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Senate Dems reach draft deal to extend ACA premiums, lower drug costs

Healthcare Dive

The bill, part of a more than $300 billion package, extends enhanced ACA premiums and allows Medicare to negotiate select prescription drug prices starting in 2026.

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Medicare Advantage offers less access to psychiatrists than ACA plans, managed Medicaid: study

Fierce Healthcare

Medicare Advantage (MA) beneficiaries have less choice when it comes to finding a psychiatrist than Medicaid enrollees or those who buy coverage on the Affordable Care Act (ACA) marketplace do, acc | Medicare Advantage continues to grow, and so does the need for beneficiaries to have access to psychiatrists, says a study in Health Affairs.

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Wyden pushes for CMS to crack down on broker misbehavior

Fierce Healthcare

A key senator is calling on the Centers for Medicare & Medicaid Services (CMS) to crack down on brokers who submit fraudulent enrollments for Affordable Care Act (ACA) plans. |

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Federal officials trumpet record high ACA enrollment

Fierce Healthcare

million people will be enrolled in an Affordable Care Act during this year's open enrollment period, Centers for Medicare & Medicaid Services (CMS) announced today. More than 21.3 Affordable Care Act enrollment has hit an all-time high, prompting federal officials to recognize its importance to the insurance marketplace today.

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CMS finalizes network adequacy standards, expands dental benefits for ACA exchange

Fierce Healthcare

States now can add routine adult dental services as an essential health benefit, the Centers for Medicare & Medicaid Services announced in its 2025 Notice of Benefit and Payment Parameters fina | In its annual Notice of Benefit and Payment Parameters final rule, CMS prioritized dental and prescription drug benefits, network adequacy standardization (..)

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers

Kaiser Health News

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

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