As home healthcare becomes more common, payers pursuing value-based care arrangements with home healthcare providers will need to establish strong home healthcare quality measurements.
The coronavirus...
A significant amount of Navigator grant funding is available for Navigator organizations to help employ more individuals to guide Americans through the 2022 plan year, CMS announced.
“Our local...
Unvaccinated COVID-19 hospitalizations cost payers and the healthcare system at large billions in healthcare spending, according to a Peterson-Kaiser Family Foundation (KFF) Health System Tracker...
CMS has requested that Medicare Advantage organizations relax or waive prior authorizations due to the impact of the coronavirus Delta variant.
“The ability of hospitals to transfer patients to...
CMS announced that Colorado’s state innovation waiver which introduced a state-based reinsurance program has successfully lowered average premiums and, as a result, received approval for a...
CMS has announced that immunocompromised individuals will receive the coronavirus booster shot without cost-sharing.
On August 12, 2021, the Food and Drug Administration (FDA) recommended a booster...
The National Association of Medicaid Directors (NAMD) is recommending that CMS approve Medicare coverage for Alzheimer’s disease therapies.
“The outcome of Medicare’s coverage...
States have an opportunity to use the increased federal matching for Medicaid home and community-based services (HCBS) to accelerate coronavirus vaccination uptake, a Kaiser Family Foundation (KFF)...
The way to determine the quality of a Medicare Advantage health plan is simple: look at the five-star rating on the Medicare website. However, the Medicare Advantage Star Rating methodology that...
Healthcare costs have declined for consumers during the special enrollment period, largely due to the American Rescue Plan Act (ARPA) subsidies, according to new data from CMS.
The Biden...
Gathering social determinants of health data continues to be a challenge for Medicare Advantage health plans, according to a report that NORC at the University of Chicago (NORC) compiled for Better...
CMS estimates that the average monthly premium for Medicare Part D coverage will increase in 2022.
“Driving down prescription drug costs remains a priority for the Biden-Harris...
CMS and the Department of Health and Human Services (HHS) are urging all states to take steps to ensure that immigrants who are eligible for Medicaid are aware of their eligibility.
“As...
Behavioral healthcare parity compliance has been complicated due to disparate strategies and data collection challenges, particularly around non-quantitative treatment limitations, a recent MACPAC...
CMS is leading a new campaign to boost the number of Americans who sign up for health insurance on the federal insurance marketplace during the special enrollment period.
The Biden administration and...
CMS has started a national coverage determination analysis and will establish Medicare coverage policies for the new Alzheimer’s drug, aducanumab.
Aducanumab is a monoclonal antibody that...
The Alliance of Community Health Plans (ACHP) has asked CMS to reassess surprise billing, cost transparency, and interoperability compliance deadlines and health data exchange policies that are putting...
The state of Oklahoma’s Medicaid expansion has improved access to coverage for its residents, CMS announced.
"Medicaid is a lifeline for millions of people in this country and a step in the long...
In its latest proposed update to the 2022 Payment Parameters, CMS has suggested steps to expanding access to coverage through the Affordable Care Act marketplace, steps which would impact the Navigator...
Payers may be prepared to comply with the interoperability rule for the July 1 deadline, but are they ready to adopt healthcare interoperability long-term?
For the past couple of years, CMS has pushed the industry to take bigger steps...
