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...
CMS has finalized a rule which promotes private payers and states negotiating value-based purchasing contracts for Medicaid drugs, along with other changes.
The final rule was built upon the Medicaid...
The American Benefits Council (ABC) issued a release outlining what payers should expect legislatively post-election including COVID-19 relief and stimulus legislation, Affordable Care Act expansion,...
As the 116th Congress comes to a close, America’s Health Insurance Plans (AHIP) and Blue Cross Blue Shield Association (BCBSA) urged legislators to provide COVID-19 relief, calling for access to...
CMS has issued a final rule to regulate the Affordable Care Act risk adjustment data validation program.
The risk adjustment data validation program, run by HHS, certifies the integrity of data that...
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...
The Department of Health and Human Services has released its finalized rebate rule which changes safe harbors around prescription drug pricing, impacting Medicare Part D plans and certain Medicaid...
Coronavirus vaccine coverage is a complex subject, as it spans multiple patient populations that typically receive vaccine coverage in different ways, a Kaiser Family Foundation brief elucidated.
As...
States that did not opt into Medicaid expansion under the Affordable Care Act (ACA) experienced worse emergency access to acute care hospitals compared to states that did, according to recent...
As the Supreme Court deliberates the fate of the Affordable Care Act after hearing the oral arguments, payers and the public alike are processing the court case and its implications for the healthcare...
America’s Health Insurance Plans (AHIP) has come forth with critique of the price transparency final rule, saying that it will drive healthcare prices up and decrease industry competition.
The...
Medicare Advantage proposed policy changes may result in a 2.82 percent average change in revenue and 4.55 percent change in growth, projected the CMS calendar year (CY) 2022 Medicare Advantage and...
CMS has released the final rule for price transparency in healthcare coverage, which aims to allow the public to have greater insight into healthcare costs in order to increase value.
“This...
CommonWell Health Alliance announced that it is expanding its interoperability services, a move which could support payers struggling with interoperability compliance related to the new CMS...
CMS has approved a Section 1332 demonstration for Georgia which, in part, moves the individual market to a private sector platform.
“I’m thrilled to support this comprehensive state-led...
Update 11/5/2020: This article has been corrected to state that the Supreme Court will hear the oral arguments regarding the Affordable Care Act’s constitutionality on November 10, 2020. A...
Beneficiaries suffer from chronic confusion over Medicare enrollment but policymakers can take action to streamline the process and improve beneficiary experience, Better Medicare Alliance asserted in...
Since the passing of late Supreme Court Justice Ruth Bader Ginsburg, many have questioned whether the Affordable Care Act is at risk of being overturned, a potentiality that would be extremely...
Update 11/5/2020: This article has been corrected to state that the Supreme Court will hear the oral arguments regarding the Affordable Care Act’s constitutionality on November 10, 2020. A...
Temporary Medicaid coronavirus flexibilities and funding may be about to expire and CMS needs to be clearer about transition guidelines in order to help states be prepared, Kaiser Family Foundation...
