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Program integrity efforts work to prevent and detect fraud, waste, and abuse, to increase program transparency and accountability, and to recover improperly used funds. This brief explains what is known about improper payments and fraud and abuse in Medicaid and describes ongoing state and federal actions to address program integrity.
As the Trump administration works to dissolve the U.S. Agency for International Development (USAID), a new KFF poll finds that two-thirds (67%) of the public believe these actions will increase illness and death in low-income countries, and a similar majority (62%) believe it will result in more humanitarian crises around the world.
PEPFAR, the U.S. global HIV/AIDS program, is - for the first time in its two-decade history - facing significant challenges that could impede its ability to fulfill its mission. This policy brief provides an overview of recent events and ongoing challenges facing the program.
The Senate Finance Committee’s reconciliation language would reduce existing state-directed payments to hospitals and nursing facilities over time until they are at or slightly above Medicare rates. This analysis identifies states that might have to reduce payment rates for hospitals or nursing facilities if the language is passed into law.
A CMS rule, once finalized, is generally intended to exist permanently or until it is repealed.... This temporary implementation may preserve the potential for the reconciliation bill to generate official savings through changes to ACA marketplaces in later years (2027–2034) if enacted.
This analysis details the number of people who would become uninsured from policy changes in the ACA Marketplaces and Medicaid. The Congressional Budget Office estimates that, taken together, these changes will result in 16 million more uninsured people in the year 2034 than would otherwise be the case.
In his latest column, KFF President and CEO Drew Altman examines the implications of Secretary Kennedy’s reorganization of HHS and why it’s a sharp break from past efforts to reorganize the department.
This brief explains fraud, waste, abuse, and improper payments in Medicare and describes actions to ensure Medicare program integrity.
This brief provides an overview of Medicare spending and financing, based on the most recent historical and projected data from the Medicare Trustees and the Congressional Budget Office (CBO). The brief highlights trends in Medicare spending and key drivers of spending growth, including higher enrollment, growth in health care costs, and increases in payments to Medicare Advantage plans.
In November 2024, CMS finalized a 2.83% decrease in the physician fee schedule conversion factor, a key aspect of payment rates under the Medicare program, resulting in a 2.93% decrease in overall payments to physicians and other clinicians. Congress has not yet enacted legislation to address this payment cut, which went into effect on January 1, 2025. This issue brief answers key questions about how physicians are paid under the Medicare program, and reviews policy options under discussion for payment reform.
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