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Virginia lawmakers eye insurance coverage for undocumented minors
A Virginia lawmaker has proposed new legislation that would expand health insurance coverage to undocumented residents under the age of 19. The bill passed in the Virginia Senate Feb. 13. -
CMS issues AI guidance for Medicare Advantage plans
Algorithms and artificial intelligence-powered software tools can be used to support Medicare Advantage plans in making coverage decisions for members, but payers are still bound by CMS' internal benefits requirements and nondiscrimination rules under the ACA, the agency said in guidance to insurers regarding its final 2024 MA rule. -
Payer execs sweat proposed Medicare Advantage rates
Payer executives are not happy with CMS' proposed Medicare Advantage rates for 2025. -
Florida sues HHS over CHIP eligibility requirements
Florida is challenging rules from CMS that require states keep eligible children enrolled in Medicaid and CHIP for a full 12 months, even if their families do not pay premiums. -
$12M Medicaid expansion campaign launches in Florida
A campaign to put a Medicaid expansion proposal to Florida voters is underway, the Tallahassee Democrat reported Feb. 1. -
CMS proposes Medicare Advantage rate cut
CMS proposed a slight decrease in Medicare Advantage benchmark payments for 2025. -
No big changes to Medicare Advantage, 61 senators urge
A bipartisan group of lawmakers is urging CMS to maintain "payment and policy" stability in Medicare Advantage. -
New Jersey signs prior authorization reform bill into law
New Jersey has signed the nation's most comprehensive prior authorization reform bill into law. -
CMS looks to tackle Medicare Advantage's 'black box'
CMS is seeking input on improving transparency in the Medicare Advantage program. -
BCBS Massachusetts pauses GI anesthesia policy
Blue Cross Blue Shield of Massachusetts is pausing a controversial policy that went into effect Jan. 1 that limited coverage for the use of monitored anesthesia for certain gastrointestinal patients undergoing endoscopic, bronchoscopic or interventional pain procedures, including colonoscopies. -
Senator accuses Medicare Advantage marketers of 'race to the bottom'
Medicare Advantage's annual enrollment period is over, but the marketing tactics used to sell older adults on the plans are still under scrutiny in Washington. -
Georgia lawmaker files bill to ban AI use for health coverage decisions
A Georgia state lawmaker filed legislation Jan. 9 that would prohibit the use of artificial intelligence technology to determine insurance, health coverage, or public assistance award decisions. -
HHS reaffirms payers' role in reproductive health access
HHS announced several new actions to protect and expand access to reproductive health services and reaffirmed the insurance industry's responsibility in maintaining that access. -
Idaho legislator introduces bill that could repeal Medicaid expansion
A proposed bill in Idaho would repeal Medicaid expansion if the state does not implement work requirements and enrollment limits in the program, Idaho Press reported Jan. 22. -
4 prior authorization updates
From the finalization of a rule CMS estimates will save $15 billion over 10 years to the implementation of another, here are four prior authorization updates Becker's has reported on since Dec. 29: -
MedPAC mulls standardizing Medicare Advantage supplemental benefits
The Medicare Payment and Advisory Commission is considering standardizing the supplemental benefits Medicare Advantage insurers can offer, to make it easier for beneficiaries to compare plans. -
Senators file bill to ban federally-funded health coverage for undocumented individuals
A group of Republican senators have introduced legislation that would ban the use of federal funding to expand state Medicaid benefits to undocumented residents. -
CMS pitched prior authorization overhaul, but timeline remains uncertain
In December 2022, CMS pitched a rule it said would streamline the prior authorization process. But 10 months after closing public comment, it remains uncertain when — or if — the proposal will be finalized, KFF Health News reported Jan. 9. -
Virginia eliminates tobacco use surcharge under ACA plans
Virginia has banned payers offering coverage on the ACA marketplace from including a surcharge for tobacco use, effective Jan. 1. -
Hospitals, payers get behind key points of CMS' Medicare Advantage proposed rule
Hospital and payer groups were broadly supportive of proposed changes to Medicare Advantage prior authorization and broker compensation regulations.
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