Three Medicare fraud schemes in recent weeks have targeted a total $139.4 million, which led the Department of Justice (DoJ) to seek multiple convictions and a combined 33 years in prison...
About 71 percent of uninsured adults aware of open enrollment periods did not enroll in state or federally-based health plans because of apprehension to rising health insurance costs and waning...
A group of five governors developed a bipartisan plan to reform the US healthcare system by using value-based care strategies such as quality reporting, insurance stabilization policies, and...
State and federal evaluations of 1115 Medicaid demonstrations have insufficient data to determine demonstration success because states tend report fragmented program results, according a new GAO...
AHIP supports a number of policy solutions that could reverse Trump Administration actions that have resulted in higher premiums and unstable markets.
In a new policy brief, the payer advocacy group...
CMS is proposing that consumers should be allowed to stay on short-term health plans, including association health plans, for twelve months at a time, despite the fact that these plans are generally...
Idaho will allow payers to offer association health plans (AHPs) that are not required to meet all of the consumer protections or benefits criteria included in the Affordable Care Act.
Governor...
The newly proposed HHS Budget for fiscal year (FY) 2019 says a repeal and replace of the Affordable Care Act (ACA) would save the government trillions, while restructuring Medicare and Medicaid could...
Medicare’s fee-for-service (FFS) cost-sharing design requires modernization to protect beneficiaries from catastrophic costs, but changing the current design may bring new financial concerns, a...
Update on 2/12/2018: Presdient Trump signed the spending bill into effect on Feburary 9th, 2018 which funds the government for two years and extends quality deadlines for Medicare Advantage...
A bill in the Alaska Senate intended to repeal protections around emergency room payments has drawn significant concern from the state’s chapter of the American College of Emergency Physicians...
The Department of Justice’s (DoJ) crackdown on Medicare fraud continued as new investigations led to one provider conviction and two multi-million dollar settlements with provider...
CMS has released the second part of its proposed Medicare Advantage (MA) and Medicare Part D changes, which include administrative upgrades to assist with combating the nation’s the opioid crisis...
The American Academy of Actuaries released a statement reaffirming its concerns with expanding association health plan (AHPs) availability in light of perceived risks to the individual insurance...
Affordable Care Act (ACA) implementation led to an 11.9-percent decrease in out-of-pocket spending but also a 12.1-percent increase in premium spending totals, according to a study published in JAMA...
The Department of Veterans Affairs (VA), HHS, and CMS agreed to participate in a healthcare fraud prevention partnership that leverages data sharing to identify fraud and abuse within healthcare...
A number of healthcare stakeholders and provider groups have praised bipartisan legislation that re-authorizes CHIP funding for the next six years.
Democratic members of the House and Senate agreed to...
The Government Accountability Office (GAO) has recommended that CMS should collect additional data on Medicare beneficiary opioid risks, including the number of beneficiaries with high-dose opioid...
In order to stabilize in-state insurance markets, stakeholders should consider strategies including reinsurance, Medicaid-sponsored health plans, and high-risk pools, according to the AHA.
Several...
Home and community-based services (HCBS) programs funded by Medicaid require additional protections from possible financial conflicts of interest, a new GAO report found.
Program assessors, including...
