CMS needs better strategies to ensure proper oversight of Medicare Part B drug payment calculations, according to a Dec. 3 report from HHS' Office of the Inspector General.

New Jersey has become the eighth state to require state-regulated health plans to cover abortion services.

New Mexico is planning several changes to its Medicaid program, focused on equity and whole-person care. 

Prime Therapeutics will add Humira biosimilars in the same position in its formulary as the original drug, joining other pharmaceutical benefit managers in announcing similar policies. 

New requirements for payers under CMS' Transparency in Coverage rule take effect Jan. 1.

Washington is the nation's first state to be approved by HHS to offer health and dental ACA coverage to any resident, regardless of immigration status, The Hill reported Dec. 12.

CMS issued a proposed rule Dec. 14 to continue its efforts to overhaul prior authorization and marketing practices around Medicare Advantage and Part D plans, along with adding health equity measures to star ratings and boosting behavioral health network adequacy requirements.

CMS is proposing a new rule to streamline options on the ACA marketplace and add more provider network requirements. 

The number of powerful voices calling for an end to the nation's COVID-19 public health emergency is growing larger.

When Cleveland Clinic said it would begin billing for certain Epic MyChart messages this November, it set off a fiery debate across the healthcare industry around hospital finances, patient access and physician burnout.

Cigna will add Humira biosimilars to its pharmacy formulary, giving the new, cheaper alternative products hitting the market next year the same position as the drug. 

New Jersey is likely to soon become the eighth state to require state-regulated health plans to cover abortion services, Bloomberg reported Dec. 1.

The Connected Health Initiative, a coalition of medical groups, payers, universities and technology companies, wrote to congressional leaders Nov. 28 urging them to extend telehealth coverage for people with high deductible health plans before they hit their deductible, a policy that expires at the end of this year.

Nearly 3.4 million people have signed up for ACA coverage since the open enrollment period began Nov. 1, or a 17 percent increase in enrollment since last year.

Sen. Bernie Sanders' office said Nov. 17 that he is looking to become chair of the Senate's Health, Education, Labor and Pensions Committee, according to The Hill.

The expiration of the federal COVID-19 public health emergency will trigger a nationwide Medicaid redetermination process, but most Medicaid members are unaware their health coverage could eventually end — and payers largely aren't getting the word out.

UnitedHealth Group's OptumRx will keep Humira in its drug formulary, in addition to three biosimilar competitors, Bloomberg reported Nov. 15. 

U.S. Senate Democrats are urging CMS to continue its oversight of Medicare Advantage marketing practices and introduce additional regulations to protect consumers from deceptive tactics.

Newly capped insulin prices for Medicare beneficiaries at $35 won't show up in Medicare Plan Finder this year. 

The U.S. will extend the COVID-19 public health emergency past January 11, 2023, CNBC reported Nov. 11.