CMS

Biden Plan Expands COVID-19 Testing Coverage, Booster Outreach

by Victoria Bailey

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...

Medicaid Will Cover Coronavirus Vaccine Counseling for Kids

by Kelsey Waddill

State Medicaid programs must cover coronavirus vaccine counseling for children as well as vaccine counseling for all pediatric vaccines for eligible beneficiaries, CMS announced. “By supporting...

CMS: Virginia Will Expand Access to Postpartum Medicaid Coverage

by Kelsey Waddill

CMS announced that Virginia is expanding its postpartum Medicaid coverage. “It is a privilege to partner with the Commonwealth of Virginia to expand access to life-saving postpartum coverage and...

ACA 2022 Open Enrollment Starts Off With 133K New Enrollees

by Kelsey Waddill

After Affordable Care Act marketplace 2022 open enrollment launched on November 1, 2021, CMS reported that the first week ended with 773,557 plan selections. Of those nearly 774,000 plan selections on...

CMS Shares Affordable Care Act Marketplace Open Enrollment Details

by Kelsey Waddill

With the Affordable Care Act marketplace open enrollment season around the corner, CMS has announced changes to its outreach and enrollment processes in a marketplace 2022 open enrollment fact...

CMMI Aims to Lower Out-of-Pocket Healthcare Spending by 2030

by Kelsey Waddill

Updated 11/1/2021: This article has been updated to refer to the Centers for Medicare & Medicaid Services Innovation Center (CMMI) as a singular center. A previous version referred to...

CO Will Add LGBTQ+ Care As Marketplace Essential Health Benefit

by Kelsey Waddill

Updated 10/13/21: This article has been updated to include a statement from Andy Marra, executive director of the Transgender Legal Defense & Education Fund (TLDEF). Colorado has received...

Expanding Social Determinants of Health Benefits Among Public Payers

by Kelsey Waddill

HHS needs to expand the list of social determinants of health that public payers can cover and hold public payers accountable to covering preventive services that can help address social determinants...

ACHP: 5 Policy Recommendations about COVID-19 Testing Coverage

by Kelsey Waddill

The Alliance of Community Health Plans (ACHP) has issued five recommendations to CMS regarding COVID-19 testing coverage. “As Americans return to their workplace, children return to in-person...

CMS: KY, ME, NM Will Launch State-Based Marketplaces in 2022

by Kelsey Waddill

Three states will launch their own state-based marketplaces in 2022, the Department of Health and Human Services (HHS) announced through CMS. Kentucky, Maine, and New Mexico will each bring have their...

275K Missourians Eligible for Coverage Following Medicaid Expansion

by Victoria Bailey

Following Missouri’s approval for Medicaid expansion, more than 275,000 individuals are eligible for healthcare coverage, CMS reported. Missouri will receive around $968 million from the...

2022 Medicare Advantage Premiums Drop, Enrollment May Rise

by Kelsey Waddill

Updated 9/30/21: This article has been updated to include a correction from Better Medicare Alliance. A previous version read "we urge lawmakers to project these gains," but this has been...

Uninsured Adults Remain Unaware of ACA Coverage, Subsidy Options

by Kelsey Waddill

Despite the White House’s efforts to increase awareness about Affordable Care Act marketplace health plans, uninsured adults are still largely unaware of their coverage options, according to...

OIG: Medicare Advantage Plans Improperly Used Chart Reviews, HRAs

by Victoria Bailey

Some Medicare Advantage plans may have improperly used chart reviews and health risk assessments to maximize risk-adjusted payments from CMS, a report from the Office of Inspector General...

CMS Makes Changes to Open Enrollment Period, Introduces New SEP

by Victoria Bailey

CMS has taken several steps to improve and expand access to healthcare coverage, including extending the open enrollment period for the Affordable Care Act marketplace. The agency added 30 days to the...

CMS Retreats from 2022 Payer-to-Payer Data Exchange Enforcement

by Kelsey Waddill

Updated 9/20/21: This article has been updated to include comments from Alexander Dworkowitz, partner at Manatt Health. CMS announced in its interoperability guidance that it would not be...

Affordable Care Act Marketplace Sees Boost in Diversity, Savings

by Kelsey Waddill

HHS has announced that 2.8 million people gained health insurance coverage through the Affordable Care Act marketplace during the special enrollment period. This influx of enrollees raised marketplace...

CMS Guidance Promotes COVID-19 Vaccine Coverage, Medicaid Expansion

by Victoria Bailey

The Biden Administration and CMS have released guidelines that detail federal funding information relating to Medicaid expansion and COVID-19 testing and vaccine administration for Medicaid and...

How States Leveraged COVID-19 Medicaid Emergency Authorizations

by Kelsey Waddill

COVID-19 Medicaid emergency authorization usage has differed most from past crises in regards to states’ utilization of Section 1115 demonstration waivers, according to a Kaiser Family Foundation...