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.

Four states are moving toward policies to keep children continuously enrolled in Medicaid to prevent coverage gaps, Kaiser Health News reported Nov. 10. 

CMS wants all traditional Medicare beneficiaries and most Medicaid beneficiaries in accountable care organizations by 2030. In a strategy report published Nov. 7, CMS detailed its plans to reach this goal. 

A CMS rule finalized Oct. 28 will reduce gaps in Medicare enrollment for new enrollees and adds special enrollment periods for extenuating circumstances. 

CMS is cracking down on deceptive marketing practices and will no longer allow Medicare Advantage or Part D prescription drug plans to advertise on television without agency approval first.

The Transparency in Coverage (TiC) final rule went into effect July 1, 2022, and requires insurers to include provider-negotiated rates, as well as allowed billable amounts for all out-of-network providers. 

The nation's uninsured rate is at a record low thanks in part to continuous Medicaid enrollment since early 2020. But with the federal public health emergency expected to come to a close in 2023, payers are prepping for a major disenrollment of beneficiaries nationwide.

When President Joe Biden declared the COVID-19 pandemic "over" Sept. 18, his message divided the medical community and sent a clear message: the nation is moving on from COVID-19.

Increased Medicare payment for biosimilars took effect Oct. 3, one of the first Medicare provisions of the Inflation Reduction Act to kick in. 

The Biden Administration unveiled a five-point plan to address hunger, nutrition and health Sept. 27. The White House wants Medicare, Medicaid and private insurers to play a role in solving food insecurity and food related illness. Here are five things to know about the proposal: 

Blue Cross Blue Shield of North Carolina is expanding its telehealth policy to include more services based on two years of telehealth claims data from the COVID-19 pandemic released Sept. 20.

Aetna considers Aduhelm to be medically necessary and said Sept. 13 it will cover the controversial Alzheimer's drug if certain criteria are met. 

Updated COVID-19 boosters designed to target the omicron variant will be provided at no cost, regardless of insurance status, CMS said Sept. 12. 

CMS approved extending Medicaid and Children's Health Insurance Program coverage for a full year after pregnancy for women in Indiana and West Virginia. 

A federal judge in Texas awarded a partial victory Sept. 7 to opponents of the ACA who challenged a key provision that requires payers and employers to cover preventive services.

The Biden-Harris Administration proposed a new CMS rule Aug. 31 to overhaul the enrollment processes for Medicaid, the Children’s Health Insurance Program, and Basic Health Programs.

Senate Finance Committee Chairman Ron Wyden has launched a probe into potentially deceptive marketing tactics used by Medicare Advantage plans. 

Payers with large Medicaid operations are expected to face negative pressure on revenues if the federal public health emergency ends in October, but the total impact on profits is likely to be small because of coverage alternatives offered by the Inflation Reduction Act, according to an Aug. 11 analysis Fitch Ratings shared with Becker's.

Massachusetts Gov. Charlie Baker signed legislation Aug. 10 that overhauls the state's mental/behavioral healthcare delivery system and reforms prior authorization practices within the specialty.