America’s Health Insurance Plans (AHIP) and Blue Cross Blue Shield Association (BCBSA) have called on Congress to ensure access to coronavirus care and healthcare coverage through federal...
While most Medigap policies did not see much change in Medigap enrollment growth, an increasing number of beneficiaries enrolled in Medigap plans G and N from 2015 through 2018, a report from...
The House of Representatives voted to expand the Affordable Care Act only days after the White House reiterated its resolve to dismantle the Affordable Care Act altogether.
The House of...
Payers have not lived up to their promise to improve the prior authorization process, the American Medical Association (AMA) charged in a recent statement.
In 2018, groups including America’s...
The debate over the usefulness of prior authorizations for value-based contracting is often torn between providers who find the administrative elements burdensome and payers who find the programs...
Experts slightly lowered their estimate for payer COVID-19 healthcare spending to a high of $546.6 billion based in part on adding delayed care savings, a study by Wakely Contracting Group found....
The coronavirus pandemic impacts on the individual health insurance market risk pool and healthcare costs for 2021 are infusing uncertainty into the 2021 rate setting process, America’s Health...
Medicaid managed care plans are innovating telehealth solutions and telehealth coverage, addressing social determinants of health, and improving access to care and informed provider selection for...
America’s Health Insurance Plans (AHIP) teamed with chief medical officers from member health plans to develop a list of principles related to coronavirus care that plans should prioritize as...
The Food and Drug Administration (FDA) and Federal Trade Commission (FTC) can streamline the biosimilar approval process and adopt other strategies to promote biosimilars and lower healthcare spending,...
CMS has finalized its Medicare Advantage and Part D rates, including finalizing the disputed Medicare Advantage end-stage renal disease (ESRD) payment rule without changes.
CMS anticipates a slight...
Despite past conflicts, now more than ever payers and providers are showing support for each other in the face of the growing pandemic.
For more coronavirus updates, visit our resource page,...
CVS Health has eliminated cost-sharing and co-pays for coronavirus-related treatment, the company announced on March 25.
For more coronavirus updates, visit our resource page, updated twice daily...
As governors across the nation order nonessential businesses to close their doors as coronavirus spreads, payers are pushing to be officially recognized as “essential businesses.”
For more...
America’s Health Insurance Plans (AHIP) committed to supporting provider partners, specifically hospitals and health systems, as they combat coronavirus.
For more coronavirus updates, visit...
Reactions to the finalized interoperability rule have fallen predictably along industry lines, as payers and providers spurn the new rules but technology companies warm up to them.
For more...
CMS has released guidance regarding how Medicare Advantage and Part D Plans can properly respond to the COVID-19 outbreak.
For more coronavirus updates, visit our resource page, updated twice...
Managed care organizations are providing Medicaid programs with lower cost prescription drugs, resulting in as much as $6.5 billion in net savings in fiscal year 2018, according to a recent report by...
While payers and Medicare Advantage proponents applauded elements of the Medicare Advantage rule that CMS proposed yesterday which will increase plans’ revenues by nearly one percent, many...
The HHS Transparency in Coverage proposed rule is not an actionable or secure method to achieving price transparency, nor is it an authorized exercise of HHS authority, AHIP argues in its comments on...
