Medicaid spending on outpatient prescription drugs has climbed sharply in recent years even as utilization remained relatively flat and enrollment declined. A March 12 report from KFF outlines the key drivers of the increase and the early impact of new…
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CMS plans to transition to an independent dispute resolution “gateway” during the second half of 2026, according to a March 16 email shared with Becker’s. The federal agency will move away from single-use web forms, instead relying on “a secure,…
New research from the Blue Cross Blue Shield Association is offering what the organization describes as the first publicly available data connecting rising hospital coding intensity to higher healthcare costs, pointing to AI-assisted coding tools as a likely driver. The…
Minnesota’s House of Representatives passed HF3378 in a 107-27 vote March 12, which aims to grant lawmakers access to the full, unredacted Optum report on the state’s Medicaid program. Optum has been acting as a third-party auditor for Minnesota in…
About 82% of the more than 16,000 available public comments on the 2027 Medicare Advantage proposed rate notice share the perspective and language of a letter from the Medicare Advantage Majority, a group with undisclosed funding sources and founders, according…
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Anthem Blue Cross Blue Shield and UnitedHealthcare offer the best mobile provider search tools among major Medicare Advantage insurers, according to a February report from Corporate Insight shared with Becker’s. The report evaluated tools available on iOS and looked at…
New Jersey Gov. Mikie Sherrill proposed that employers with at least 50 workers on Medicaid should either cover the workers’ healthcare or pay a fine, she said in her 2027 budget address March 10. The governor said the fines would…
The Medicare Payment Advisory Commission estimated Medicare Advantage payments will be 14% greater than fee-for-service Medicare in 2026, according to a March 12 report from the congressional agency. That 14% equates to an extra $76 billion for MA, with the…
Montana is slated to roll out Medicaid work requirements July 1, according to a Department of Public Health and Human Services presentation on March 9. Under HR 1, Medicaid expansion states, such as Montana, must install community engagement requirements —…
Aetna has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate diagnosis codes for its Medicare Advantage enrollees in order to increase payments from CMS. The settlement…