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HHS cuts 7 drugs from Medicare Part B rebates list
HHS has removed seven drugs from its initial list of 27 drugs subject to inflation rebates. -
CMS finalizes rule addressing Medicare Advantage marketing, prior authorization
CMS issued a final rule April 5 that, among other things, aims to streamline Medicare Advantage and Part D prior authorizations and clamp down on misleading marketing practices. -
Senators float 'no upcode' act to crack down on Medicare Advantage overpayments
Two Senators are introducing legislation aimed at reducing Medicare Advantage overpayments. -
CMS to phase in Medicare Advantage risk adjustment changes, bumping payments by 3%
CMS will move ahead with Medicare Advantage risk adjustment changes payers and some provider groups opposed, but the agency will phase in the model over three years. -
Medicaid redeterminations begin April 1
After more than three years, the nation's continuous Medicaid enrollment policy has come to an end, setting off a pivotal redetermination period that will present unprecedented challenges for payers, health systems, and state Medicaid agencies alike. -
BCBS Association's recommendations for data collection: 4 things to know
Clear data collection standards will help advance health equity, the Blue Cross Blue Shield Association says. -
Senators question HHS Secretary over proposed Medicare Advantage rates
HHS Secretary Xavier Becerra told the Senate Finance Committee that proposed Medicare Advantage rate changes will not lead to cuts in benefits. -
CMS resumes all No Surprises Act payment determinations
CMS has instructed all independent dispute resolution entities to resume issuing No Surprises Act payment determinations involving out-of-network services and items. -
Cigna to re-release paperwork demand paused in 2022
Cigna is moving forward with an updated version of a paperwork demand it paused last year amid criticism from medical groups, the California Medical Association said March 16. -
CMS seeks input on 1st-ever Medicare drug negotiation process
CMS laid out more details on how it plans to implement the first-ever negotiation process of drug prices under Medicare, which will first apply in 2026. -
North Carolina lawmakers reach Medicaid expansion deal
Leaders of the North Carolina House and Senate have agreed on a Medicaid expansion plan, radio station WUNC reported March 2. -
Why hospitals could be facing millions of newly uninsured patients this year
As the end to the nation's COVID-19 public health emergency looms, hospitals and health systems are prepping for an unprecedented period — the unwinding of federal policy that led to a complete transformation of care delivery operations, including billing processes, patient coverage and telehealth flexibilities. -
California considers expanding ACA Exchange access to residents without legal status
California lawmakers are mulling legislation to allow immigrants without legal status to purchase health insurance on Covered California, the state's ACA Exchange, the Sacramento Bee reported Feb. 24. -
Lawmakers: Keep kids continuously enrolled in CHIP
A group of senators is urging CMS and states to ensure kids can stay continuously enrolled in the Children's Health Insurance Program. -
Lawmakers want payers to cover home COVID-19 tests after the PHE ends
A group of senators is calling on health plans to continue covering at-home COVID-19 tests for members when the public health emergency comes to an end. -
More than 6 million children could lose CHIP coverage when redeterminations begin, new estimates show
Up to 6.7 million children nationwide are at risk of losing their CHIP coverage when Medicaid redeterminations begin this spring, according to a new analysis from the Georgetown University Center for Children and Families. -
BCBS Massachusetts extends telehealth coverage
Blue Cross Blue Shield of Massachusetts will continue reimbursing telehealth at the same rate as in-person services for primary and chronic care for now. -
Connecticut considers bill to reimburse insurers for pricey claims
Connecticut lawmakers are considering a proposal to reduce premiums by reimbursing insurers for the most costly claims, CT News Junkie reported Feb. 16. -
West Virginia considers Medicaid 'buy-in' program
West Virginia lawmakers are considering adding a Medicaid "buy-in" program to provide insurance to low-income workers making too much to qualify for the program, the News and Sentinel reported Feb. 16. -
HHS: Medicare Advantage audits, risk adjustment changes are not funding cuts
Medicare Advantage audits are "unequivocally not cuts" in funding, HHS says.
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