By allowing the HHS to negotiate drug prices tied to international standards, Title I of the Lower Drug Costs Now Act of 2019 (HR-3) would save the federal government $345 billion from 2023 to 2029,...
Update 10/11/2019: This article has been updated to include a statement from the Michigan Association of Health Plans.
Michigan is the latest among state Medicaid programs to back away from...
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...
If the Affordable Care Act (ACA) was not in effect in 2018, 45 percent of families would have one non-elderly adult with a pre-existing condition for which they might be declined from healthcare...
On Thursday, President Trump issued the Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors that will authorize the Department of Health & Human Services to expand...
Out-of-network specialty visits in California may have declined by 17 percent since implementing AB 72, California’s surprise billing law, a study by the University of Southern...
The health insurance tax, mandated in the Affordable Care Act, will be back in effect in 2020 and is set to generate $15.5 billion in taxes due to CMS’s new 2020 payment rule.
“This new...
America’s Health Insurance Plans (AHIP) and Blue Cross Blue Shield Association (BCBSA) joined together to defend prior authorizations in a statement submitted to the Committee on Small...
The Orphan Drug Act no longer serves its original purpose but instead increases prescription drug spending and healthcare spending, American’s Health Insurance Plans (AHIP) stated in a recent...
In 2018, 8.5 percent of the nation did not have health insurance coverage at any point during the year, the Census Bureau’s report revealed, arguably the first rise in the uninsurance rate since...
A CMS rule expands its ability to revoke or deny providers’ position serving in federal networks in an effort to combat fraud in Medicare, Medicaid, and CHIP.
“The provisions we are...
America’s Health Insurance Plans (AHIP) discouraged CMS from finalizing the risk adjustment data validation (RADV) changes suggested in the agency’s Notice of Proposed Rulemaking (NPRM)...
Plans on the federal health insurance exchange will publicly display quality ratings on a five-star system in plan year (PY) 2020, CMS announced. The quality ratings will be available for the 2020 open...
Indiana submitted an application for an amendment to the state’s Healthy Indiana Plan Section 1115 Demonstration that would help transition members off of the HIP and into commercial coverage....
CMS finalized a decision to provide Medicare coverage for chimeric antigen receptor (CAR) T-cell therapy, which is an FDA-approved gene therapy used to treat non-Hodgkin lymphoma and B-cell precursor...
The Senate Finance Committee has passed the Prescription Drug Pricing Reduction Act (PDPRA), a bipartisan piece of legislation that checks pharmacy benefit managers’ practices of overpayment and...
Federal Judge Richard J. Leon recently ruled in favor of an HHS final rule issued in August 2018 that made short-term health plans renewable for up to 36 months.
Short-term, limited-duration health...
CMS recently proposed five alternative payment models for chronic kidney disease (CKD) treatments.
One model is mandatory and the others are optional. All of the models are in response to the...
Yesterday, CMS announced a proposed rule that would cut down the regulatory burden for long-term care (LTC) facilities and released a finalized rule which updated the requirements for nursing home...
CMS recently released new state relief and empowerment waiver resources for states to use as they stabilize their insurance markets through reinsurance and other methods.
“While states have...
