Healthcare stakeholders push Congress to make Medicare coverage of telehealth permanent: It’s set to expire at the end of March. We explore what’s at stake for seniors, many of whom are used to getting care remotely.

DOJ will examine UnitedHealth’s Medicare billing practices: The Trump administration has made “waste, fraud, and abuse” a rallying cry. Now, we find out how serious they are about it.

CMS unveils list of drugs for the next round of Medicare price negotiations: Drugmakers’ efforts to win over the Trump administration could amend the process in their favor—up to a certain point.

Drugmakers will push Trump to delay Medicare price negotiations: We believe the drug price negotiation program is well-intended given how much Medicare and US consumers pay for certain medications. While a program reversal is unlikely, we’ll find out soon what the Trump administration thinks.

Ozempic is becoming cheaper for Medicare beneficiaries: Falling prices are welcome news for seniors’ wallets. But a new proposal to expand access to GLP-1s for Medicare members could threaten the federal health insurance program itself.

CMS must recalculate UnitedHealthcare’s Medicare Advantage star ratings: The ruling could be a good omen for Medicare Advantage insurers whose ratings were downgraded.

CMS must recalculate UnitedHealthcare’s Medicare Advantage star ratings: The ruling could be a good omen for Medicare Advantage insurers whose ratings were downgraded.

Trump taps Dr. Oz to helm the CMS: We detail what the celebrity doctor’s appointment would mean for the future of Medicare, Medicaid, the Affordable Care Act, and consumers enrolled in these plans.

More bad news for Medicare Advantage insurers: Humana’s huge drop in star ratings is another indicator that MA plans will likely cut seniors’ benefits in the future.

Medicare and Medicaid. Kennedy couldn’t clearly explain the difference between Medicare Parts A, B, and C. He also falsely stated that Medicaid premiums and deductibles are too high. [Note: Medicaid members don’t pay premiums or have deductibles except in rare circumstances.]. 3. Distrust of federal health agencies.

Lower Medicare Advantage (MA) star ratings—which impact Aetna’s bonus payments from the federal government—was another headwind. How CVS plans to win over Wall Street: The company’s modest 2025 guidance suggests it won’t miss financial benchmarks like it did in 2024. The most impactful piece of the Aetna/MA turnaround will entail dropping “unprofitable” health plan members.

The order also instructs the HHS to consider cutting off Medicare and Medicaid reimbursement for hospitals that don’t oblige. Hospitals in locations including Colorado, Virginia, and Washington, DC have paused such care while administrators evaluate the order.

GLP-1 drug manufacturers should brace for the reality that weight loss medications won’t be cleared for Medicare coverage. The Biden administration proposed regulation that would require Medicare (which is currently prohibited by law from doing this) and Medicaid to cover GLP-1s for weight loss.

Why it matters: Kennedy is only one full Senate vote away from heading the HHS, where he would be tasked with overseeing the federal public health system, Medicare and Medicaid policy, national healthcare research money, and food and drug regulation. There is little standing in the way of Kennedy’s ascension to the HHS’ top spot.

Talkspace pushed into the Medicare market last year and will prioritize marketing more to seniors in 2025. Meanwhile, its consumer revenues declined about 30% YoY. Another potential driver Talkspace pointed out is its partnership with Amazon Health Services to help consumers discover digital mental health benefits offered through their health insurer or employer.

Medicare beneficiaries get access to RxPass. RxPass is Amazon Pharmacy’s prescription drug discount program for generic medications. It was launched in 2023 for Prime members but initially excluded Medicare. Now, Prime members in 46 US states who have Medicare insurance can access about 60 generic medications for a flat fee of $5 per month with no restrictions on the number of prescriptions.

The Centers for Medicare & Medicaid Services under the Biden administration took enforcement against just 18 hospitals between June 2022 and January 2025, per government data. Monetary fines were levied in most of those cases. Why it matters: The order cites one projection that consumers, employers, and insurers would have saved $80 billion if the first administration’s rules were fully implemented.

The Healthcare Distribution Alliance warned that the US will likely see new and worsened drug shortages and that costs will be passed down to payers and patients, including those in Medicare and Medicaid.

It reimagined its health insurance strategy due to underwhelming performance in the Medicare Advantage (MA) space. As a whole, Aetna may finish the year operating at a loss—a remarkable downfall after generating nearly $5.6 billion in adjusted operating income for 2023. MA was the primary culprit, chiefly due to enrollees receiving more medical care than the company planned for.

Its efforts have been focused on the Centers for Medicare and Medicaid Services (CMS), whose offices DOGE representatives have been on site at this week, per The Wall Street Journal. The representatives have gained access to key payment and contracting systems and are examining the spending that flows through them for signs of what they consider to be fraud.

The price hikes also tell us that drugmakers are taking steps to mitigate the impact of the government being able to negotiate drug prices in Medicare for the first time. Amid skyrocketing prescription drug spending in the US, government intervention led to the completion of the first round of price negotiations under the Inflation Reduction Act.

Will Trump take a tougher or weaker stance than Joe Biden on Medicare drug price negotiations? As part of Biden’s Inflation Reduction Act (IRA), the government was authorized to negotiate directly with pharmaceutical manufacturers to lower drug prices for Medicare for the first time. The final negotiated prices of the first 10 prescription drugs were released in August.

The administration likely won’t meddle too much with Medicare drug price negotiations. But attempts to reign in D2C drug advertising as well as anti-vaccine rhetoric won’t go over well with Big Pharma. We’ll be closely monitoring the confirmations of Trump’s picks for key federal health agencies in early 2025.