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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. -
Medicare to cover at-home COVID-19 tests
Medicare will cover up to eight at-home COVID-19 tests for beneficiaries beginning in early spring, CMS announced Feb. 3. -
States unprepared for 15 million people losing coverage when COVID-19 ends
States are anticipating that the federal government will end the COVID-19 public health emergency sometime in 2022, which would require them to potentially unenroll upwards of 15 million people from Medicaid programs, according to Politico. -
Why UnitedHealthcare reprocessed 1.6M COVID-19 vaccine claims
UnitedHealthcare has reprocessed 1.6 million COVID-19 vaccination claims that shortchanged providers, according to a Jan. 20 congressional report from Sen. Bob Casey, D-Pa. -
Payers backed Sen. Joe Manchin following Build Back Better swing vote
Payers including Anthem, Cigna and CVS Health contributed to a pool of nearly $300,000 in donations to Sen. Joe Manchin, D-W.Va., following his swing vote blocking President Joe Biden's $1.75 trillion Build Back Better spending package, according to CNBC. -
AMA calls out payers on 15 years of 'parity failures,' seeks congressional support
The American Medical Association is calling on members of Congress to act on "repeated failures" of health insurers to comply with substance use and mental health parity regulations over the past 15 years. -
California universal healthcare bill dies before key vote
Lawmakers did not vote by its Jan. 31 deadline on a California Assembly bill that would establish universal healthcare in the state, killing the bill, according to the Los Angeles Times. -
346 House members reiterate bipartisan support for Medicare Advantage
Nearly 350 bipartisan members of the House of Representatives cosigned a letter to CMS stating their support for Medicare Advantage as the program continues to grow. -
AHIP, AHA comment on proposed standards for health plans in 2023
Both America's Health Insurance Plans and the American Hospital Association submitted comments to HHS and CMS on the agencies' 2023 benefit and payment parameters. -
Single-payer healthcare bill faces key decision in California
The California Assembly is poised to vote on a bill Jan. 31 that aims to create a single-payer healthcare system in the state — the bill's first major battle since a funding proposal for the program was introduced Jan. 6 — according to KTVU FOX 2.
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