CMS published its 2027 Medicare Advantage and Part D proposed rule on Nov. 25 that includes an overhaul of how star ratings are calculated, new enrollment flexibilities, and rollbacks of Biden-era health equity requirements. The proposed rule is subject to…
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ACA enhanced tax credits may best be described as a “will they or won’t they” — will Congress extend them past the end of the year, or are they on track to expire? While an extension could happen, the outcome…
Arkansas will see the largest percentage increase in average ACA benchmark premiums between 2025 and 2026, while Alaska is the only state where the average benchmark premium will decline, according to KFF. The U.S. average increase is 26%. Premiums were…
Cigna is joining a handful of other payers in CMS’ health technology “ecosystem,” according to a news release from the company. The CMS website said participants in the ecosystem agree to align on an interoperability framework for healthcare data and…
The American College of Physicians published recommendations for managed care Nov. 25 in the group’s flagship journal, Annals of Internal Medicine. Managed care plans, like HMOs and PPOs, are insurance models that focus on mitigating costs and utilization while maintaining…
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The Illinois Department of Healthcare and Family Services launched home-visit coverage for pregnant and parenting Medicaid enrollees, effective Nov. 21. Under the initiative, the state covers some prenatal visits, including sessions for health education, blood pressure monitoring, behavioral health screenings,…
HHS is appealing a judgment that vacated CMS’ Medicare Advantage Risk Adjustment Data Validation program final rule, according to a Nov. 21 filing in the U.S. District Court for the Northern District of Texas. The 2023 final rule allowed CMS…
Payers have faced state penalties in 2025 for slow reimbursements, improper claims denials, and mental health parity violations. Fines in 2024 are here. Payers fined by states in 2025:
Vermont will have the highest average monthly premiums for the lowest-cost Gold-tier marketplace plan in 2026, while Maryland will have the lowest, according to KFF. The national average is $615. Premiums were analyzed using the lowest-cost premium for a 40-year-old…
Vermont will have the highest average monthly premiums for the lowest-cost Bronze-tier marketplace plan in 2026, while Maryland will have the lowest, according to KFF. The national average is $456. Premiums were analyzed using the lowest-cost premium for a 40-year-old…