Medicare & Medicaid Programs
Expert articles and analysis related to medicare & medicaid programs.
AI Summary — Last 24 Hours
CMS is extending the application deadline for the Medicaid GENEROUS drug-pricing model amid strong manufacturer interest, signaling that the Trump administration’s CMMI team is still leaning into state–manufacturer value-based purchasing and drug-cost accountability within Medicaid (Healthcare Finance). At the same time, Medicare Advantage remains under dual pressure: CMS’s 2027 MA rule both strengthens and rolls back beneficiary protections, while DOJ scrutiny and a $117.7 million Aetna false-claims settlement reinforce rising compliance risk around MA coding, risk adjustment, and plan oversight (KFF). For VBC leaders, the immediate takeaway is a widening spread between CMS-backed experimentation in Medicaid affordability models and increasingly adversarial enforcement/payment dynamics in MA.
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