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Sanders reintroduces single-payer Medicare bill with record sponsors
Sen. Bernie Sanders, along with Rep. Pramila Jayapal and Rep. Debbie Dingell, introduced the Medicare for All Act of 2023 on May 17 to create a federally administered single-payer healthcare system. -
Appeals court pauses Texas ruling against ACA preventive care coverage
The U.S. 5th Circuit Court of Appeals has temporarily blocked a Texas court's ruling earlier this year that struck down an ACA provision requiring payers and employers to provide coverage for preventive services. -
Medicaid work requirements would have 'negligible effect on employment,' CBO says
The Congressional Budget Office said a proposal to add work requirements for Medicaid eligibility would have "a negligible effect on employment status or hours worked by people who would be subject to the work requirements." -
CMS proposes rate transparency rules for Medicaid
CMS proposed two new rules April 27 that would establish national standards of care provided through fee-for-service Medicaid/CHIP and managed care plans, along with a requirement to publicly disclose provider payment rates online. -
AMA leads push against Cigna modifier 25 policy
The American Medical Association and more than 100 physician and healthcare organizations are asking Cigna to reconsider a policy they say will add administrative costs and burdens and potentially negatively affect patients. -
600,000 would be kicked off Medicaid under work requirement proposal: CBO
House Republicans' Medicaid work requirement proposal would result in an estimated 600,000 people losing coverage, the Congressional Budget Office said in an April 25 report. -
HHS releases proposed rule to expand Medicaid, ACA access to DACA recipients
HHS unveiled its proposed rule that, if finalized, would expand healthcare coverage access to an estimated 129,000 previously uninsured Deferred Action for Childhood Arrivals program recipients. -
CMS to limit non-standard ACA plans, add special enrollment periods: 5 notes
CMS is upping its proposed number of non-standard ACA plans payers can offer in each region from two to four. -
HHS cuts 7 drugs from Medicare Part B rebates list
HHS has removed seven drugs from its initial list of 27 drugs subject to inflation rebates. -
CMS finalizes rule addressing Medicare Advantage marketing, prior authorization
CMS issued a final rule April 5 that, among other things, aims to streamline Medicare Advantage and Part D prior authorizations and clamp down on misleading marketing practices. -
Senators float 'no upcode' act to crack down on Medicare Advantage overpayments
Two Senators are introducing legislation aimed at reducing Medicare Advantage overpayments. -
CMS to phase in Medicare Advantage risk adjustment changes, bumping payments by 3%
CMS will move ahead with Medicare Advantage risk adjustment changes payers and some provider groups opposed, but the agency will phase in the model over three years. -
Medicaid redeterminations begin April 1
After more than three years, the nation's continuous Medicaid enrollment policy has come to an end, setting off a pivotal redetermination period that will present unprecedented challenges for payers, health systems, and state Medicaid agencies alike. -
BCBS Association's recommendations for data collection: 4 things to know
Clear data collection standards will help advance health equity, the Blue Cross Blue Shield Association says. -
Senators question HHS Secretary over proposed Medicare Advantage rates
HHS Secretary Xavier Becerra told the Senate Finance Committee that proposed Medicare Advantage rate changes will not lead to cuts in benefits. -
CMS resumes all No Surprises Act payment determinations
CMS has instructed all independent dispute resolution entities to resume issuing No Surprises Act payment determinations involving out-of-network services and items. -
Cigna to re-release paperwork demand paused in 2022
Cigna is moving forward with an updated version of a paperwork demand it paused last year amid criticism from medical groups, the California Medical Association said March 16. -
CMS seeks input on 1st-ever Medicare drug negotiation process
CMS laid out more details on how it plans to implement the first-ever negotiation process of drug prices under Medicare, which will first apply in 2026. -
North Carolina lawmakers reach Medicaid expansion deal
Leaders of the North Carolina House and Senate have agreed on a Medicaid expansion plan, radio station WUNC reported March 2. -
Why hospitals could be facing millions of newly uninsured patients this year
As the end to the nation's COVID-19 public health emergency looms, hospitals and health systems are prepping for an unprecedented period — the unwinding of federal policy that led to a complete transformation of care delivery operations, including billing processes, patient coverage and telehealth flexibilities.
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