-socialist candidate makes sense from the standpoint of promoting working-class interests, defending democracy, and building a socialist current in the process. If your “principles” prevent you and DSA from helping achieve the momentous stride forward of having a Democratic candidate in 2028 run on Medicare for All and ending aid to Israel, those “principles” are not very good. In fact, they actively undermine the causes they’re aiming to support. We shouldn’t confuse principles (working-class independence) with tactics (the best way to advance this in a given context). In my recent article in Catalyst on Milwaukee sewer socialism (I’ve uploaded the full text here), I have a section showing how similarly rigid rules about endorsements had to be eventually discarded in the old Socialist Party nationwide after WWI because they tended to lead socialists towards a sectarian abstention from broader anti-corporate electoral insurgencies beyond their party’s control. For what it’s worth, Lenin’s current under Tsarism frequently backed bourgeois candidates in the second round of elections and Lenin himself advocated that British Communists support Labour Party candidates; for his part, Kautsky in 1912 defended the German Social Democracy’s electoral pact with the Progressives in the runoffs. If our predecessors could be that tactically flexible in an era before the limits of their underlying strategic assumptions about intransigent class politics in capitalist democracies were made clear, then there’s no need to insist on being more tactically rigid today, after a century’s worth of accumulated experience. As long as you maintain your own political profile and organization while engaging in broader coalitional efforts, there’s zero inherent contradiction with the principle of political independence. More specifically: DSA and allied organizations should enthusiastically back Michigan’s Abdul El-Sayed if AOC declines to run and he throws his hat in the presidential ring. (I have no idea whether he’s even considering this path, but there’ll surely be chatter about it if he wins his Senate race this November.) Though he doesn’t call himself a socialist, El-Sayed is a principled Berniecrat, a consistent fighter for Palestine, and would have a clear path to victory. Using the “s” word is far less important than whether a campaign fights for the interests of working people at home and abroad — and whether actively participating in it can grow the organized working class and the Left. And the same holds true if a less anti-corporate candidate were, under pressure, to adopt our two Healthcare Not Warfare planks. Why focus only on M4A and ending US aid to Israel? There are so many other important issues to fight for! Obviously there are many pivotal issues beyond healthcare and Israel, and our candidate — and especially our organizations involved in the campaign — should be prepared to speak on all of these. But one of the crucial lessons of the Zohran campaign is that you have to relentlessly stay on message if you want to cut through the noise. CNN and Fox News will want to talk about DSA’s views on Venezuela and abolishing the police; we need to polarize the debate on the widely and deeply felt issues that are most favorable for growing the Left, isolating our opponents, and winning urgently needed changes. One recent poll found 63% of Americans support M4A, even after respondents were told it would raise taxes and eliminate most private insurance. Another found that 74% of Democrats opposed “providing additional economic and military support to Israel.” And focusing on two demands sets the campaign up to be able to leverage its mandate to make clear demands upon other candidates (which we can’t do if we run with a laundry list of demands). Talking about a Plan B is a distraction from the more urgent work of building a groundswell of calls on AOC to run. It’s good for DSAers, fightback unionists, and progressive organizations to try to convince AOC to run. This proposal is meant as an addendum to pushes to get AOC to run and to line DSA up for that eventuality, not as a substitute for those efforts. But I’m worried that, like in 2024, we might eventually find ourselves with no time to find a viable alternative unless we start now. DSA, with its abundant deliberative processes, moves slowly. The approach you’re suggesting seems risky. If a DSA candidate runs but doesn’t receive a lot of votes, it’ll undercut our current national momentum. This is a reasonable worry. All big initiatives always carry risks, and the path I’m advocating is certainly not free of these. That said, if a Healthcare Not Warfare campaign doesn’t catch on like we envisioned, it’s a pretty simple pivot in March 2028 to explain that in the future we really need our standard-bearers like AOC, or our growing bench of national electeds, to step up in presidential primaries. Moreover, it’s worth noting that the risk of my Plan B proposal is on the whole significantly less than the risk entailed by an AOC run. We should all back her if she runs, since she’d fire up the base, provide huge openings for organizing, have a real shot at defeating a Republican (especially given MAGA’s unpopularity), be a great standard-bearer for our issues, particularly M4A and ending aid to Israel, and be less willing than mainstream candidates to capitulate to any anti-democratic machinations from Trump and co. But it’s also true that AOC could lose, which would be a devastating setback to the country and the Left. Or she could win and find herself unable to pass much, if any, of her (and our) program, a demoralizing prospect. So if we’re willing to take these risks with AOC (and we should), it follows that we should be able to take lower-level risks if she doesn’t throw her hat in the ring. What’s Your Plan B? The US Left is facing its biggest opening for growth and influence since the 1930s. Initiatives that would have been impossible a few months ago are now potentially feasible. A President AOC is now easier to imagine, but if she ultimately assesses that the risks aren’t worth the potential reward in 2028, we can’t be left flat-footed. So even if you’re not convinced by the specifics of my Plan B, I hope you can at least agree that it’d be a disaster for us not to have one — and not to start getting a Plan B into motion. Hopefully other organizers and political currents will put forward their responses and alternative ideas ASAP. The stakes are too high to just wait and see. More As always, please share this article widely. This newsletter depends on all you lovely people to get the word out. Thank you! I uploaded the full text of my Catalyst article on Milwaukee sewer socialism here (it’s updated and 3x as long as the version published earlier on this substack). If you haven’t yet, please make sure to subscribe to Catalyst here; I read every issue front to back, highly recommend. 🌹🎵 Ivan Lins (arranged by Arthur Verocai) — “General da Banda” 🌹🎵

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Aug 3 • 12:50 PM EDT • Politics • laborpolitics.com
Jacksonville-based Complete Health to pay $14M in Medicare Advantage settlement

Complete Health Partners Holdings has agreed to pay $14.1 million to settle allegations that it caused false diagnosis codes to be submitted to boost payments from the Medicare Advantage program, the Department of Justice said.

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Aug 3 • 12:17 PM EDT • Health • news4jax.com
Debt Digest | Federal Debt is a Health Care Problem

Welcome David Ditch to the Debt Dispatch! We are pleased to announce a new regular contributor: David Ditch will be joining the Cato Institute as a Policy Analyst for Budget and Entitlement Policy later this week. David has more than a decade of experience in fiscal policy issues, with a particular focus on federal spending. He previously worked at the Senate Budget Committee, the Heritage Foundation, and the Economic Policy Innovation Center. David’s areas of expertise include appropriations, transportation, agriculture, federalism, grantmaking, and policy options for deficit reduction. Originally from the Rochester, N.Y. area, David has a BA in Economics and Political Science from the University of Rochester and a MA in Political Management from George Washington University. David currently lives in Arlington, VA. You may have enjoyed his earlier guest posts: CBO: New Highway Bill Has More Spending, Taxes, and Deficits Trump Administration’s Proposed Changes to Federal Grants Highlight Problems of Big Government Here are this week’s reading links and fiscal facts: The federal debt is largely a health care problem. In a new report, the Congressional Budget Office and Joint Committee on Taxation find that “In 2026, federal subsidies for health insurance, net of related payments to the government, are projected to equal $2.4 trillion, or 7.4 percent of gross domestic product (GDP). In CBO and JCT’s projections, those subsidies grow by 65 percent, reaching $3.9 trillion, or 8.4 percent of GDP, in 2036. Subsidies for Medicare contribute most to that overall growth, increasing by $900 billion. Over the entire 2026–2036 period, federal subsidies for health insurance total $33.6 trillion.” Cato’s Michael Cannon emphasizes, “The long-term federal debt problem is a health care problem. […] Only two categories of federal outlays will grow faster than gross domestic product (GDP): health care subsidies and interest payments on the debt. The former is, therefore, the primary driver of the latter.” The bond market fears deficits, not the loss of tariff revenue. Responding to a New York Times essay claiming tariff revenue has grown too important for a future administration to unwind, Cato’s Kyle Handley argues: “Bond investors are not attached to customs duties as a line item revenue source. They care about the government’s overall fiscal position.” He continues, “tariff revenue is a side hustle. And the Trump administration has already promised to dole out the funds through schemes like tariff dividend rebates, farm subsidies, and pay-fors on tax cuts or other spending.” Furthermore, “tariff revenue is simply not large enough to transform the government’s fiscal trajectory.” Take net interest for example: it “reached $970 billion in fiscal year 2025, absorbing 18.5 percent of federal receipts. Customs duties accounted for only 3.7 percent of receipts—and that was before refunds (see Figure 2).” Handley concludes, “The real bond-market concern is a large and growing interest bill, persistent budget deficits, and a political system unwilling to bring spending and revenue into alignment.” Medicare’s spending growth is driven by more volume and utilization. A Congressional Research Service report finds that Medicare spending “grew at an average annual rate of 7.3%” from 1985 through 2025, and the trustees project health care expenditures will keep rising “faster than gross domestic product (GDP) in most future years.” Citing CBO, the report attributes Medicare’s projected 2026–2036 spending growth to “23% from higher enrollment, 31% from inflation, and 47% from the growth of inflation-adjusted spending per beneficiary. In other words**, the largest single driver of Medicare spending growth during the next decade is expected to be higher volume and intensity of health care services.”** Boccia and Thakur explain: “as the economy grows, Medicare spending tends to grow at least as fast—and often faster—because the program automatically pays the bill for more and more healthcare consumption by seniors, even as prices rise.” The Fed has little control over market interest rates. Cato’s Jai Kedia documents that the Fed has held its rate target steady since December, yet “nearly every rate Americans actually borrow at has climbed over the same stretch.” Kedia continues, “The Fed did nothing, and the cost of credit went up anyway. […] Markets spent these months repricing macroeconomic events such as sticky core inflation, a volatile energy market driven by the conflict in the Middle East, and global trade disrupted by tariffs, among others. None of that required a policy change to show up in borrowing costs because markets, not the FOMC, set prices.” He concludes, “Accurately priced borrowing rates will come from credible disinflation and disciplined budgets and from a Fed content to follow the economy rather than pretend it leads it.” Nearly half of US farm income comes from taxpayers. Former Reagan OMB director David Stockman notes that “in the most recently completed full year (FY 2025) farmer incomes in the US totaled $97.8 billion, but fully 42.7% or $41.8 billion of that amount came from taxpayers, not the marketplace. Nor is this some kind of one-year aberration. If we look at the most recent decade as a whole, total farm income posted at nearly $708 billion, but, as indicated, fully $322 billion or 45% of this came compliments of US taxpayers.” Cato’s Chris Edwards explains why so little of that income is market-earned: “Farmers are businesspeople, but the government shields them from just about every type of weather and market risk. Furthermore, just about every part of the agricultural industry is subsidized, including insurance, loans, marketing, research, export sales, and land improvements.” The Debt Dispatch is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe

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Aug 3 • 8:33 AM EDT • Health • debtdispatch.substack.com
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Sentara announces possible contract terminations with Anthem health insurance

That potential termination, which includes Medicare and Medicaid contracts, could affect close to 380,000 Anthem members in Virginia around the start of next year.

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Aug 2 • 11:41 AM EDT • Health • pilotonline.com
N.C. health experts warn about Medicare Part D changes

Medicare literacy experts encourage participants to seek help or educate themselves on the changes that will be implemented in 2027.

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Jul 31 • 6:34 PM EDT • Health • spectrumlocalnews.com
CMS Administrator Oz Joins Governors and NGA to Advance Rural Health Transformation and Address Medicaid Program Integrity

OKLAHOMA CITY – The National Governors Association (NGA) today welcomed Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz for discussion to advance the Rural Health Transformation Program (RHTP) and address Medicaid program integrity in states across the country. Tennessee Gov. Bill Lee facilitated the wide-ranging conversation during NGA’s annual Summer Meeting in Oklahoma City. “With […]

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Jul 31 • 6:02 PM EDT • Health • nga.org
ACC releases calculator for payments based on 2027 Medicare physician fee schedule

ACC created a Medicare payment calculator for practices to see the possible impacts on their 2027 payments.

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Jul 31 • 4:32 PM EDT • Business • cardiovascularbusiness.com
DOJ issues declination of charges against eye care group, opting to indict CEO for role in $3.4M fraud scheme

The shift in prosecutorial focus is part of a new enforcement policy to address healthcare fraud. The U.S. Department of Justice alleges the CEO of CampusEye paid kickbacks to doctors for referrals, going on to bill Medicare for unnecessary tests.

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Jul 31 • 4:16 PM EDT • Health • healthexec.com
Nearly two-thirds of Wisconsin hospitals receive top federal quality ratings

Of the 86 Wisconsin hospitals rated by the Centers for Medicare and Medicaid Services, 64 percent received a four- or five-star rating for overall hospital quality.

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Jul 31 • 6:00 AM EDT • Health • wpr.org
CMS announces end to Medicare Part D prescription drug subsidies

With the change, premiums are expected to rise. However, the Centers for Medicare & Medicaid Services confirmed they cannot inflate by more than 6%, as capped by the Inflation Reduction Act.

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Jul 31 • 5:13 AM EDT • Health • healthexec.com
Judge rejects lawsuit from 26 states challenging Medicaid work requirements

A U.S. District Court judge ruled that the states were unable to show they would be irreparably harmed by complying with the policy, as the Centers for Medicare & Medicaid Services is covering 90% of the associated costs.

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Jul 31 • 5:03 AM EDT • Health • healthexec.com
Local advocates mark Medicare, Medicaid anniversary, push for affordable health care

13WHAM ABC Rochester provides local news, weather forecasts, traffic updates, health reports, notices of events and items of interest in the community, local sports and entertainment programming for Rochester and nearby towns and communities including Greece, Victor, Pittsford, Penfield, Henrietta, Webster, Irondequoit, Fairport, Chili, Gates, Rush, Wheatland, Canandaigua, Farmington, Spencerport and Hilton.

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Jul 30 • 8:54 PM EDT • Health • 13wham.com
Alignment Healthcare Turns Profit As Insurer Gets Handle On Costs

Alignment Healthcare’s second quarter net income more than doubled to $36.6 million compared to the year ago period as costs in its Medicare Advantage plans eased.

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Jul 30 • 4:01 PM EDT • Health • forbes.com
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Dunlap, LePage spar over healthcare options

LePage senior advisor Brent Littlefield said during LePage’s time as governor, he paid off “massive hospital debt” to keep Maine hospitals afloat. He said Medicare for All would reduce care options for Mainers.

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Jul 30 • 2:00 PM EDT • Politics • spectrumlocalnews.com
Trump administration to end Medicare Part D subsidy program in 2027

The prescription drug benefit is used by millions of seniors.

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Jul 29 • 8:12 AM EDT • Health • abcnews.com
The Trump administration is halting a Medicare drug subsidy. Will premiums rise?

A temporary subsidy that reduced monthly premiums will end, and insurance companies are examining the impact.

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Jul 29 • 5:00 AM EDT • Health • washingtonpost.com
Exclusive | Medicare Part D Premiums Set to Rise as Trump Ends Subsidies

Program that held down premiums wouldn’t be renewed for 2027, resulting in higher costs for some seniors.

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Jul 28 • 4:00 PM EDT • Health • wsj.com
Abbott gathering real-world data on FDA-approved TriClip system

Abbott's TriClip system for tricuspid regurgitation is approved by the FDA and covered by Medicare. To learn more about its real-world performance, researchers will now track 1,000 patients for a total of five years.

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Jul 28 • 2:26 PM EDT • Business • cardiovascularbusiness.com
Holland & Knight Health Dose: July 28, 2026 | Insights

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would establish new indirect hold harmless thresholds for healthcare-related taxes.

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Jul 28 • 8:00 AM EDT • Health • hklaw.com
Paltry Medicare pay fueling imaging access gaps, radiology experts charge

Along with radiology providers, Medicare’s failure to keep pace with inflation is harming patients, too, according to new Neiman Health Policy Institute research.

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Jul 28 • 1:21 AM EDT • Business • radiologybusiness.com
American College of Radiology outlines 2027 Medicare fee schedule’s impact on imaging pay

ACR said the document compares newly proposed payment amounts against 2026 ones across all individual, radiology- and radiation oncology-related codes.

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Jul 28 • 1:10 AM EDT • Business • radiologybusiness.com
New findings on health care affordability in NYC

Private insurance and Medicare do not fully shield low-income New Yorkers from issues affording health care, according to a new study.

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Jul 27 • 10:00 AM EDT • Health • politico.com
He Sold His HVAC Business and Trucks in One Year. Two Years Later, Medicare Billed Him Like a Millionaire.

An HVAC contractor sold his business, paid his taxes, and booked a trip to Portugal. Two years later, Medicare sent him a premium notice sized for someone still running a seven-figure operation, and the clock to fight it was already running.

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Jul 27 • 7:02 AM EDT • Business • finance.yahoo.com
Retirees need at least $185K set aside to cover healthcare, even with Medicare, study finds

The figure comes from research by Fidelity Investments. The group said their estimate, updated annually, jumped 7.5% since last year.

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Jul 27 • 4:29 AM EDT • Health • healthexec.com
Business briefs, July 27

New CMS voting memo sparks concerns over resident assistance in nursing homes … Initial jobless claims decline 22K week over week, falling to a seasonally adjusted tally of 187K … House Energy and Commerce Committee passes package to streamline Medicare Advantage prior authorization … 1 in 4 US workers sticking with a job strictly for health insurance … Fitch Ratings affirms Greenwood Village South at BBB-; outlook stable

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Jul 26 • 8:01 PM EDT • Business • mcknightsseniorliving.com
Medicare 2027 Physician Fee Schedule Proposed Rule

Policies with Potential to Improve Health Care Affordability for Patients and Taxpayers

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Jul 23 • 12:34 PM EDT • Health • bipartisanpolicy.org
Fidelity estimates retirees will spend $185,500 on healthcare and medical expenses in retirement

Fidelity's 2026 estimate shows a 65-year-old retiree may face $185,500 in medical expenses despite Medicare coverage, a 7.5% jump from last year.

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Jul 23 • 9:18 AM EDT • Health • foxbusiness.com
Fidelity estimates retirees will spend $185,500 on healthcare and medical expenses in retirement

Fidelity's 2026 estimate shows a 65-year-old retiree may face $185,500 in medical expenses despite Medicare coverage, a 7.5% jump from last year.

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Jul 23 • 9:18 AM EDT • Business • foxbusiness.com
RELEASE: Gottheimer Hosts Telephone Town Hall to Discuss Health Care Costs, Medicare, Social Security, Utility Prices, Affordability in Jersey

Above: Gottheimer conducts a Telephone Town Hall with North Jersey families. WASHINGTON, D.C. — Last night, July 22, 2026, U.S. Congressman Josh Gottheimer (NJ-5) hosted a Telephone Town Hall with thousands of North Jersey residents to discuss his bipartisan efforts to lower health care and prescription drug costs, protect Social Security and Medicare, cut taxes, lower […]

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Jul 23 • 8:00 AM EDT • Health • gottheimer.house.gov
CMS appeals court ruling on Medicare Advantage star rating methodology as insurers file lawsuits

The agency announced its appeal of a court ruling it lost to Clover Health, which resulted in the agency recalculating the grades it gave to the payer’s Medicare Part C plans. Other insurers are now asking for the same redo, spurring CMS to appeal the initial ruling.

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Jul 23 • 7:56 AM EDT • Health • healthexec.com
Jayapal, Dingell, CPC Members Host Universal Healthcare Shadow Hearing

Full video of the hearing can be watched HERE. WASHINGTON, D.C. — The Congressional Progressive Caucus (CPC) today hosted a shadow hearing on Medicare for All, led by Chair Emerita Congresswoman Pramila Jayapal (WA-07) and Congresswoman Debbie Dingell (MI-06), the lead sponsors of the Medicare for All Act of 2025. During the hearing, CPC Members and witnesses […]

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Jul 22 • 3:06 PM EDT • Health • jayapal.house.gov
Does Medicare Cover GLP-1s For Weight Loss? What To Know In 2026

Does Medicare Cover GLP-1s For Weight Loss? What To Know In 2026

forbes.com logo
Jul 21 • 11:28 AM EDT • Health • forbes.com
Senate Democrat proposes universal health care for children

Sen. Andy Kim (D-N.J.) on Tuesday unveiled a proposal for all American children to receive Medicare, a program he’s dubbed MediKids, saying Democrats must bring new ideas to move the conversa…

thehill.com logo
Jul 21 • 10:39 AM EDT • Health • thehill.com
COVID-19 Linked to Short-Term Increases in Medicare Health Care Spending

Postacute COVID-19 symptom diagnoses, health care spending, and utilization among Medicare beneficiaries diminish within 3 months of infection.

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Jul 21 • 9:22 AM EDT • Health • infectiousdiseaseadvisor.com
Democratic senator proposes expanding Medicare to cover children

The approach represents a potential way forward on a priority issue for Democrats if the party regains power in the future.

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Jul 21 • 7:50 AM EDT • Politics • washingtonpost.com