5 Medicare Advantage changes coming in 2024
CMS will implement new risk adjustment payment rates, prior authorization requirements and network standards for Medicare Advantage plans in 2024.
View ArticleSenators concerned Medicare Advantage plans deny long-term care
A pair of senators are asking CMS to require Medicare Advantage plans to cover stays in long-term care facilities at the same rate as traditional Medicare.
View ArticleCalifornia expands Medicaid to all eligible undocumented individuals
Starting Jan. 1, California will become the first state to offer Medicaid coverage to all eligible undocumented individuals, Cal Matters reported Dec. 28.
View ArticleNew payer price transparency rules take effect in 2024
New requirements for payers under CMS' Transparency in Coverage rule took effect Jan. 1.
View ArticleNew CMS prior authorization rule takes effect
A new CMS rule aiming to streamline Medicare Advantage and Part D prior authorizations took effect Jan. 1.
View ArticleHospitals, payers get behind key points of CMS' Medicare Advantage proposed...
Hospital and payer groups were broadly supportive of proposed changes to Medicare Advantage prior authorization and broker compensation regulations.
View ArticleVirginia eliminates tobacco use surcharge under ACA plans
Virginia has banned payers offering coverage on the ACA marketplace from including a surcharge for tobacco use, effective Jan. 1.
View ArticleCMS pitched prior authorization overhaul, but timeline remains uncertain
In December 2022, CMS pitched a rule it said would streamline the prior authorization process. But 10 months after closing public comment, it remains uncertain when — or if — the proposal will be...
View ArticleSenators file bill to ban federally-funded health coverage for undocumented...
A group of Republican senators have introduced legislation that would ban the use of federal funding to expand state Medicaid benefits to undocumented residents.
View ArticleMedPAC mulls standardizing Medicare Advantage supplemental benefits
The Medicare Payment and Advisory Commission is considering standardizing the supplemental benefits Medicare Advantage insurers can offer, to make it easier for beneficiaries to compare plans.
View Article4 prior authorization updates
From the finalization of a rule CMS estimates will save $15 billion over 10 years to the implementation of another, here are four prior authorization updates Becker's has reported on since Dec. 29:
View ArticleIdaho legislator introduces bill that could repeal Medicaid expansion
A proposed bill in Idaho would repeal Medicaid expansion if the state does not implement work requirements and enrollment limits in the program, Idaho Press reported Jan. 22.
View ArticleHHS reaffirms payers' role in reproductive health access
HHS announced several new actions to protect and expand access to reproductive health services and reaffirmed the insurance industry's responsibility in maintaining that access.
View ArticleGeorgia lawmaker files bill to ban AI use for health coverage decisions
A Georgia state lawmaker filed legislation Jan. 9 that would prohibit the use of artificial intelligence technology to determine insurance, health coverage, or public assistance award decisions.
View ArticleSenator accuses Medicare Advantage marketers of 'race to the bottom'
Medicare Advantage's annual enrollment period is over, but the marketing tactics used to sell older adults on the plans are still under scrutiny in Washington.
View ArticleBCBS Massachusetts pauses GI anesthesia policy
Blue Cross Blue Shield of Massachusetts is pausing a controversial policy that went into effect Jan. 1 that limited coverage for the use of monitored anesthesia for certain gastrointestinal patients...
View ArticleCMS looks to tackle Medicare Advantage's 'black box'
CMS is seeking input on improving transparency in the Medicare Advantage program.
View ArticleNew Jersey signs prior authorization reform bill into law
New Jersey has signed the nation's most comprehensive prior authorization reform bill into law.
View ArticleNo big changes to Medicare Advantage, 61 senators urge
A bipartisan group of lawmakers is urging CMS to maintain "payment and policy" stability in Medicare Advantage.
View ArticleCMS proposes Medicare Advantage rate cut
CMS proposed a slight decrease in Medicare Advantage benchmark payments for 2025.
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