An Illinois lawmaker has introduced legislation that aims to provide greater oversight of how insurers use artificial intelligence in decision-making processes.

CMS proposed major reforms on Nov. 26 for the Medicare Advantage and Part D programs for contract year 2026, including changes to prior authorization and weight loss drug coverage. 

Changes could be coming for Medicaid in the next presidential administration. 

Payer executives expressed confidence in the continuation of enhanced ACA subsidies in some form past 2025. 

CMS will give less weight to call center metrics in future Medicare Advantage star ratings, according to a top CMS official. 

Illinois voters have passed an advisory referendum aimed at requiring all health plans that cover pregnancy to also cover in vitro fertilization, or IVF, and other assisted reproductive treatments on an unlimited basis.

Medicare Advantage companies are bringing in billions in "questionable" payments found during in-home visits and chart-reviews, HHS' Office of Inspector General claimed in a new audit. 

The Biden administration is proposing rules that would require insurers to cover the costs of over-the-counter contraceptives without a prescription. 

Vice President Kamala Harris has proposed expanding Medicare coverage for home healthcare, NPR reported Oct. 8. 

CMS is proposing new regulations on the ACA marketplace in 2026, which include some aimed at cracking down on fraud. 

The federal government will spend $5 billion to keep Medicare Part D premiums stable in 2025, according to an Oct. 2 report from the Congressional Budget Office. 

Over the last month, California Gov. Gavin Newsom has signed 17 bills pertaining to the deployment and regulation of generative AI technology, including legislation that will require health insurers to ensure that physicians supervise the use of AI tools that make decisions about services and insurance claims. 

A new bill will require some forms of insurance in California to pay for IVF. 

Average Medicare Advantage premiums and Medicare Part D premiums will decrease in 2024, CMS said Sept. 27. 

CMS is providing states new guidance to ensure states comply with required Medicaid services for children. 

States must be in full compliance with all of CMS' Medicaid renewal requirements by the end of 2026.  

Deregulating the individual insurance market would be part of former President Donald Trump's healthcare agenda in a second term, according to his running mate, Sen. JD Vance.

Optum Rx will join the other major pharmacy benefit managers and exclude Humira from some formularies. 

Insurers and employers are pushing back on new rules that would toughen requirements for mental health parity. 

The Biden administration has finalized new requirements for health plans to strengthen mental health parity laws for 175 million Americans.