Latest news with #CentersforMedicare&MedicaidServices
Time of India
4 days ago
- Business
- Time of India
Retirement Trust Fund Depletion: Social Security benefits may shrink by 2033. Here's why, how it may affect you, what can be done to avert crisis and how to prepare for future
A recent government report has raised concerns about the future of Social Security. The Social Security Board of Trustees now says the retirement trust fund could be depleted by 2033. This is one year earlier than its last estimate. Millions of Americans who rely on these benefits may see reduced payments if no action is taken, media reports said. Trust Fund Depletion Expected in 2033 The Social Security Board of Trustees released its 2024 annual report. It shows that the retirement trust fund may run out by 2033. This change was shared with the Centers for Medicare & Medicaid Services. The new timeline increases concerns for future retirees. If Congress does not take steps soon, benefits could be reduced. A 23% cut may occur. This would affect many Americans who depend on the system. Also Read: Baba Vanga World War 3 Prophecy: Did Bulgarian mystic predict war between Iran and Israel? Here's how she said it would end How It May Affect You? The Old-Age and Survivors Insurance (OASI) Trust Fund is at risk. This fund gives monthly checks to retired workers and their families. If the fund runs dry, payroll taxes will only cover about 77% of scheduled payments. This would mean smaller checks for millions of retirees. Live Events Many people use these payments as their only income. A cut in benefits could create serious challenges for these households. Why is it Happening? Several issues have caused the trust fund to weaken faster. One factor is the Social Security Fairness Act. This law helped nearly 3 million retired public workers by improving their benefits. However, it also added pressure to the trust fund. Demographic changes are also a factor. More people are retiring as baby boomers age. People are living longer and having fewer children. This means fewer workers are paying into the system while more people collect benefits for longer. Also Read: Never Before Ever: US President lashes out at Israel for violating ceasefire with Iran. See how did Trump criticize Netanyahu What Can be Done to Avert Crisis? Lawmakers have suggested different ways to strengthen the fund. One idea is to raise the Full Retirement Age . It is now 67, but some propose increasing it to 70. Early retirement age could also move from 62 to 65. Another idea is to raise the cap on income subject to Social Security taxes. At present, only income up to $176,000 is taxed. Increasing this limit could mean higher contributions from high earners. How to Prepare for Future? Financial experts believe millennials and Gen Z may not receive full benefits. Some may receive only partial benefits or none at all. These groups are advised to start preparing now. Retirement planning experts recommend early saving. Starting a Roth IRA or increasing contributions to a 401(k) are good options. These actions help build personal savings to rely on later in life. FAQs What happens if the Social Security trust fund runs out in 2033? If the fund runs out, only 77% of scheduled benefits will be paid. Retirees may face a 23% cut unless Congress takes action to fix the issue. How can younger people prepare for reduced Social Security benefits? Younger workers should save more through Roth IRAs or 401(k)s. Financial planners suggest preparing for retirement without depending on full Social Security payments.
The Hill
5 days ago
- Health
- The Hill
HHS promotes insurer pledge to scale back prior authorization
Federal health officials on Monday touted pledges they have received from the health insurance industry to streamline and reform the prior authorization process for Medicare Advantage, Medicaid Managed Care and Affordable Care Act Health Insurance Marketplace plans which account for most insured Americans. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services Administrator Mehmet Oz took part in a roundtable discussion with insurers in which the payers pledged commitments to six key reforms to the prior authorization process. Health care providers must obtain approval from an insurer before a specific service is covered, and they've criticized that process for being time-consuming and a drag on providing health care. According to Oz, the roundtable included the CEOs of health insurance companies who cover about 75 percent of Americans. The CMS administrator said he would like fewer services to be subject to preauthorization. Medicare Director Chris Klomp gave the example of colonoscopies or cataract surgeries as procedures that could be moved out of the prior authorization process. Referencing the biblical passage that reads 'the meek will inherit the earth,' Oz said in a press briefing that health insurance companies and hospital systems have 'agreed to sheath their swords, to be meek for a while.' Major health insurers including Cigna, UnitedHealthcare and Aetna said they would be simplifying the process and reducing the number of health care claims subject to prior authorization. The voluntary commitments include standardizing the electronic prior authorization process; reducing the number of claims subject to prior authorization; ensuring continuity of care when patients change plans; enhancing communication and transparency when it comes to determinations; increasing the numbers of real time responses; and ensuring medical review of denied requests. By cutting down on red tape, Oz said 'tens of billions of dollars of administrative waste' could be saved. Kennedy acknowledged that similar commitments have been made by the health insurance industry in the past, but said this instance was different because of the number of insurers who have signed on to the voluntary agreement. 'The other difference is we have standards this time. We have, we have deliverables. We have specificity on those deliverables, we have metrics, and we have deadlines, and we have oversight,' said Kennedy. Oz suggested another difference was a change in Americans' current consensus on prior authorization compared to the past. 'I mean, there's violence in the streets over these issues. This is not something that is a passively accepted reality anymore. Americans are upset about it,' said Oz. 'I think the major factor is the industry realizes that some of the things that are preauthorized just don't make any sense.' 'The health care system remains fragmented and burdened by outdated manual processes, resulting in frustration for patients and providers alike. Health plans are making voluntary commitments to deliver a more seamless patient experience and enable providers to focus on patient care, while also helping to modernize the system,' said Mike Tuffin, president and CEO of the health insurance trade association AHIP. According to a 2024 survey by the American Medical Association, 91 percent of physicians said the prior authorization process can lead to negative clinical outcomes and 82 percent said it could lead to patients abandoning their course of treatment. Acknowledging the voluntary nature of the commitments, Oz said, 'If the insurance industry cannot address the needs of preauthorization by themselves, there are government opportunities to get involved. They might not be as nimble, but they will be used if we're forced to use them.' Actor Eric Dane, who recently disclosed his diagnosis of amyotrophic lateral sclerosis (ALS), appeared at the press conference to put his support behind the move. Dane famously played a physician on the show 'Grey's Anatomy.' 'I'm here today to speak briefly as a patient battling ALS, also known as Lou Gehrig's disease. When that diagnosis hits and you find out that you're sick, your life becomes filled with great uncertainty,' said Dane. 'The worst thing that we can do is add even more uncertainty for patients and their loved ones with unnecessary prior authorization.' Sen. Roger Marshall (R-Kan.) and Rep. Greg Murphy (R-N.C.) joined Kennedy and Oz at HHS headquarters. Both lawmakers have previously introduced legislation seeking to reform and streamline the prior authorization process under Medicare. Marshall and Murphy, both physicians, touched on how the prior authorization process has negatively impacted their patients. 'I vividly remember a patient I once had scheduled for an infertility surgery. She'd taken time off work and arranged help at home, only to be told the morning of a procedure that her insurance company had added another step to the prior authorization process, abruptly canceling her surgery,' Marshall recounted. 'Now, whether you need a hip replacement or a heart catheterization, many patients feel their critical care has been delayed by an opaque and burdensome prior authorization process.' The senator from Kansas said he was still committed to codifying preauthorization reforms despite the commitments made Monday. Describing himself as a 'skeptic,' Murphy said he would be keeping an eye on insurers to make sure they're 'doing what they're saying they're going to do.' He touched on the role of artificial intelligence in today's prior authorization process. 'Artificial intelligence should help this tremendously, tremendously, and it should take out a lot of the variances that happen between doctors, hospitals, regions of the country, etc. But remember, artificial intelligence only is as good as what you put into it,' said Murphy. Physicians have previously expressed concerns about the role of artificial intelligence in the preauthorization process, with some evidence suggesting AI-use results in higher rates of denials. In March, Murphy joined with bipartisan House colleagues in reintroducing the Reducing Medically Unnecessary Delays in Care Act. Among other measures, the bill would bar Medicare administrative contractors from denying coverage of health care services solely because it does not meet an evidence-based standard and would require input from practicing physicians prior to establishing clinical criteria for preauthorization review.
Miami Herald
5 days ago
- Business
- Miami Herald
Trump Administration Says Health Insurance Move Will Save $12 Billion
The Centers for Medicare & Medicaid Services (CMS) has announced it is in the final stages of implementing a new rule that it says will 'lower individual health insurance premiums' by 5 percent on average. CMS said the move is expected to save American taxpayers up to $12 billion in 2026, by 'combating the surge of improper enrollments in the Affordable Care Act (ACA) Exchanges.' Concern has been raised by some that these new measures will push many Americans off their health coverage. 'They will indeed save government money, but only by throwing off the ACA rolls millions of individuals who deserve to be on,' Jonathan Gruber, a professor of economics at Massachusetts Institute of Technology, told Newsweek. Newsweek has contacted CMS via email for comment. According to a CMS release, the new rules are being brought in to tackle 'waste, fraud and abuse' in health insurance markets-an issue that is at the forefront of the Trump administration's policies. A Government Accountability Office (GAO) report from 2024 found that $100 billion was discovered in 'improper payments' in 2023 across the Medicare and Medicaid programs. While wasteful spending in health insurance markets has been targeted by the administration to lower the tax burden for Americans, critics are concerned that sweeping cuts and changes will only push many off health coverage, subsequently driving up costs in the long-term. The new regulation, known as the 2025 Marketplace Integrity and Affordability Final Rule, will target 'improper enrollments' in the Affordable Care Act (ACA) Exchanges via a number of measures. It would repeal the monthly special enrollment period (SEP) for individuals with household incomes at or below 150 percent of the federal poverty level, which CMS called was a kind of loophole for unauthorized enrollments. The policy has been 'used by some agents and brokers to improperly enroll ineligible consumers and perform unauthorized plan switching to gain commissions,' CMS said. Income verification will now be required for most new and auto-renewed enrollments receiving premium subsidies to 'ensure people qualify for the premium subsidies they receive,' CMS added. There will also be additional eligibility requirements for the majority of enrollments through SEPs, in order to close 'loopholes that allowed people to wait to enroll until they needed care,' CMS said. In addition, the rule will reduce advanced payments of the premium tax credit (APTC) by $5 a month for auto-renewed plans without eligibility verification. Most of these policy changes are temporary and will expire after the 2026 plan year-they are simply being used as measures to 'immediately tamp down on improper enrollments and the improper flow of federal funds,' according to CMS. Experts have warned about the impact these measures could have on Americans, with Timothy S. Jost, a professor of law at Washington and Lee University telling Newsweek, 'as many as 1.8 million people could lose ACA coverage.' 'This is an addition to the 4.2 million who will lose coverage because the Congress is not extending the enhanced premium tax credits that were adopted during the Biden administration,' he added. Additional actions being made by CMS in regard to ACA Exchanges include a move to ensure federal ACA subsidies will no longer be available 'to help cover the cost of specified sex-trait modification procedures to align an individual's physical appearance or body with an asserted identity that differs from the individual's sex.' Jonathan Gruber, a professor of economics at Massachusetts Institute of Technology, told Newsweek: 'This is classic doublespeak. These actions will throw millions of people off the ACA rolls by setting up arbitrary administrative barriers that make it hard to enroll.' He added: 'There is undoubtably fraud in ACA exchange enrollment. But this is a blunt solution that will remove many deserving enrollees for every undeserving enrollee and lead to hardship for millions.' Timothy S. Jost, a professor of law at Washington and Lee University, told Newsweek: 'The rules that have just been published will dramatically reduce enrollment in the health insurance exchanges by creating barriers to enrollment leaving many people uninsured. The rules are likely to increase premiums rather than reduce them because the added bureaucratic barriers to enrollment will discourage healthy individuals from enrolling and those covered will be much sicker and more costly. To the extent that rules do reduce premiums for some, it will be primarily because the policies they will be buying will be of lower value, with higher deductibles and co-payments and because the premium tax credits they receive will be reduced.' He added: 'The rule may reduce government expenditures, but simply because it reduces the number of Americans covered and the value of their coverage. There has been some fraud by brokers in the federal marketplace but this was already being addressed by excluding fraudulent brokers.' Robert F. Kennedy Jr., U.S. Health and Human Services Secretary, said: 'We are strengthening health insurance markets for American families and protecting taxpayer dollars from waste, fraud, and abuse. With this rule, we're lowering marketplace premiums, expanding coverage for families, and ensuring that illegal aliens do not receive taxpayer-funded health insurance.' Dr. Mehmet Oz, CMS Administrator, said: 'CMS is restoring integrity to ACA Exchanges by cracking down on fraud, protecting American taxpayer dollars, and ensuring coverage is there for those who truly need it. This is about putting patients first, stopping exploitation of the system, and realigning the program with the values of personal responsibility and fiscal discipline.' The finalized policies will apply to plan years 2025 and 2026, after which they are set to expire. Related Articles Aflac Cyber Breach May Expose Customer Health Data, Social Security NumbersMedicare Update: Lawmakers Introduce Bill to Expand Health Care ProgramNew Yorkers Warned of 38 Percent Spike in Health InsuranceMap Shows States Where People Are Being Removed From Health Care Plan 2025 NEWSWEEK DIGITAL LLC.
Business Wire
18-06-2025
- Health
- Business Wire
Netsmart myUnity ® Receives CHAP Verification for Home Health
OVERLAND PARK, Kan.--(BUSINESS WIRE)-- Netsmart, a leading provider of healthcare solutions and software for post-acute care communities, announced that its myUnity electronic health record (EHR) platform has received the Community Health Accreditation Partner (CHAP) Verification for Home Health. CHAP is a recognized non-profit accrediting organization authorized by the Centers for Medicare & Medicaid Services (CMS). This verification demonstrates the Netsmart commitment to advancing the home health market, by delivering high-quality, compliant solutions that meet the needs of providers and patients alike. CHAP Verification is more than a credential—it's a reflection of the Netsmart dedication to supporting agencies with solutions that meet the highest standards of care, compliance and quality. CHAP Verification is more than a credential—it's a reflection of the Netsmart dedication to supporting agencies with solutions that meet the highest standards of care, compliance and quality. This verification reinforces the Netsmart commitment to help providers deliver care that exceeds nationally recognized benchmarks. By achieving CHAP Verification, Netsmart aims to give clients the confidence that they are equipped with technology aligned to best practices, built to strengthen trust with patients and families and designed to support success in value-based care. It's another step forward in the Netsmart mission to deliver reliable, standards-aligned tools that help agencies grow, thrive and lead in a competitive landscape. To earn CHAP Verified status, Netsmart underwent an extensive survey process, confirming that myUnity demonstrates no barriers to compliance. Following this comprehensive evaluation, the platform was validated without requiring any modifications, showcasing its effectiveness and reliability. 'Agencies need flexible, innovative solutions to advance value-based care, and a certified EHR platform like myUnity is critical to achieving that,' said David Strocchia, SVP & GM of Provider Solutions at Netsmart. 'We are committed to providing solutions that make providers' work easier, more efficient and more meaningful, allowing clinicians and staff to focus on delivering the best outcomes for those they serve. This CHAP Verification is another testament to our dedication to support providers with reliable, standards-aligned technology that empowers them to excel in a competitive landscape.' Purposefully built for post-acute care settings, the myUnity platform simplifies scheduling, clinical documentation, billing and care transitions, enabling home health agencies to deliver coordinated, high-quality care more efficiently. Its robust interoperability features and compliance tools support providers' efforts to improve outcomes and streamline operations across care settings. Additionally, myUnity is integrated with the Netsmart CareFabric ® platform to extend capabilities beyond the EHR in areas such as referral management, patient and family engagement, workforce management, collection automation and much more. 'Receiving verification for home health following their recent hospice care certification highlights the Netsmart commitment to delivering high-quality technology and supporting providers across the post-acute care continuum,' said CHAP COO Teresa Harbour. 'We congratulate Netsmart on their recent verifications and are proud to recognize their myUnity solution that continues to demonstrate a strong dedication to delivering optimal care and setting a new industry standard.' As the post-acute care landscape evolves, CHAP-verified technology remains essential for agencies aiming for compliance and excellence. Following this verification, Netsmart plans to pursue CHAP Verified status for home care, palliative care and pediatric care. About Community Health Accreditation Partner (CHAP) CHAP is an independent, nonprofit organization accrediting providers of home and community-based care. Founded in 1965, CHAP was the first to recognize the need for and value of home and community-based care standards and verification. As a Centers for Medicare & Medicaid Services (CMS)–approved accrediting organization, CHAP surveys organizations providing home health, hospice, and home medical equipment services to establish if Medicare Conditions of Participation and DMEPOS Quality Standard are met and recommend certification to CMS. CHAP's purpose is to partner with organizations nationwide to advance quality in the delivery of care and services in the home and community. About Netsmart Netsmart is an industry-leading healthcare technology organization empowering providers to deliver value-based care to the individuals and communities they serve. The Netsmart CareFabric ® platform serves as a unified, connected framework of solutions and services for human services, post-acute, payer and public sector communities. Together with our clients and Marketplace vendors, we develop and deliver innovative technology, including electronic health records (EHRs), interoperability, analytics, augmented intelligence (AI), population health management and telehealth solutions and services that assist organizations in transforming the care they deliver. The result has helped make a positive impact on the lives of more than 147 million individuals. For more than 55 years, Netsmart has helped provider organizations in their efforts to improve the health and wellbeing of the communities we collectively serve. To learn more, visit and connect with us on LinkedIn, Facebook or X.
Business Wire
18-06-2025
- Business
- Business Wire
mPulse Leads Conversations Around Trust in Healthcare for Better Consumer Experience and Outcomes at Activate2025
LOS ANGELES--(BUSINESS WIRE)-- mPulse, a leading provider of Health Experience and Insights (HXI) technology, today announced details for Activate2025, the company's industry conference for healthcare executives to learn, network, and celebrate innovative health engagement. This year's event will convene healthcare and technology thought leaders in Austin, Texas from September 23-24, 2025. The company also announced renowned 2025 keynote speakers, Chiquita Brooks-LaSure and Kate O'Neill, who will bring their decades of experience and expertise to event participants. As the industry's premier Health Experience and Insights conference, this year's theme will focus on Building Trust for Better Outcomes: Digital Strategies to Empower the Consumer Health Experience. Disrupting the status quo is necessary to drive new levels of consumer centricity. Activate2025 will provide cutting-edge strategies and real-world success stories, so attendees leave with actionable next steps to drive a tangible impact. The conference content tracks explore innovations in technology including AI, key enhancements for new regulations, emerging data, and insights capabilities that drive hyper-personalization and orchestration, and best practices for payer and provider collaboration. Prominent Keynotes Address Healthcare's Biggest Challenges This year's distinguished keynote speakers will include: Chiquita Brooks-LaSure, a nationally respected healthcare policy leader, former Administrator of the Centers for Medicare & Medicaid Services, and champion for health equity. Brooks-LaSure will bring clarity, insight, and ability to connect policy decisions with real-world impact for attendees to drive better health outcomes for all communities. Kate O'Neill, a digital innovator, chief executive, business writer, and globally recognized speaker. As the founder and CEO of KO Insights, a strategic advisory firm that enhances human experiences at scale through data-driven and AI-led interactions, O'Neill will provide cross-industry perspectives on consumer trust and how organizations can deliver more meaningful digital experiences. 'Improving health equity, expanding care access, and modernizing the nation's healthcare infrastructure are the elements paramount to ensuring people in America can live healthy, thriving lives,' said Brooks-LaSure. 'In order to drive better health outcomes for all communities, conversations with healthcare leaders like the ones happening at Activate2025, are critical to uncover the challenges and opportunities across healthcare including the transformative innovations needed to drive the future of healthcare for all.' 'As the promise of technology - including AI-led innovation - continues, we must remember it's not technology that determines the future, it's the decisions made about it that shape our experiences,' said O'Neill. 'Converging decision makers to uncover strategic foresight to help healthcare leaders interact with customers in a way that enhances human experiences creates a path to long-term success by centering humans in digital transformation.' mPulse Activate Awards Additionally, supporting over 400 healthcare organizations - encompassing 40 of the country's 50 largest health plans – that provide coverage for 245 million lives, mPulse will host its annual awards program at Activate2025 to recognize the success of leading healthcare organizations. The mPulse Activate Awards acknowledge industry leading innovation and outcomes performance across six categories with the winners announced at the conference. mPulse is also hosting its product user groups across health portals, omnichannel engagement, and predictive analytics in exclusive workshops for customers ahead of the event. The focus centers on exploring best practices and strategies to improve outcomes across key engagement areas including portals adoption, CAHPS & HOS performance, and advanced CX strategies. "mPulse is excited to host the ninth annual Activate2025 conference, providing the opportunity for hundreds of forward-thinking leaders to connect and collaborate on ways to elevate the health consumer experience,' said Bob Farrell, CEO of mPulse. 'mPulse takes seriously being a leader in this space, from best-in-class technology and healthcare expertise, to facilitating a space for industry leaders - and keynote icons like Brooks-LaSure and O'Neill - to discuss the most essential topics in healthcare today, most notably understanding, creating, and growing consumer trust.' To view the full agenda and register for Activate2025, please visit: About mPulse mPulse, a leader in digital solutions for the healthcare industry, is transforming consumer experiences to deliver better, more equitable health outcomes. By combining AI-powered analytics, omnichannel outreach and digital health navigation technology, mPulse creates personalized health journeys and provides advanced insights to power collaboration across the healthcare ecosystem. With over a decade of experience and 4 billion consumer touchpoints annually, mPulse is the trusted Health Experience and Insights (HXI) partner for over 400 healthcare organizations. To learn more, visit
