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UnitedHealthcare's 2nd wave of prior authorization cuts begins
The second and final wave of UnitedHealthcare's prior authorization cuts began Nov. 1. -
Private payer's prices highest in upper Midwest and Southeast, price transparency study finds
Payers' negotiated prices for office visits and medical services can vary widely from county to county, according to a price transparency study published Oct. 27 in JAMA Health Forum. -
Senators want to bust Medicare Advantage 'ghost' networks
Lawmakers are introducing a bill to crack down on inaccurate provider directories in Medicare Advantage. -
Lawmakers look to ease Medicaid churn
A group of U.S. senators and representatives are introducing legislation to provide Medicaid enrollees with a year of continuous coverage. -
Senators urge more action from CMS on misleading Medicare Advantage marketing
A group of senators says CMS actions to crack down on misleading marketing of Medicare Advantage plans do not go far enough. -
The Better Medicare Alliance's vision for MA: 10 things to know
The Better Medicare Alliance is recommending a set of policies to Congress and CMS to improve prior authorization, behavioral health access, equity and more in the program. -
Michigan codifies ACA provisions into state law
Michigan has codified several provisions of the Affordable Care Act into state law, ahead of a Supreme Court case that could strike down the law's preventive care coverage requirements. -
Former BCBS CEO: Health plans should consider medical marijuana coverage
Payers could soon face pressure to reconsider medical marijuana coverage policies following HHS' recommendation in August that the Drug Enforcement Administration reschedule the drug to a substance accessible through a prescription under federal law. -
Lawmakers are scrutinizing managed care
Federal lawmakers have been probing payers on a variety of issues in recent months, raising concerns on prior authorizations, Medicare Advantage costs, artificial intelligence and more. -
Looming government shutdown could disrupt Medicaid redeterminations
A government shutdown could cause hiccups in the unwinding of Medicaid continuous coverage requirements. -
AHIP backs legislation expanding Medicare Advantage supplemental benefits
Two lawmakers are introducing legislation that would expand the scope of supplemental benefits offered in Medicare Advantage. -
AHIP, health systems on opposite sides of No Surprises Act debate
Payers and providers don't agree on much when it comes to the No Surprises Act dispute resolution process. -
New Mexico orders payers to expand behavioral health access
New Mexico's superintendent of insurance has ordered payers operating in the state to expand access to behavioral health services, the Albuquerque Journal reported Sept. 19. -
Some health plans slow to cover new COVID booster
Updated COVID-19 boosters have started rolling out to pharmacies nationwide, but some individuals are reporting a high price tag associated with getting a shot. -
Oregon to establish basic health program for lower income adults
Oregon is asking CMS to approve a basic health program for lower-income individuals who make too much to qualify for Medicaid, a move that could raise premiums prices on the state's individual insurance market. -
Hawaii pausing Medicaid terminations in wake of wildfires
Hawaii is pausing Medicaid disenrollments for all Hawaii residents for the remainder of 2023 in the wake of the Maui wildfires. -
What 3 payers have said about their prior authorization cuts
As prior authorizations have come under the regulatory and legislative microscope, several payers have announced cuts to their requirements. -
BCBS Michigan to cut 20% of prior authorization requirements
Blue Cross Blue Shield of Michigan is the latest payer to announce it is scaling back its prior authorization requirements. -
UnitedHealthcare's prior authorization cuts begin
The first wave of UnitedHealthcare's prior authorization cuts began Sept. 1. -
CMS to states: Fix your broken Medicaid eligibility systems
CMS is urging states to correct an issue that could result in eligible people being removed from Medicaid.
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