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CMS pitches Part D premium stabilization plan: 5 things to know
CMS is implementing a voluntary demonstration program designed to test policy changes to stabilize premiums year to year for Medicare Part D enrollees. -
Federal Medicare Advantage scrutiny isn't going away
Medicare Advantage won't be out of federal watchdogs' sights anytime soon. -
Humana's CEO backs Medicare Advantage prior auth bill
Humana CEO Jim Rechtin is putting his support behind federal legislation aimed at reforming the Medicare Advantage prior authorization process. -
North Carolina adds Medicaid coverage for weight loss drugs
North Carolina will cover GLP-1 drugs for weight loss through its Medicaid program. -
CMS cracks down on 'unauthorized' ACA broker activity
CMS has issued new policies aimed at blocking "unauthorized changes" from brokers when enrolling individuals on the state and federal health insurance exchanges. -
Judge declines to extend Georgia's Medicaid work requirement program
A federal judge rejected Georgia's request to extend its Medicaid work requirement program, the Georgia Recorder reported July 16. -
8 payers sign on to Washington's value-based care pact
Eight payers have signed an agreement to promote value-based payment models in Washington state. -
Illinois gov. signs prior authorization reform bill
Illinois Gov. JB Pritzker has signed a pair of health insurance reform bills into law. -
Court blocks Medicare Advantage broker fee caps
A federal judge has paused implementation of CMS regulations capping the amount Medicare Advantage companies can pay brokers that sell their plans. -
5 more states to provide Medicaid coverage to incarcerated people
CMS has approved requests from five states to provide Medicaid coverage to incarcerated people before they are released. -
Oregon expects to insure 100,000 under new program
Oregon has launched a program to provide Medicaid benefits to individuals earning up to 200% of the federal poverty level, the Oregon Capital Chronicle reported July 1. -
BCBS Rhode Island dropping 65% of prior authorization requirements for PCPs
Blue Cross and Blue Shield of Rhode Island is eliminating nearly 65% of prior authorization requirements for primary care providers by early 2025. -
Congress warms to Medicare coverage of weight loss drugs
The House Ways and Means Committee advanced a proposal to allow Medicare coverage of weight loss drugs for beneficiaries who were prescribed the drug for at least a year before switching to Medicare. -
Tougher rules needed for Medicare Advantage AI, 51 lawmakers say
Lawmakers are pushing CMS to do more to prevent misuse of artificial intelligence by Medicare Advantage plans. -
Court keeps ACA preventive care mandate in place
A federal court kept the ACA preventive care mandate in place for now but raised questions about its constitutionality. -
Washington state opens health coverage to noncitizens
Washington state opened applications for its Medicaid-like health insurance program for undocumented adult immigrants on June 20. -
3 states tackling prior authorization
Three states recently passed legislation reforming the prior authorization process: -
Minnesota Medicaid to drop for-profit carriers
In 2025, Minnesota's Medicaid program will no longer award managed care contracts to for-profit HMOs. -
Illinois passes prior authorization reform bill
The Illinois General Assembly has passed a pair of health insurance reform bills, which Gov. JB Pritzker has indicated he will sign. -
The two-midnight rule and Medicare Advantage: 8 updates
In 2024, Medicare Advantage plans must provide coverage for an inpatient admission when the admitting physician expects the patient to require hospital care for at least two midnights, otherwise known as the two-midnight rule.
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