Medicare Policy Tracker

The DOJ's fraud crackdown is accelerating across scales, with providers facing heightened scrutiny on fabricated claims.

• Nationwide scale: 324...

Beneficiaries face a $2,100 TrOOP cap in 2026, after which covered drugs cost $0.

• Deductibles capped at $615; many enhanced plans offer $0.
• Fewer...

A daughter's investigation uncovered stark gaps between marketing claims and reality at a Medicare-certified facility.

• Facility brochure promised...

CMS's May 2026 enrollment moratorium blocks new hospice and home health applications while signaling stricter enforcement for existing agencies.

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Costs rising sharply for 2026: Part B premium at $202.90, MA out-of-pocket cap $9,250, Part D cap $2,100, and possible totals up to...

Medicare's new transitional GLP-1 Bridge program launches July 1, 2026, offering eligible Part D beneficiaries a flat $50 monthly copay for...

Illinois House passed SB 3496 to create an independent board that would automatically apply the first 10 Medicare-negotiated Maximum Fair Prices...

The Health Subcommittee held a hearing examining Medicare physician payment issues and MACRA reforms.

Congressman Greg Murphy's Provider...

• Medicare Advantage now covers over half of beneficiaries while federal enforcement stays limited and mostly monetary.
• JAMA study found 87% of 844...

OIG found less than 1% net price difference for 60 high-cost drugs between vertically integrated Part D plans and others.

Integrated firms paid...

Recent cases reveal Medicare fraud's vast scale, from everyday scams to massive operations.

• Nationwide losses exceed $100 billion annually, with...

CMS imposed a six-month nationwide freeze on new Medicare enrollments for hospices and home health agencies, coordinated with Vice President JD...

Three Medicare Savings Programs can fully cover the $202.90 Part B premium for qualifying low-income beneficiaries, saving $2,434.80 yearly plus Extra...

Democratic senators' new framework aims to add a Medicare home care benefit and expand Medicaid HCBS, marking a major policy shift welcomed by...

CMS published its monthly report detailing Ad hoc Corrective Action Plans and Warning Letters for Medicare Part C and Part D, underscoring continued agency oversight of plan compliance.

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