Congress has passed a new law that seeks to eliminate surprise billing, particularly surprise bills that result from contract disputes, inaccurate provider directories, and air ambulatory...
Both houses of Congress have voted to repeal an anti-trust exemption in the McCarran-Ferguson Act of 1945 which protects payers from federal competition laws.
The Competitive Health Insurance Reform...
New CMS regulations around Medicaid managed care include several major changes regarding network adequacy, beneficiary protection, quality, and payment, according to the Kaiser Family Foundation...
At 10am EST on November 10, the Supreme Court heard the oral arguments in the California v Texas regarding the Affordable Care Act’s constitutionality.
The case is pivotal as the outcomes could...
On August 14, the Federal Circuit court made two decisions affecting payers which centered around practices meant to lower costs for Affordable Care Act marketplace enrollees: government reimbursement...
Major payers and payer organizations objected to the finalized HHS nondiscrimination rule—Affordable Care Act Section 1557—saying that the rule eliminates much of the specific language in...
The Internal Revenue Service (IRS) has issued guidance extending flexibilities to high deductible health plan (HDHP), employer-sponsored cafeteria plan, and flexible spending arrangement (FSA) plan...
Private payers could issue a total of $2.7 billion in medical loss ratio rebates in 2020, more than double the previous year’s record high of $1.4 billion, according to estimates from the Kaiser...
In an 8-1 decision, the Supreme Court has ruled that the federal government must pay $12 billion to insurers enrolled in the Affordable Care Act’s risk corridor program.
The risk corridor...
Centene has created a support program to assist its network providers with grant writing, small business loan applications, and other key activities.
For more coronavirus updates, visit...
The Families First Coronavirus Response Act, the second relief package for the coronavirus pandemic, passed on March 18 with an overwhelming majority in the House and Senate. The act extends...
Best’s Special Report, which HealthPayerIntelligence obtained by email, has discovered that healthcare payer technological innovations and partnerships often thrive under change and urgency,...
With its new interoperability rule, CMS pushed ahead with the anticipated mandates, which direct payers to provide Patient Access application programming interfaces (APIs) and Provider Directory APIs,...
CMS has released the next phase of the 21st Century Cures Act on interoperability.
The rule, which was expected to be announced at HIMSS20 before the conference was canceled, supports the...
Update 03/03/2020: This article has been updated to include a statement from America’s Health Insurance Plans (AHIP) on the Supreme Court’s decision to review the case.
The Supreme...
The Fifth Circuit Court found the individual mandate to be unconstitutional but sidestepped making a decision on the rest of the Affordable Care Act (ACA).
“The law has been a focal point of our...
Reinsurance programs reduced premiums by 16.9 percent, on average, in the first year of program enactment relative to estimated premiums without reinsurance, according to a continuing Avalere analysis....
When the House Committee on Energy and Commerce brought in CMS Administrator Seema Verma to testify regarding the White House’s attempts to repeal the Affordable Care Act, the hearing covered...
Colorado officials said that the state’s public option plan would save Coloradans 9 to 18 percent or more on monthly premiums, but payers and providers have concerns.
The state released a draft...
To resolve the lack of dental health plan coverage available for Medicare enrollees, the Kaiser Family Foundation (KFF) outlined five ways to improve seniors’ dental health plan...