Virginia lawmakers eye insurance coverage for undocumented minors
A Virginia lawmaker has proposed new legislation that would expand health insurance coverage to undocumented residents under the age of 19.
View ArticleThe two-midnight rule and Medicare Advantage: 7 updates
In 2024, Medicare Advantage plans must provide coverage for an inpatient admission when the admitting physician expects the patient to require hospital care for at least two midnights, otherwise known...
View ArticleNebraska lawmakers mull Medicaid coverage of weight loss drugs
Nebraska lawmakers are considering requiring the state's Medicaid program to cover GLP-1 drugs, the Omaha World-Herald reported Feb. 15.
View ArticlePayers urge 'stability' from CMS on Medicare Advantage
CMS needs to do more to account for rising utilization rates in Medicare Advantage, the Better Medicare Alliance argued.
View ArticleFriday Health collapse spurs consumer protection bill in Colorado
Colorado lawmakers are considering a bill that would prevent customers from incurring extra out-of-pocket costs if their insurer goes bankrupt in the middle of the year.
View ArticleSingle payer still a tough sell in California
California legislators are putting a single-payer system back on the table, but it still faces long odds of becoming a reality, the Los Angeles Times reported Feb. 21.
View ArticleMaryland could open ACA exchange to undocumented immigrants
Maryland legislators are considering a bill that would allow people to purchase insurance on Maryland's health insurance exchange, regardless of their immigration status.
View ArticleA 'paradigm shift' in weight loss drug coverage
Wegovy is now approved to be used to reduce the risk of heart attack, stroke and cardiovascular death, which could lead to broader payer coverage of the drug.
View ArticleBiden administration pitches 'Medicaid-like' coverage in nonexpansion states
The Biden Administration is doubling down on a proposal to create "Medicaid-like" coverage for low-income adults in states that have not expanded the program.
View ArticleAMA calls for list of payers offering advanced provider payments following...
The American Medical Association is asking for more flexibility and resources from the federal government for providers that continue to face disruptions from the Change Healthcare hack in late February.
View ArticleSenators eye dual-eligible changes: 5 things to know
A bipartisan group of senators is introducing legislation to require states to offer integrated Medicaid and Medicare plans to dual-eligible beneficiaries.
View ArticleCMS to cut red tape for Medicaid, CHIP enrollment in final rule
CMS finalized new rules that are intended to eliminate barriers to Medicaid and CHIP access.
View ArticleBiden cracks down on junk health plans
The Biden administration is cracking down on short-term 'junk' health plans that can leave members with poor coverage and large medical expenses.
View ArticleCMS to extend ACA signup window for those losing Medicaid coverage
CMS will extend a special enrollment period for ACA coverage with the goal of getting more people losing Medicaid insured.
View ArticleKentucky prior authorization gold carding bill 'dead'
Proposed legislation in Kentucky to create a gold carding program for prior authorization requests has failed, the Winchester Sun reported March 29.
View ArticleCMS finalizes 2025 Medicare Advantage rates
CMS finalized a slight decrease in Medicare Advantage benchmark payments for 2025.
View ArticleWhy higher Medicare Advantage utilization wasn't reflected in 2025 rates
CMS has finalized a slight decrease in Medicare Advantage benchmark payments for 2025, despite large insurers reporting rising costs and utilization among MA members.
View ArticleCMS finalizes marketplace network rules: 5 things to know
CMS finalized several proposed changes to regulations for the ACA marketplace in 2025.
View ArticleCMS finalizes 2025 Medicare Advantage rule: 11 key updates
CMS issued its final 2025 Medicare Advantage and Part D rule April 4, setting new standards around marketing, broker payments, and prior authorization.
View ArticleCMS delays implementation of new Medicare, Medicaid data rules
CMS will delay implementation of new policies designed to heighten security around Medicare and Medicaid data that drew criticism from researchers.
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