CMS has lifted its enrollment freeze on Gold Kidney of Florida after state regulators restored the insurer’s ability to accept new members. The agency released its intermediate sanction on Gold Kidney’s Medicare prescription drug plan, effective Dec. 15, 2025. The…
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Optum has begun reviewing Minnesota Medicaid claims as part of an enhanced prepayment audit, state officials said, as the state grapples with a widening fraud crisis in its public assistance programs. On Jan. 5, Minnesota Gov. Tim Walz said he…
New Mexico’s health insurance marketplace has reached record enrollment, despite the expiration of enhanced federal subsidies at the end of 2025, the Albuquerque Journal reported. More than 80,400 people have enrolled for medical or dental coverage through BeWell, the state’s…
Health insurance marketplace Access Health CT is extending its enrollment window until Jan. 31 for coverage that starts in February, according to an update on its website. The open enrollment period for qualified health plans and stand-alone dental plans began…
Public safety retirees in Arizona can access broader cancer insurance benefits through a new state law clarifying eligibility. Eligible retirees include former firefighters, law enforcement officers and corrections officers. The legislation passed in the spring, but the changes were effective…
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Medi-Cal no longer covers GLP-1s for weight loss as of Jan. 1. Wegovy, Zepbound and Saxenda have been removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for weight loss or weight-loss indications. The…
Enhanced ACA premium tax credits expired Dec. 31, with congressional efforts to extend them stalled and no resolution in sight. The enhanced subsidies, introduced under the 2021 American Rescue Plan Act, increased subsidy amounts and expanded marketplace eligibility to households…
Blue Cross and Blue Shield of Alabama is dropping its Medicare fitness benefit, a spokesperson confirmed Dec. 31 to Becker’s. A spokesperson for the insurer said it reevaluates its Medicare benefits “to ensure our products are competitive and remain financially…
Asset limits will return to California’s Medicaid, Medi-Cal, next year, and new enrollments are on pause for those lacking “satisfactory immigration status,” according to the state Department of Health Care Services. While income is the only factor for Medicaid eligibility…
State Medicaid agencies have made an estimated $289 million in improper capitation payments to managed care organizations on behalf of deceased enrollees since 2016, according to a series of audits from the HHS Office of Inspector General. The latest OIG…