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Georgia pitches transition program to counter Medicaid enrollment cliff
Georgia lawmakers are pitching a bill that would require families to be rescreened for possible eligibility if they lose their health insurance — a failsafe as states brace for an ACA enrollment cliff — according to the Augusta Chronicle. -
FTC urges top PBMs to outline effects on drug pricing, pharmacies
The FTC is requesting large, vertically-integrated players in the pharmacy benefit management industry share insights on their influence over drug pricing and access. -
Lawmakers urge CMS to extend transitional health plans as agency hesitates
Two Iowa lawmakers are calling on CMS to extend the eligibility for transitional health plans through 2023. -
Maine blends small group, individual insurance markets to support price stability
Maine is the first state to combine its individual and small group insurance markets under the ACA, according to the Press Herald. -
CMS seeks feedback on access to care for Medicaid, CHIP enrollees
CMS is looking to receive feedback from stakeholders on how Medicaid and the Children's Health Insurance Program can increase healthcare access. -
Senators' letter thrusts 'junk insurance' back into limelight
Forty senators penned a letter calling on HHS Secretary Xavier Becerra to implement more consumer protections against "junk insurance." -
Michigan passes pharmacy benefit manager transparency bill
Michigan lawmakers passed a bipartisan bill Feb. 16 that seeks to increase the transparency of its pharmacy benefit managers in an effort to bring down prescription drug prices. -
Over 30 lawmakers call for 'crack down' on payer birth control denials
Thirty-four U.S. senators issued a joint statement to the Biden administration Feb. 16 urging it to increase enforcement against payers who illegally deny birth control coverage. -
CMS broadens Medicaid lung cancer screenings coverage
CMS updated Medicaid's coverage of an early-detection lung cancer screening Feb. 10, a move that would expand coverage nationwide. -
FTC to vote on pharmacy benefit manager competition probe
The Federal Trade Commission will vote Feb. 17 whether to investigate the anticompetitive impacts of pharmacy benefit managers on independent pharmacies. -
AHIP calls CMS Alzhimer's drug guidance 'the right approach'
America's Health Insurance Plans supported CMS' preliminary guidance on covering Aduhelm, Biogen's Alzheimer's disease treatment, calling its decision "the right approach." -
Mississippi amendment to bar Centene from Medicaid contract picks up steam
Mississippi's House of Representatives passed an amendment to a bill that would bar the state from contracting Medicaid services to entities that have settled with the state for over $50 million — a move specifically targeting Centene — according to the Daily Journal. -
CMS releases over-the-counter COVID-19 testing coverage guidance
CMS released additional guidance Feb. 4 on how payers should best cover at-home COVID-19 tests. -
Biden administration to remove state Medicaid fees in Trump-era policy flip
President Joe Biden's administration is no longer allowing several states to charge premiums to newly-eligible Medicaid enrollees — an undoing of Obama and Trump-era allowances, according to NPR. -
California suspends Medicaid prior authorization for most drugs
California's Health Care Services Department issued a notice Feb. 6 that removed prior authorization requirements for most drugs Under Medi-Cal, the state's Medicaid program. -
Bipartisan bill seeks to extend, expand Medicare telehealth coverage
Two U.S. senators have introduced a bill that would temporarily extend pandemic-era policies that expanded Medicare's coverage of telehealth services. -
AMA to Congress: Payer disregard for mental health parity 'rampant'
The American Medical Association sent statements to two congressional committees claiming that payers are rampantly disregarding mental parity law due to a lack of enforcement. -
Viewpoint: At-home COVID-19 test coverage gives providers 'unchecked power' over payers
There's no such thing as free, even when it comes to free COVID-19 testing, writes Cameron Kaplan, PhD, economist and assistant professor of medicine at the University of Southern California’s Keck School of Medicine, in a Feb. 3 Wall Street Journal op-ed. -
AHIP to Congress: COVID-19 test price gouging still a problem
COVID-19 test price gouging is still a "significant problem," America's Health Insurance Plans said in a statement submitted to Congress. -
CMS pitches Medicare Advantage rate, Part D payment policy changes: 9 details
CMS is seeking input on an Advanced Notice that includes proposed changes to Medicare Advantage capitation rates and Part D payment policies.
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