bcbsmi

Logo

March 6, 2025

Paragon Says Improper Medicaid Payments Could Be Over $1 Trillion The Paragon Health Institute is an extremely powerful think tank with the ear of the Trump administration and some in Congress. Its newest report, in conjunction with the Economic Policy Innovation Center, says that improper payments under Medicaid could be as much as $1.1 trillion over ten years. The Centers for Medicare and Medicaid Services (CMS) estimated improper payments at $543 billion over ten years, but Paragon says that does not include eligibility check errors. The report urges Congress to cut funding to states found with greater than 3% erroneous payments based on eligibility errors. Many of the errors are tied to the suspension of eligibility checks during the COVID pandemic. The ineligible population includes people over income limits and illegal immigrants. The report gives hope that the GOP Congress can reduce Medicaid spending and perhaps certain Medicare spending without

Read More »
Logo

March 5, 2025

Budget Reconciliation And DOGE Updates Two key developments on the spending reduction front. Republican senators met with Elon Musk on his Department of Government Efficiency (DOGE) commission reductions. Many senators, rightists and moderates, told him that Congress must sign off on the reductions. On one hand, the senators were asserting their branch’s constitutional authority. On the other, they said it insulates the DOGE cuts from court attacks. Musk was open to Senate approval but indicated he did not think some of the reductions had to come back to Congress. He also was surprised that a rescission package can be passed by just a majority vote. Rescission is authorized by the Impoundment Act of 1974. Some House Republicans want to repeal the rescission process to allow the president to exercise what they see as the president’s inherent impoundment authority. It is ironic that the same act could be used to validate

Read More »
Logo

March 4, 2025

Tariff Costs Likely Passed Through On Drugs And Medical Devices Drug and device makers abroad will be levied a tariff if their imported product origin is Mexico, Canada or China and the costs are likely to be passed through to consumers. This means various providers, including hospitals and physicians, will see cost increases. The costs, too, would be passed through in the drug channel, ultimately hitting employer groups, government programs, and consumers. Consumers could see higher premiums as well as cost-sharing hikes. Canada and Mexico will have 25% tariffs under the Trump administration’s announcement this week. China has total tariffs since September of 20% or more as well. (Article may require a subscription.) #healthcare #drugpricing #tariffs #hospitals #physicians https://www.modernhealthcare.com/digital-health/tariffs-mexico-canada-cardinal-intuitive Healthcare Entities Could See Pressure On Margins If Medicaid Cuts Pass While healthcare entities would not have major shifts in 2025, Medicaid cuts could mean pressure on margins according to Fitch,

Read More »
Logo

March 3, 2025

House Dems Run Spending Cut Ads In Swing Districts A House Democratic campaign organization officially kicked off the 2026 elections by running a television advertising blitz hitting House Republicans over the prospect of Medicaid cuts in budget reconciliation. The ads are running in 23 swing districts in 13 states. (Article may require a subscription.) #medicaid #election2026 #budgetreconciliation https://www.modernhealthcare.com/politics-policy/medicaid-cuts-tv-ads-gop BCBSMI Had Major 2024 Loss Blue Cross Blue Shield Michigan (BCBSMI), a top insurer in the nation, reported a $1.03 billion loss in 2024 due to rising costs and what it called “unsustainable” market conditions. It had revenue of $40.6 billion. It said the costs were driven by rising utilization of expensive medical services and costs for prescription and specialty drugs. Additional article: https://www.modernhealthcare.com/insurance/blue-cross-michigan-2024-healthcare-costs (Some articles may require a subscription.) #healthplans #margins #bcbsmi https://www.beckerspayer.com/payer/bcbs-michigan-posts-1b-loss-in-2024.html SNP Plans Grow In Enrollment Season While enrollment growth in Medicare Advantage (MA) was lower than previous years,

Read More »

Available Now

$30.00