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UNDERREPORTED

Trump administration moves to slash Medicare double-billing fees for seniors

The White House is set to cut Medicare evaluation-and-management payments by half for same-day exams and procedures, aiming to reduce overall program costs.

President Donald Trump and Health Secretary Dr. Mehmet Oz are advancing a rule that will reduce Medicare’s evaluation-and-management reimbursement by half when a distinct procedure occurs on the same day. Currently, physicians can charge seniors twice for the same exam, a practice highlighted by a recent HHS Office of the Inspector General audit showing 42% of beneficiaries were double-billed for intravitreal injections.

The regulation, expected to take effect in January, will primarily affect states like California and Florida, which together cover about 10 million Medicare recipients. While the administration argues the change will curb unnecessary spending, the American Hospital Association and other provider groups contend it may lead to fragmented care and reduced access. CMS is reviewing public comments submitted through mid-September before finalizing the rule.

Why it matters

The rule could lower Medicare spending but also reshape how seniors receive same-day medical services.

In this story

Medicaredouble billingevaluation and management feesame-day examhealthcare cost reductionCMS rulehospital association opposition
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