Payer organizations such as AHIP and the Alliance for Community Health Plans (ACHP) have raised some concerns in their comments on the advance notice of methodological changes for Medicare Advantage...
Medicare beneficiaries are experiencing healthcare affordability challenges in 2022 due to Medicare Part B premiums and inflation, according to a MedicarePlans.com survey.
Pollfish surveyed 1,250...
Chronic diseases are on the rise in the United States, leaving healthcare payers with the challenge of covering care for patients with these expensive, long-term conditions.
Chronic diseases are such...
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...
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...
More than 340 members of the US House of Representatives have penned a letter to CMS asking the agency to continue to uphold Medicare Advantage benefits, including stable premium rates and supplemental...
The uninsurance rate in 2021 fell below pre-pandemic levels, according to a report from the Assistant Secretary for Planning and Evaluation’s (ASPE) Office of Health Policy. CMS followed up by...
CMS and HHS have announced that the Affordable Care Act marketplace gained 5.8 million new enrollees in the 2022 open enrollment season, contributing to a record-breaking 14.5 million...
In a sample of online retailers, only a fraction of the at-home COVID-19 testing opportunities were available the week before CMS announced the new at-home COVID-19 test coverage requirements for...
Payers are reacting to the CMS proposed Medicare coverage determination for Alzheimer’s treatments that use monoclonal antibodies directed at amyloid, such as Biogen’s...
Updated 1/12/2022: This article has been updated to correct the drug price for Aduhelm. The article previously cited the drug price as the original price, which was $56,000. However,...
Updated 1/11/2022: This article has been updated to include comments from leaders at the Alliance of Community Health Plans (ACHP).
Health insurers will be responsible for the costs of at-home...
CMS released the calendar year 2023 Medicare Advantage and Part D proposed rule which aims to improve network adequacy, elucidate medical loss ratio reporting, open the possibility of assigning star...
The Department of Health and Human Services (HHS) announced the Notice of Benefit and Payment Parameters 2023 proposed rule for the Affordable Care Act marketplace and released Medicaid waiver...
In a letter to CMS, the Alliance of Community Health Plans (ACHP) has requested that the federal government establish certain requirements for at-home COVID-19 testing coverage.
“We support the...
Better Medicare Alliance (BMA) has penned a letter to CMS detailing a number of Medicare Advantage policy recommendations regarding Medicare Advantage benefits and care coordination, health equity, and...
As the weather gets colder and the Omicron variant of the coronavirus emerges in the United States, the Biden administration has released an action plan that included steps to expand COVID-19 testing...
