The US Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), has approved a section 1115 demonstration in California to help improve access to...
Under a newly proposed rule, the Biden administration would remove the moral exemption for health plan coverage of birth control while keeping the religious exemption intact, a fact sheet from the US...
The US Department of Health and Human Services (HHS) has released a final rule that aims to introduce more oversight into the Medicare Advantage risk adjustment data validation and payment...
CMS announced that there will be a special enrollment period on the Affordable Care Act marketplace for individuals who lose their Medicaid coverage due to the public health emergency...
Affordable Care Act marketplace enrollment broke the previous all-time high by surpassing 16.3 million signups for the 2023 plan year, CMS and the Department of Health and Human Services (HHS)...
The US Preventive Services Task Force (USPSTF) released a list of its top preventive care recommendations that were finalized in 2022.
The list is not comprehensive. Rather, USPSTF named the...
In accordance with the Inflation Reduction Act, the US Department of Health and Human Services (HHS) announced that Medicare will begin drug price negotiations for prices going into effect in 2026 and...
Nearly 16 million people have enrolled in Affordable Care Act (ACA) marketplace plans since the 2023 marketplace open enrollment period began, including 3.1 million new enrollees and 12.8 million...
The US Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), has expanded access to specialty behavioral healthcare for Medicaid and...
The Department of Health and Human Services (HHS) and CMS released guidance for state Medicaid programs’ in lieu of services or settings (ILOS) to improve the quality of Medicaid social...
More than 150 million people receive health insurance through public programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), according to the latest enrollment...
The dual eligible market is changing, creating new challenges and opportunities that health plans should take into account when considering entering the market, experts from Manatt Health found in a...
Better Medicare Alliance (BMA) has called on CMS to improve the Medicare Advantage program by auditing all health plans annually, creating best practices for in-home health risk assessments, and...
Nine safety net health plans that are part of the Association for Community Affiliated Plans (ACAP) announced they would include the CMS birthing-friendly hospital designation in their provider...
The Biden administration has released its 2024 Notice of Benefit and Payment Parameters Proposed Rule which focused on streamlining Affordable Care Act health plan selection, simplifying Affordable...
Payer and provider organizations are responding positively to the CMS proposed rule that would change the prior authorization process to better support electronic prior authorization.
“CMS is...
The CMS proposed rule to streamline the Medicaid eligibility process could potentially prevent coverage losses for around a third of dual eligible beneficiaries, according to data from the Kaiser...
The ERISA Industry Committee (ERIC), a nonprofit that represents the largest employers who are sponsors of employer sponsored health plans, responded to the request for information on the advanced...
The Alliance of Community Health Plans (ACHP) had five recommendations for CMS regarding how to streamline processes in Medicaid, Children’s Health Insurance Program (CHIP), and the Basic Health...
After receiving evidence of deceptive marketing practices by Medicare Advantage plans, the Senate Finance Committee has offered recommendations to CMS for reducing marketing complaints and preventing...
