Policy & Regulation

CMS Proposed Rule Addresses Drug Cost Transparency in Medicaid

by Victoria Bailey

The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that aims to increase the transparency of prescription drug costs in Medicaid. “This proposed rule prioritizes...

The History of Medicare Advantage: From Inception to Growing Popularity

by Victoria Bailey

Medicare Advantage’s popularity continues to grow in 2023 as enrollment figures and plan options increase. The private program has received mixed reviews from healthcare stakeholders, with members generally reporting high plan...

1.7M Beneficiaries May Lose Coverage Under Medicaid Work Requirements

by Victoria Bailey

Around 1.7 million Medicaid beneficiaries could potentially lose coverage and $10.3 billion in spending would shift from federal to state governments if Medicaid work requirements were implemented, an...

CMS Proposes Transparency, Access Standards for Medicaid Managed Care

by Victoria Bailey

The Centers for Medicare and Medicaid Services (CMS) has released two proposed rules that would establish national access standards for Medicaid managed care plans and increase transparency of Medicaid...

Medicaid Work Requirements Could Disrupt Coverage Access for 21M People

by Victoria Bailey

Around 21 million Americans could face barriers to health insurance coverage if Congress passes the debt ceiling bill that includes Medicaid work requirements, according to an analysis from the US...

Medicaid Waivers Reduced Disenrollment Among Autistic Adolescents

by Victoria Bailey

Medicaid waivers that focus on individuals with autism spectrum disorder (ASD) can help reduce disenrollment rates among autistic adolescents, a study published in JAMA Network Open found. Autistic...

60% of Privately Insured Patients Utilized Some ACA Preventive Care

by Sarai Rodriguez

Researchers from the Peterson-Kaiser Family Foundation (KFF) Health System Tracker discovered that in 2018, nearly 100 million privately insured Americans, or 6 out of 10, utilized some of the...

How Massachusetts’ Benchmark Impacted Healthcare Cost Growth

by Victoria Bailey

Massachusetts’ statewide benchmark for healthcare cost growth has generally helped curb increases in healthcare spending, but its influence has dwindled over time due to poor accountability...

CMS Issues Over-the-Counter Coronavirus Testing Guidance

by Kelsey Waddill

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...