Tag: Medicare

  • DOGE targets Medicare agency, looking for fraud

    DOGE targets Medicare agency, looking for fraud

    Elon Musk’s Department of Government Efficiency (DOGE) is working with the Centers for Medicare and Medicaid Services (CMS) and has gained access to payment and contracting systems in search for potential fraud, the Wall Street Journal reported Wednesday.

    Trump’s DOGE has already gutted USAID, but Musk argued on X that Medicare and Medicaid are where the “big money fraud” is happening.

    CMS oversees Medicare, the health coverage program for older and disabled Americans, and Medicaid, for lower-income enrollees, which provides insurance for over 140 million U.S. citizens.

    The CMS regularly deals with improper payments that represent fraud or abuse but might also be due to a state, contractor, or provider missing an administrative step.

    RUBIO PAUSES FOREIGN AID FROM STATE DEPARTMENT AND USAID TO ENSURE IT PUTS ‘AMERICA FIRST’

    WSJ reported, citing one of the people familiar with DOGE’s work at CMS, that Musk’s allies have not been given access to databases that include identifiable personal health information of Medicare or Medicaid enrollees.

    The new campaign comes just days after DOGE targeted USAID, leading to the firing of 50 top officials and the organization being folded into the State Department.

    AFTER RAUCOUS FIRST WEEK IN OFFICE, DONALD TRUMP TO KEEP HIS FOOT ON THE GAS

    Signs were also removed from USAID’s headquarters in the Ronald Reagan Building in Washington, D.C., and the DOGE team took over the computer systems, sources said. USAID is responsible for distributing civilian foreign aid and development assistance to countries around the globe.

    Elon Musk, the chair of DOGE, has been leading an investigation into USAID’s spending practices as the agency comes to a standstill. (Getty Images)

    Musk referred to the organization as a “viper’s nest.” The agency managed approximately $40 billion in appropriations last year, according to the Congressional Research Service.

    TRUMP ADMINISTRATION NEEDS MORE PLANES TO CARRY OUT DEPORTATIONS: REPORT

    The actions came after Secretary of State Marco Rubio, acting on Trump’s executive order, paused all U.S. foreign assistance funded by or through the State Department and USAID.

    USAID protests erupt after Trump shuts down agency

    Employees and supporters gather to protest outside of USAID headquarters on Feb. 3, 2025, in Washington, D.C. (Kevin Dietsch/Getty Images)

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    The 90-day pause has halted thousands of U.S.-funded humanitarian, development and security programs worldwide and forced aid organizations to lay off hundreds of employees because they can’t make payroll.

    Fox News Digital’s Greg Wehner, Chris Pandolfo, the Associated Press and Reuters contributed to this report.

  • Trump handed opportunity ‘to save Medicare’ after Biden admin’s final blow to seniors: expert

    Trump handed opportunity ‘to save Medicare’ after Biden admin’s final blow to seniors: expert

    President Donald Trump was handed the “opportunity to save Medicare” after the Biden administration rolled out its final Medicare Advantage proposal early in January that experts say underfunds the insurance plan after already facing rate cuts in previous years. 

    “This is Trump’s opportunity to save Medicare,” former Republican New York Rep. Ann Marie Buerkle, who is also a former nurse and was chairwoman of the Consumer Product Safety Commission until 2019, told Fox News Digital in January. 

    “Medicare Advantage is Medicare for 34 million Americans who choose it. Those seniors are experiencing disruption with their healthcare as a result of two years of cuts — if Trump ensures MA gets funded in line with projected medical cost trends in 2026, he’ll be fixing Joe Biden’s mistake and giving seniors the healthcare they deserve right before the GOP’s midterm elections.” 

    Medicare Advantage plans are private health insurance plans that contract with Medicare and are used by roughly 34 million Americans. The program mostly enrolls adults older than the age of 65, but also offers benefits to people of all ages with disabilities. Traditional Medicare, conversely, is a federal health insurance program for adults older than the age of 65, as well as younger individuals with disabilities. 

    The Biden administration previously had made cuts to Medicare Advantage rates, including in April 2024, when experts said enrollees would face an additional $33 a month for out-of-pocket costs, or $396 a year, due to the cuts. Critics at the time said the cuts would be especially devastating to seniors living on fixed incomes who are already coping with ongoing inflation issues. 

    DON’T LET BIDEN SNEAK IN MORE MEDICARE CUTS ON HIS WAY OUT THE DOOR

    The Biden administration previously had made cuts to Medicare Advantage rates, including in April 2024, when experts said enrollees would face an additional $33 a month for out-of-pocket costs, or $396 a year, due to the cuts. (Yuri Gripas/Abaca/Bloomberg via Getty Images)

    Roughly two weeks before leaving office, the Biden administration rolled out its final regulation affecting Medicare Advantage, which did not outright cut rates as it did for 2024 and 2025, but increased the average benchmark payment to Medicare Advantage plans by 2.2%. 

    The proposal, however, seemingly works as another cut and underfunds Medicare Advantage because the proposed rates are still lower than the current rate of inflation, Buerkle said, with the consumer price index showing a 12-month inflation rate of 2.7%. The proposal also comes on the heels of the Biden administration finalizing a 1.12% cut for fiscal year 2024 and a 0.16% cut for fiscal year 2025. 

    TRUMP PUTS BIDEN ON DEFENSE FOR MEDICARE ADVANTAGE CUTS

    “Underfunding for Medicare Advantage will result in higher premiums, more out-of-pocket costs, and higher deductibles for the 34 million Americans who choose Medicare Advantage,” Buerkle told Fox News Digital. “This, on top of the inflation that the Biden Administration caused by their flagrant spending creates a difficult situation for those seniors on a fixed income.” 

    Donald Trump smiles in a navy suit and red tie

    The Trump administration has until April 7 to finalize its policy for fiscal year 2026. (Evan Vucci/The Associated Press)

    The proposal is not yet locked in, as the newly minted Trump administration has until April 7 to finalize its policy for fiscal year 2026. 

    “Medicare Advantage saved the federal government $144 billion over the last decade,” Buerkle said. 

    That is because Medicare Advantage plans “use taxpayer dollars more efficiently than traditional Medicare,” she said. “By managing the care for 34 million seniors, MA plans are able to offer more benefits for the same price as original Medicare. Senior satisfaction rate is high, too, with 96% of seniors reporting their satisfaction with their MA plan. So, making sure MA is funded appropriately is a gift to taxpayers,” Buerkle said. 

    The Centers for Medicare and Medicaid Services touted the proposal when it was released in early January, saying the health plan will continue providing affordable care, while “being a good steward of taxpayer dollars.”

    The agency “has worked to ensure that people with Medicare Advantage and Medicare Part D have access to stable and affordable offerings,” said Centers for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure. “Today’s Advance Notice continues CMS’ efforts to provide access to affordable, high-quality care in Medicare Advantage while being a good steward of taxpayer dollars. We are also continuing implementation of the Inflation Reduction Act, ensuring people with Medicare Part D have more affordable coverage for their medications.”

    Joe Biden and Donald Trump split image

    A Trump administration official told Fox Digital that staffers are reviewing Biden administration proposals and polices skeptically, but that no policy has been set in stone related to Medicare Advantage. (Getty Images)

    Former Republican Louisiana Gov. Bobby Jindall, who served as an advisor to the U.S. secretary of Health and Human Services under President George W. Bush’s administration, published an op-ed for Fox Digital in December 2024, warning against the Biden administration issuing any last-minute Medicare Advantage cuts ahead of Trump taking back the Oval Office. 

    “Over the past two years, the administration has implemented a series of changes that have effectively reduced funding for Medicare Advantage,” he wrote. “These cuts are disguised as ‘payment adjustments,’ but the reality is clear: they are cutting funding for a program that seniors overwhelmingly support. The results? Higher premiums, reduced benefits, and narrower provider networks for many Medicare Advantage enrollees.” 

    Jindall added that Medicare Advantage can be improved to better serve seniors and other enrollees, but he argued “the left” has resisted improving the system in favor of promoting a government-focused program. 

    “Members in both parties have called for modifying the calculation of risk adjustments, to improve a system that can be gamed and often rewards companies for documenting patient acuity rather than actually improving outcomes,” he wrote. “But, the left does not want to improve Medicare Advantage — they want to undermine the program to advance their long-term goal of centralizing more health care under the government’s control.” 

    A Trump administration official told Fox Digital that staffers are reviewing Biden administration proposals and polices skeptically but that no policy has been set in stone related to Medicare Advantage. 

    Trump joined House Republican lawmakers in Florida on Jan. 27, when he vowed not to cut Medicare or Social Security. 

    “I will not sign any bill that cuts even a single penny from Medicare or Social Security for our great seniors. We don’t have to do that. We don’t have to do that. We’ll not touch those benefits in any way, shape or form. I want to use that because during the campaign, they had these fake ads that Trump is going to cut Social Security,” he said. 

    BIDEN-HARRIS MEDICARE CUTS ARE HARMING SENIORS WITH COVERAGE LOSSES, PREMIUM HIKES: FORMER CONGRESSWOMAN

    Donald Trump, Joe Biden

    President Donald Trump, left, joined House Republican lawmakers in Florida on Jan. 27, when he vowed not to cut Medicare or Social Security. Roughly two weeks before leaving office, the administration of former President Joe Biden, right, rolled out its final regulation affecting Medicare Advantage.  (Getty Images)

    Buerkle previously spoke to Fox News Digital that the Biden administration’s cuts for 2024–2025 served as a backdoor attempt to gut Medicare Advantage in an effort to promote “Medicare for All,” a government-focused health system that has long been on a policy wishlist for left-wing lawmakers. 

    Buerkle said the Biden admin’s latest and last policy proposal on Medicare Advantage “absolutely” serves as another backdoor attempt to push Medicare for All.

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    “Medicare for All advocates despise the success of Medicare Advantage because it reveals the flaws in a government-run managed care system,” she said. “The goal is simple: destroy MA as a means to get to Medicare for All.” 

  • RFK JR. grilled on Medicare: What is Medicare Part A, Medicare Part B and Medicaid? What are they?

    RFK JR. grilled on Medicare: What is Medicare Part A, Medicare Part B and Medicaid? What are they?

    Robert F. Kennedy Jr. was grilled by senators over ideas for reforming Medicaid and Medicare on Wednesday during his first confirmation hearing as President Donald Trump’s nominee to become the next secretary of Health and Human Services.

    In this role, RFK Jr. would have authority over the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) as well as the National Institutes of Health and the Centers for Medicare & Medicaid Services (CMS), which is responsible for the Medicare and Medicaid programs. Dr. Mehmet Oz was nominated by Trump to run the CMS. 

    During the Wednesday hearing, Kennedy told senators that “Medicaid is not working for Americans.” 

    “It’s specifically not working for the target population,” he said. 

    Kennedy said the premiums and deductibles are too high, the “networks are narrow,” and the best doctors and healthcare systems don’t accept it. 

    FEDERAL JUDGE PAUSES TRUMP ADMIN’S TEMPORARY FEDERAL GRANTS, LOANS FREEZE

    Medicaid, originally designed for the poorest Americans, has been “dramatically expanded,” leading to increased financial pressures on that population, he said.

    Robert F. Kennedy Jr. takes his seat during his Senate Finance Committee confirmation hearing on Jan. 29, 2025, in Washington, D.C. (Anna Moneymaker/Getty Images / Getty Images)

    “The irony of the expansion is that the poorest Americans are now being robbed,” he continued. 

    A patient waits in a room at a doctor's office.

    A patient waits in a room at a doctor’s office. (  / iStock)

    In terms of Medicare, Kennedy believes more people would rather be on Medicare Advantage “because it offers very good services” but it’s too expensive. 

    When asked what reforms he would recommend to improve service and make it more cost-effective, Kennedy said there are “many things” we can do but stopped short of offering specifics. He said the ultimate goal is to increase transparency and accountability as well as “transition into a value-based system rather than a fee-based system.” 

    What to know about Medicare Part A, Medicare Part B, Medicare Advantage and Medicaid: 

    Medicare 

    Medicare is health insurance for people who are at least 65 years old. It is also for certain individuals under 65 that have disabilities and conditions. There are various plans within Medicare. When you sign up for Medicare, you can choose which way to get your Medicare coverage. 

    FACT OR FICTION: WILL TRUMP’S FEDERAL FUNDING FREEZE IMPACT STUDENT LOANS, GRANTS?

    There are two main options for consumers. One is original Medicare, which includes Part A and Part B, or Medicare Advantage (also known as Part C). 

    Doctor prescription medication medicine patient

    A doctor writes a prescription for a patient. (  / iStock)

    Medicare Part A 

    Part A, otherwise known as hospital insurance, helps cover inpatient care in hospitals, skilled nursing facility care, hospice care and home health care, according to the CMS. 

    Medicare Part B 

    It is medical insurance that covers services from doctors and other healthcare providers, outpatient care, home healthcare and durable medical equipment such as wheelchairs, walkers, hospital beds, and other equipment. It will also cover many preventive services such as screenings, shots or vaccines, and yearly “Wellness” visits, according to CMS. 

    You can use Medicare Part A and Part B at any doctor or hospital that takes Medicare in the U.S. Consumers can also buy supplemental coverage that helps pay for their out-of-pocket costs. 

    Medicare Part D

    It helps cover the cost of prescription drugs and includes many recommended shots or vaccines. However, consumers have to add this plan in order to get Medicare drug coverage.

    Medicare Advantage 

    It is a Medicare-approved plan from a private company that offers an alternative to original Medicare for your health and drug coverage. It is known as Part C and usually bundles Part A, Part B, and usually Part D plans. 

    Typically, this has different out-of-pocket costs than original Medicare or supplemental coverage like Medigap, which is supplemental insurance consumers can buy from a private company that helps pay your share of costs in original Medicare.

    With Part C, consumers may also have an additional premium, according to CMS. 

    RFK Jr testifies

    Robert F. Kennedy Jr. testifies during his Senate Finance Committee confirmation hearing on Jan. 29, 2025, in Washington, D.C. (Win McNamee / Getty Images)

    However, the plans may offer benefits that Original Medicare doesn’t.

    Medicaid 

    This is a joint federal and state program designed to provide health coverage for individuals with limited income and resources. It offers benefits such as nursing home care, personal care services, and help with paying Medicare premiums and other costs. 

    The state will pay your monthly premiums, and depending on the level of Medicaid eligibility, it may also cover Medicare costs, such as deductibles, coinsurance and copayments. In some cases, it could also cover Part A premiums, according to CMS.

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    Recipients will also receive assistance with prescription costs. Medicaid may cover medications and services that Medicare doesn’t, as noted by CMS.

    However, each state has different rules around who’s eligible for this program. To qualify, you must meet your state’s rules for your income and resources, in addition to other rules such as being a resident of the state. 

    However, sometimes a state will offer loopholes. For instance, some states will let a consumer “spend down” the amount of their income that’s above the state’s Medicaid limit.