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The White House wants CMS and private insurers to address food insecurity: 5 things to know
The Biden Administration unveiled a five-point plan to address hunger, nutrition and health Sept. 27. The White House wants Medicare, Medicaid and private insurers to play a role in solving food insecurity and food related illness. Here are five things to know about the proposal: -
How the pandemic shaped BCBS North Carolina's new telehealth policy
Blue Cross Blue Shield of North Carolina is expanding its telehealth policy to include more services based on two years of telehealth claims data from the COVID-19 pandemic released Sept. 20. -
Aetna: Aduhelm is medically necessary
Aetna considers Aduhelm to be medically necessary and said Sept. 13 it will cover the controversial Alzheimer's drug if certain criteria are met. -
CMS: COVID-19 vaccines, including updated boosters, still free
Updated COVID-19 boosters designed to target the omicron variant will be provided at no cost, regardless of insurance status, CMS said Sept. 12. -
Postpartum Medicaid coverage to expand in West Virginia, Indiana
CMS approved extending Medicaid and Children's Health Insurance Program coverage for a full year after pregnancy for women in Indiana and West Virginia. -
Federal judge awards partial victory to ACA opponents, rules against HIV drug coverage
A federal judge in Texas awarded a partial victory Sept. 7 to opponents of the ACA who challenged a key provision that requires payers and employers to cover preventive services. -
Biden administration proposes rule to overhaul Medicaid, CHIP enrollment process
The Biden-Harris Administration proposed a new CMS rule Aug. 31 to overhaul the enrollment processes for Medicaid, the Children’s Health Insurance Program, and Basic Health Programs. -
Lawmaker investigating Medicare Advantage marketing tactics
Senate Finance Committee Chairman Ron Wyden has launched a probe into potentially deceptive marketing tactics used by Medicare Advantage plans. -
Inflation Reduction Act may help ease payers' Medicaid losses if public health emergency ends, Fitch says
Payers with large Medicaid operations are expected to face negative pressure on revenues if the federal public health emergency ends in October, but the total impact on profits is likely to be small because of coverage alternatives offered by the Inflation Reduction Act, according to an Aug. 11 analysis Fitch Ratings shared with Becker's. -
Massachusetts governor signs law to overhaul mental health coverage, reform prior authorization
Massachusetts Gov. Charlie Baker signed legislation Aug. 10 that overhauls the state's mental/behavioral healthcare delivery system and reforms prior authorization practices within the specialty. -
HHS releases guidance reminding payers of ACA contraception coverage requirement
HHS, the Labor Department and Treasury Department put payers on notice that they are required to cover birth control and family planning counseling under the Affordable Care Act in every state. -
Democrats reach deal to give Medicare price negotiation powers, extend ACA subsidies
Senate Democrats reached a deal June 27 on a major healthcare and energy reform bill that will extend Affordable Care Act tax credits to 2025, empower Medicare to negotiate the cost of some drugs and put the U.S. on a path toward 40 percent lower carbon emissions by 2040, according to CNN. -
Federal government approves Maine's plan to merge individual and small group markets
CMS has approved Maine's plan to improve health insurance for small businesses and tackle rising premiums by merging its individual and small group markets under the ACA into a single, pooled market, starting in 2023. -
Illinois health system blocks fertility coverage for LGBTQ employees
Peoria, Ill.-based OSF HealthCare will only cover fertility treatment for employees in opposite-sex marriages, Bloomberg Law reported July 18. -
Aetna drops noncoverage policy for cardiac PET/CT scans at behest of medical groups
Aetna has dropped its policy to not cover cardiac PET/CT scans following a joint letter from the American Society of Nuclear Cardiology and the Society of Nuclear Medicine and Molecular Imaging. -
Senate Democrats advance plan to give Medicare drug price negotiation powers: 6 notes
U.S. Senate Democrats reached a legislative agreement June 6 that would allow Medicare to negotiate the cost of prescription drugs starting next year. -
Aetna drops prior authorization for cataract surgeries
Aetna will no longer require pre-approval for member's cataract surgeries starting July 1. -
Payers must post negotiated prices starting today: 8 things to know
CMS' Transparency in Coverage final rule took effect July 1, requiring payers nationwide to publish the cost of nearly every healthcare service they've negotiated with providers. -
CMS rule limiting 3rd-party Medicare Advantage, Part D marketing now in effect
A CMS rule revising Medicare Advantage and Part D marketing and communication regulations went into effect June 28 to increase oversight over third-party marketing organizations. -
California will become first state to offer Medicaid to all eligible residents
California is set to become the first state to allow any eligible resident to enroll in Medi-Cal regardless of immigration status, according to The Sacramento Bee.
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