AHIP and the Blue Cross Blue Shield Association (BCBSA) have filed amicus briefs that support the Department of Health and Human Services (HHS) in the surprise billing lawsuit raised by the Texas...
A handful of the largest private payers are evenly split regarding whether they provide direct coverage for at-home COVID-19 testing, according to the Kaiser Family Foundation (KFF) which assessed both...
Payers are reacting to the CMS proposed Medicare coverage determination for Alzheimer’s treatments that use monoclonal antibodies directed at amyloid, such as Biogen’s...
Updated 1/11/2022: This article has been updated to include comments from leaders at the Alliance of Community Health Plans (ACHP).
Health insurers will be responsible for the costs of at-home...
CMS released the calendar year 2023 Medicare Advantage and Part D proposed rule which aims to improve network adequacy, elucidate medical loss ratio reporting, open the possibility of assigning star...
The Department of Health and Human Services (HHS) announced the Notice of Benefit and Payment Parameters 2023 proposed rule for the Affordable Care Act marketplace and released Medicaid waiver...
The drug inflation rebate provision included in the Build Back Better Act could lead to a $111 billion reduction in employer-sponsored health plan premiums between 2022 and 2031, according to an Urban...
As the weather gets colder and the Omicron variant of the coronavirus emerges in the United States, the Biden administration has released an action plan that included steps to expand COVID-19 testing...
Updated 11/22/21: This article has been updated to include a statement from AHIP.
Payers and stakeholder organizations have had mixed reactions to the Build Back Better Act, which passed in the...
CMS announced that Virginia is expanding its postpartum Medicaid coverage.
“It is a privilege to partner with the Commonwealth of Virginia to expand access to life-saving postpartum coverage and...
Prescription drug spending in the US drives healthcare spending primarily due to high US drug pricing, not necessarily because of the number of drugs that providers prescribe use, a Commonwealth Fund...
The Build Back Better Act includes measures that aim to reduce Medicare Part D drug spending and bolster the ability for both Medicare Part D plans and potentially private payers to control drug...
The Biden administration has issued an interim final rule that requires group and individual health insurance market plans to send data related to prescription drug spending of both patients and their...
Health Insurance Innovations, a short-term insurance policy under Health Plan Intermediaries Holdings, LLC, will pay $625,000 to settle allegations that the payer engaged in deceptive and illegal...
Updated 9/20/21: This article has been updated to include comments from Alexander Dworkowitz, partner at Manatt Health.
CMS announced in its interoperability guidance that it would not be...
Updated 9/13/21: This article has been updated to reflect that AHIP has taken a stance regarding the potential outcomes if the proposed policy passes. A previous version of the article incorrectly...
The low- and middle-income communities’ shifts in uninsurance rates differed largely based on the state’s Medicaid expansion status, a Robert Wood Johnson Foundation and Urban Institute...
Purchaser Business Group on Health (PBGH) supported President Joe Biden’s plan to allow Medicare to negotiate drug prices.
“The truth is high drug costs are perpetuated by all parties...
The Alliance of Community Health Plans (ACHP) voiced its support for the Quality Payment Relief Act, which the organization argued would correct the use of Medicare Advantage benchmark caps and enable...
The American Rescue Plan Act (ARPA) supported New Yorkers who lost their employer-sponsored health plan coverage during the pandemic in three ways, according to a United Hospital Fund (UHF) issue...
