CMS has announced a $26 million cut to funding grants for ACA navigators, from $36 million down to $10 million.
CMS will provide a minimum of $100,000 in each of the states that operate a...
CMS has temporarily withheld $10.4 billion in risk adjustment payments for 654 healthcare payers, citing a ruling in the US District Court of New Mexico that invalidated the agency’s risk...
Vermont’s Department of Financial Regulation (DFR) is planning to implement emergency rules and regulations for association health plans (AHPs) following the Department of Labor’s final...
CMS has released three new reports indicating that the individual health plan and federal exchange markets faltered somewhat in 2017 because of increasing premiums, decreasing competition, and stagnant...
HHS Secretary Alex Azar and Attorney General Jeff Sessions have announced the largest healthcare fraud takedown yet after HHS, the Department of Justice (DOJ), and other law enforcement agencies...
The US District Court for the District of Columbia has blocked Kentucky from implementing work requirements within its 1115 Medicaid waiver demonstration, despite CMS approval of the community...
CMS has approved the nation’s first value-based drug purchasing agreement for Medicaid by allowing Oklahoma’s state program to negotiate supplemental prescription drug rebates based on...
CMS has announced a new set of Medicaid program integrity initiatives that leverage enhanced data sharing, claims auditing, and provider education to reduce the incidence of improper payments and help...
The US Senate Budget Committee has penned a letter to HHS Secretary Alex Azar urging the department to address approximately $89 billion in improper payments within Medicare and Medicaid.
The Senators...
The Department of Labor (DOL) has issued a final rule that expands consumer availability of association health plans (AHPs) starting on September 1, 2018.
The rule comes months after President Trump...
Federal judges in the US Federal Circuit Court of Appeals have issued an opinion stating that healthcare payers, and not HHS, are responsible for the costs of the ACA’s risk corridor...
AHIP and a number of professional societies and provider groups are urging the Trump Administration to enforce key provisions of the the Affordable Care Act after the Department of Justice (DOJ) said...
The Department of Justice (DoJ) has argued against the Affordable Care Act’s essential health benefits (EHBs) and the law’s individual mandate by supporting a lawsuit that argues the...
President Trump signed the Veterans Affairs’ Mission Act into law midweek which will provide over $50 billion in federal investments to privatize a portion of the VA’s healthcare system and...
A state-level court in Maine has forced Governor Paul LePage (R) and the Maine Department of Health and Human Services (DHHS) to uphold a ballot initiative that implements Medicaid expansion under...
The Affordable Care Act’s (ACA) individual mandate spurred greater high-income enrollment in health plans and is a key component of increasing enrollment and stability in the nation’s...
CMS has released new Medicaid scorecards that contain care quality data on a state-by-state basis in order to improve transparency and accountability across the Medicaid program.
CMS Administrator...
The Virginia General Assembly has passed Medicaid expansion as part of a two-year budget bill that could provide coverage to 400,000 newly eligible residents.
The action would make Virginia the 33rd...
The Government Accountability Office (GAO) has appointed five new public policy and healthcare payment experts to the Medicare Payment Advisory Commission (MedPAC).
GAO chief Gene L. Dodaro,...
Minnesota Governor Mark Dayton has signed a bill into law that allows patients and providers to execute overrides on payer step therapy programs for prescription drug treatments in certain clinical...
