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What 3 payers have said about their prior authorization cuts
As prior authorizations have come under the regulatory and legislative microscope, several payers have announced cuts to their requirements. -
BCBS Michigan to cut 20% of prior authorization requirements
Blue Cross Blue Shield of Michigan is the latest payer to announce it is scaling back its prior authorization requirements. -
UnitedHealthcare's prior authorization cuts begin
The first wave of UnitedHealthcare's prior authorization cuts began Sept. 1. -
CMS to states: Fix your broken Medicaid eligibility systems
CMS is urging states to correct an issue that could result in eligible people being removed from Medicaid. -
UnitedHealthcare community plans prior authorization cuts by category
UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1. -
North Carolina Medicaid expansion unlikely in 2023
North Carolina's Medicaid expansion could be delayed until 2024, North Carolina Health News reported Aug. 29. -
UnitedHealthcare individual exchange plan prior authorization cuts by category
UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1. -
Texas HHS employees sound alarm on "numerous and growing issues" during Medicaid unwinding
Anonymous employees with Texas HHS have filed a whistleblower complaint against the agency over "numerous and growing system issues" they say are leading to incorrectly terminated health coverage during the Medicaid redeterminations process, according to an Aug. 24 Nexstar report. -
CMS pitches guidance for Medicare Part D monthly payment plan: 5 things to know
CMS published draft guidance for a new program that will allow Medicare Part D beneficiaries to spread out their out-of-pocket prescription costs over an entire year. -
UnitedHealthcare's Medicare Advantage prior authorization cuts by category
UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1. -
CMS updates ACO Reach: 5 things to know
CMS will make several tweaks to the ACO REACH model in 2024, designed to make payments from the model more predictable for participants and adjust equity benchmarks. -
UnitedHealthcare's commercial plan prior authorization cuts by category
UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1. -
3 payers halting policies after pushback
Humana, UnitedHealthcare and Cigna changed or paused policies this year after receiving criticism from medical groups and other organizations. -
UnitedHealthcare's prior authorization cuts to begin Sept. 1
The first wave of UnitedHealthcare's previously announced 20 percent reduction in prior authorization requirements takes effect Sept 1. -
AHA, AMA, payers urge CMS not to implement new electronic prior authorization standards
The American Hospital Association, American Medical Association, AHIP and the Blue Cross Blue Shield Association are urging CMS not to move forward with implementing electronic transaction standards for healthcare attachments during prior authorization they say would create "costly burdens" across the healthcare industry. -
Lawmakers introduce bill incentivizing value-based care in Medicare
Lawmakers are proposing legislation that would extend incentives for value-based care in Medicare. -
6 states with price transparency requirements for payers
Though federal price transparency requirements for payers have been in effect since July 2022, several states moved faster to enact their own requirements and add additional regulations, according to a July 21 analysis from the National Conference of State Legislatures. -
University of Texas dropping weight loss drug coverage for employees
The University of Texas System is planning to drop coverage for weight loss drugs such as Wegovy under its employee and retiree health plans, citing high costs and low adherence rates. -
Biden administration pitches tougher mental health parity standards for payers
The White House is proposing stronger standards for insurers' coverage of mental health services. -
Ascension drops weight loss drug coverage for employees
St. Louis-based Ascension has dropped coverage for weight loss drugs such as Wegovy from its employee health plan.
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