Medicare Payment Advisory Commission insights, Congressional reports and enrollment data have all been released in the early months of 2026. Some methodology has been questioned by insurers and CMS, even directly on the Congressional floor. Despite the challenges, here are…
Author: Elizabeth Casolo
Thirty-six percent of providers believe payers reliably deliver on promises, according to an inaugural Aetna provider survey released April 8. The survey will run quarterly, polling representatives of U.S. healthcare providers. This round fielded responses from 827 hospital system executives, physicians, nurses,…
West Virginia and New Mexico are both launching Medigap “birthday rules” within the next year. Federal law does not include ongoing protections for beneficiaries who want to switch Medicare supplement coverage beyond the established one-time, six-month window. However, these state…
A federal judge in Minnesota denied the state’s motion challenging the federal government’s deferral of Medicaid funds, according to an April 6 opinion and order. The state filed a complaint against CMS, HHS and their respective leaders March 2. Earlier…
Ten states have not expanded Medicaid under the ACA. If those states were to move toward expansion, 2.3 million people would secure health insurance coverage. While Medicaid expansion has long been a possibility, there is still some room for upheaval…
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In early February, Republican lawmakers in Oklahoma introduced a state bill and joint resolution that could shake up the future of Medicaid expansion. The April 6 version of HB 4440 poses a state question asking whether Medicaid expansion provisions should…
Philadelphia-based Jefferson Health filed a lawsuit against Aetna over its “level of severity inpatient payment policy” for Medicare Advantage beneficiaries, according to an April 6 filing in a Pennsylvania federal court. The policy took effect in 2026 after Aetna bumped…
CMS is raising Medicare Advantage payments by 2.48%, or more than $13 billion, according to its finalized 2027 rate announcement. The agency said April 6 that when estimated risk score trends in MA are accounted for, the final rate amounts…
As the Medicaid cuts from H.R. 1 begin to settle in, states are looking for workarounds to continue funding their programs. Iowa Republican Gov. Kim Reynolds signed a bill March 25 allowing a steeper HMO tax, which will also affect…
A judge for the U.S. District Court for the District of Massachusetts denied a motion to dismiss a lawsuit alleging an antitrust conspiracy by healthcare technology company Zelis and five major health insurers, according to a March 30 court filing.…