HHS

HHS extends special enrollment period for former Medicaid beneficiaries

April 2, 2024 - HHS has extended the temporary special enrollment period to facilitate marketplace enrollment for beneficiaries who lost Medicaid or Children’s Health Insurance Program (CHIP) coverage following eligibility renewals. The Medicaid continuous coverage policy ended on March 31, 2023, and states could resume eligibility determinations on April 1,...

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CMS chops short-term, limited duration plan length to 4 months

by Kelsey Waddill

The Biden administration has reduced the timeframe of short-term limited duration insurance plans, also known as “STLDI” or “junk” plans, in an effort to curb underinsurance,...

CMS final rule aims to simplify Medicaid, CHIP enrollment, coverage

by Kelsey Waddill

A new CMS final rule, the “Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal...

HHS, payers meet to address Change Healthcare cyberattack response

by Kelsey Waddill

Officials from the Department of Health and Human Services (HHS) met with 15 health insurance companies, including major payers and organizations like UnitedHealth Group, Elevance Health, and...

HHS Will Provide Technical Assistance to States Addressing Homelessness

by Victoria Bailey

The Department of Health and Human Services (HHS) and the Department of Housing and Urban Development (HUD) are increasing access to federal programs and resources that address homelessness in eight...

HHS Seeks Stakeholder Input to Improve Medicare Advantage Transparency

by Victoria Bailey

HHS has issued a request for information (RFI) to help improve data-sharing and transparency in the Medicare Advantage. Over half of all Medicare beneficiaries are enrolled in Medicare Advantage,...

Elevance Health Lawsuit Slams Medicare Advantage Star Ratings Calculation

by Victoria Bailey

Elevance Health has filed a lawsuit against the Department of Health and Human Services (HHS), alleging its methodology for determining Medicare Advantage star ratings is unlawful. The payer and its...

Key Regulations and Policies That Will Impact Payers in 2024

by Victoria Bailey

As healthcare stakeholders and the federal government work to make healthcare more accessible and affordable for consumers, CMS and HHS are frequently introducing and finalizing new rules and regulations. There were a couple of key...

ACA Marketplace Enrollment Up By 33%, Surpassing 19M Enrollees

by Victoria Bailey

More than 19 million people have enrolled in Affordable Care Act (ACA) marketplace plans for 2024 coverage, HHS announced. This figure reflects enrollment data as of December 15, 2023, for states...

HHS Urges States to Reduce Medicaid, CHIP Child Disenrollments

by Victoria Bailey

The Department of Health and Human Services (HHS) is urging states to employ federal strategies to help reduce child disenrollments from Medicaid and the Children’s Health Insurance Program...

HHS Patient Assistance Program Aims To Boost Access to COVID-19 Drug

by Kelsey Waddill

The Department of Health and Human Services (HHS) will ensure access to a coronavirus therapy from Pfizer for Medicare and Medicaid beneficiaries and the uninsured through a patient assistance program,...

Who is Challenging the Medicare Drug Price Negotiation Rule?

by Victoria Bailey

The Medicare drug price negotiation provisions in the Inflation Reduction Act hold promising spending reductions for beneficiaries, but drug companies are not backing down without a fight. In August...

CMS Orders States to Provide Continuous Coverage for Kids in Medicaid, CHIP

by Victoria Bailey

CMS is reminding state health officials of the upcoming continuous coverage requirements for children in Medicaid and the Children’s Health Insurance Program (CHIP). Provisions in the...

HHS Releases First 10 Drugs Eligible for Medicare Price Negotiation

by Victoria Bailey

Updated 10/3/2023: This article has been updated to include the drug companies' decisions to participate in the negotiation process. HHS has announced the first ten drugs that will be available...

HHS Attributes Record Low Uninsurance Rate to ACA Enrollment

by Mark Melchionna

Following the Affordable Care Act (ACA) open enrollment period that concluded in January 2023, the United States Department of Health and Human Services (HHS) reported that uninsurance among American...

HHS Proposed Rule Aims to Distinguish STLDI from Comprehensive Plans

by Kelsey Waddill

The Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury have released a notice of proposed rulemaking that applies to short-term, limited-duration...

New York Extends Medicaid Postpartum Coverage to 12 Months After Birth

by Victoria Bailey

New York has extended Medicaid postpartum coverage, marking the 35th state that will provide comprehensive coverage to individuals for 12 months after pregnancy, HHS and CMS announced. “New...

Health Plans Must Continue Covering Preventive Care Services

by Victoria Bailey

A federal appeals court approved an agreement between parties in Braidwood Management v Becerra, preserving the mandate requiring health plans to cover preventive care services based on recommendations...

Lawmakers Request More Info on Medicaid Redetermination Compliance

by Victoria Bailey

Lawmakers are calling on CMS and HHS to provide additional information on Medicaid redetermination standards following early reports of disenrollments due to administrative issues. In a letter to HHS...

Biden Admin Increases Access to School-Based Mental Health Services

by Victoria Bailey

The Biden-Harris Administration has announced three initiatives to increase access to school-based mental health services for children with Medicaid. “We are taking bold actions to strengthen...

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