Since the Biden administration has eliminated the ability to deny coronavirus testing claims due to “medical necessity,” payers should expect higher coronavirus testing rates across all...
Congress passed a $1.9 trillion relief package to support the nation’s coronavirus pandemic response efforts and the law could have particular significance for Medicaid and CHIP programs.
The...
CMS will be offering $2.3 million in additional navigator funding for grantees in light of the special enrollment period, the agency announced by email.
“President Biden has made clear that...
The special enrollment period on the Affordable Care Act marketplace opened to boost healthcare coverage during the coronavirus pandemic, but familiar barriers—namely, cost—could still...
Given the positive social determinants of health impacts that Medicaid managed care organizations have achieved in Medicaid programs, policymakers should offer them greater flexibility to maximize that...
Opponents of expanding the Affordable Care Act’s premium tax credit policy have argued that doing so would have a negative effect on employer-sponsored insurance, but recent research from the...
All Americans should have healthcare coverage and six steps can make universal coverage a reality, according to several significant healthcare organizations and entities including America’s...
The Biden administration has reversed CMS policy on Medicaid work requirements, according to letters the agency sent to multiple Medicaid programs.
In a letter to Wisconsin’s Medicaid director...
The Department of Justice has backed down from its opposition to the Affordable Care Act, a letter from the Department of Justice to the Supreme Court announced.
“Following the change in...
An Anti-Kickback and False Claims Act lawsuit against Humana and Roche Diagnostics Corp. and Roche Diabetes Care, Inc. (Roche) has finally come to a close, Sanford Heisler Sharp, LLP announced.
The...
The impacts related to the No Surprises Act—which Congress included in the Consolidated Appropriations Act in order to address surprise billing—remain unclear, a Kaiser Family Foundation...
Major payer organizations, specifically America’s Health Insurance Plans (AHIP) and the Association for Community Health Plans (ACAP), are calling for a reversal on key Trump healthcare...
The recent executive order from the Biden administration represented a reversal in US healthcare policy that could have major implications for Medicaid and the Affordable Care Act...
The Biden Administration’s coronavirus relief plan seeks to expand healthcare coverage during the pandemic by increasing and extending COBRA and Affordable Care Act premium subsidies and...
CMS has released its final rule for Contract Year 2022 Medicare Advantage and Part D which requires Part D plans to offer a real-time benefits comparison tool.
The agency estimated that the...
CMS has issued a final rule entitled Medicare Coverage of Innovative Technology (MCIT) that aims to accelerate Medicare coverage of technological innovations.
“Government processes have slowed...
Congress has passed a new law that seeks to eliminate surprise billing, particularly surprise bills that result from contract disputes, inaccurate provider directories, and air ambulatory...
Medically underserved areas of the country received higher payments from The Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund. But these funds are likely insufficient for...
Both houses of Congress have voted to repeal an anti-trust exemption in the McCarran-Ferguson Act of 1945 which protects payers from federal competition laws.
The Competitive Health Insurance Reform...
CMS has finalized a rule which promotes private payers and states negotiating value-based purchasing contracts for Medicaid drugs, along with other changes.
The final rule was built upon the Medicaid...