AHIP is urging CMS to consider the potential adverse impacts of its proposed rule for Medicare Advantage policy and technical changes, specifically raising concerns about the star rating changes, new...
The Department of Health and Human Services (HHS) has released three models intended to bring down prescription drug spending for consumers in Medicare and Medicaid.
“These selected models will...
Medicaid managed care organizations have a key role to play in the public health unwinding, a Kaiser Family Foundation (KFF) brief found.
The brief’s findings are based on two study components:...
Non-group qualified health plans (QHPs) on the Affordable Care Act (ACA) marketplace denied, on average, almost 17 percent of in-network claims in 2021, according to an issue brief from the Kaiser...
Enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) has increased by 20.2 million beneficiaries since the start of the COVID-19 pandemic, according to an analysis from the...
Medicare Advantage plans denied 2 million prior authorization requests in 2021 and just 11 percent of those requests were appealed, according to an issue brief from the Kaiser Family Foundation...
CMS released the 2024 Medicare Advantage Advance Notice with changes for Medicare Advantage plans and Medicare Part D, stirring up concerns among some large payer organizations.
“Medicare...
Nearly all Medicare Advantage plans offered supplemental benefits in 2022, but CMS received limited encounter data from the plans, a report from the Government Accountability Office (GAO) found.
GAO...
The US Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), has approved a section 1115 demonstration in California to help improve access to...
The US Department of Health and Human Services (HHS) has released a final rule that aims to introduce more oversight into the Medicare Advantage risk adjustment data validation and payment...
CMS announced that there will be a special enrollment period on the Affordable Care Act marketplace for individuals who lose their Medicaid coverage due to the public health emergency...
Almost two-thirds of beneficiaries were uninsured for part or all of the year following disenrollment from Medicaid or the Children’s Health Insurance Program (CHIP), an issue brief from the...
Medicaid expansion was associated with a reduction in postpartum hospitalizations during the first six months after delivery, according to a Health Affairs study.
Federal policy requires Medicaid to...
Affordable Care Act marketplace enrollment broke the previous all-time high by surpassing 16.3 million signups for the 2023 plan year, CMS and the Department of Health and Human Services (HHS)...
The Federal Communications Commission (FCC) has issued guidance allowing federal and state governmental agencies to send automated calls and text messages providing individuals with information about...
The Affordable Care Act marketplace premium tax credits were introduced in 2010 and continue to play an integral role in US health insurance.
A Google search on premium tax credits will demonstrate...
The Patient Protection and Affordable Care Act (ACA) helped boost health insurance coverage for individuals with schizophrenia, according to data published in JAMA Psychiatry.
Between 0.25 percent and...
Around 8 million people gained health insurance coverage during the second year of the COVID-19 pandemic, primarily due to increased access to public coverage, a Health Affairs study found.
Temporary...
Medicaid expansion was associated with reductions in county-level eviction judgments and eviction rates, but results varied across states, according to a study published in JAMA Network Open.
In 2020,...
The US non-senior uninsurance rate declined from 11.1 percent in 2019 to 10.5 percent in 2021, with low-income and historically underserved demographics seeing the highest growth in health insurance...
