Applying an out-of-pocket spending cap to Medicare Part D could be a tool for promoting health equity, according to an insight from Avalere.
Avalere researchers leveraged 2019 Medicare Part D Drug...
AHIP has responded to the latest updates to opioid prescribing guidelines from the Centers for Disease Control and Prevention (CDC).
CDC’s proposed updates to the opioid prescribing guidelines...
CMS has finalized its national coverage determination for monoclonal antibodies directed against amyloid, a new potential treatment for Alzheimer’s disease.
The agency moved forward with its...
The No Surprises Act used a couple of methods to reduce surprise billing, though the need for some modifications may remain, according to a resource from AHIP.
“The real problem of surprise...
CMS announced an 8.5 percent boost on average to payer revenues next year in the 2023 Medicare Advantage and Part D Rate, according to a CMS press release.
This final rate announcement was higher than...
Uninsured individuals may lose access to free COVID-19 testing, treatment, and vaccines when federal funds and supplies are exhausted, according to an issue brief from the Kaiser Family Foundation...
Transitioning Medicare-Medicaid plans into dual eligible special needs plans may pose challenges that the proposed rule for 2023 Medicare Advantage and Medicare Part D policy and technical changes...
After Congress zeroed out the Affordable Care ACct's individual mandate, the Latino community experienced a rise in uninsurance that coincided with a deterioration in other important quality of...
Major payer organizations are reacting to payer-related aspects of the State of the Union address, including making permanent the American Rescue Plan Act premium subsidies and lowering drug...
In states that have not adopted Medicaid expansion, individuals with HIV have limited access to care, but pending legislation and potential future expansions could change those circumstances, a Kaiser...
CMS has announced that it will expand the eligibility criteria for a national coverage determination for lung cancer screenings.
“Expanding coverage broadens access for lung cancer screening to...
AHIP supported CMS on its national coverage determination for monoclonal antibodies (mAbs) directed against amyloid for treating Alzheimer’s Disease and offered recommendations for clarification...
CMS released guidance around the over-the-counter coronavirus testing requirement, providing greater clarity regarding what kinds of direct-to-consumer access mechanisms fall under compliance and...
AHIP is urging Congress to take action and address the ongoing price gouging of COVID-19 tests that payers are facing from out-of-network providers.
In a statement submitted to the House Committee...
CMS has announced that Medicare will cover over-the-counter coronavirus tests.
Medicare beneficiaries will be able to access free over-the-counter coronavirus tests through covidtests.gov. The tests...
In the 2023 Medicare Advantage and Part D Advance Notice, CMS is requesting comments on the agency’s health equity index which it seeks to introduce into Part D and Medicare Advantage Star...
Healthcare stakeholders are responding to the 2022 Mental Health Parity and Addiction Equity Act (MHPAEA) Report, with the American Medical Association (AMA) releasing a statement saying that this...
Payers are responding to the proposed Notice of Benefit and Payment Parameters for 2023 for the individual health insurance marketplace.
The proposed rule addressed a broad range of issues on the...
Payers have not improved their execution of the mental health parity compliance assessment, the Department of Labor’s Employee Benefits Security Administration (EBSA) recently reported to...
More than 20 percent of consumers have experienced barriers to COVID-19 testing in the last six months, such as struggling to find a test or forgoing a test because there were no testing options...