U.S. Reps. Adrian Smith, R-Neb., and Debbie Dingell, D-Mich., introduced a bill that would create a five-year pilot for skilled nursing facility services to be administered at home, according to a Nov. 12 news release. The Bringing Rehabilitation, Integrated Delivery…
Policy Updates
Just over one week after Democrats swept both chambers of Congress, the party’s impending healthcare agenda has come into focus around reversing pieces of HR 1 and ramping up oversight of the health insurance industry. Rep. Richard Neal, the incoming…
The No Surprises Act and its arbitration system is now under more scrutiny than at any point since the law went into effect in 2022. Providers have filed millions of disputes and are winning about 85% of them, but collecting…
Humana has launched a cancer care model aimed at easing the prior authorization process for oncology providers. The model was developed in partnership with the American Oncology Network and specialty care management company Evolent, according to a Nov. 10 news…
Sen. Tammy Baldwin, D-Wis., announced the Medicare at 50 Act on Nov. 10, aiming to lower the eligibility age. Under the bill, people ages 50-64 could buy into Medicare. The buy-in would be optional, and these beneficiaries would be entitled…
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“Medicare for All” had dominated campaigns and media coverage leading up to the 2026 midterm elections, but a spin on it is also emerging as part of Democrats’ latest healthcare push. The Medicare for All movement garnered substantial support leading…
CMS finalized its Home Health Prospective Payment System final rule Nov. 4, including a 2.4% home health payment boost for 2027. The rule also includes stricter Medicare provider enrollment provisions as the federal government continues to target alleged fraud, waste…
HHS, the Labor Department and the Treasury Department are denying recertification for two independent dispute resolution entities — Island Peer Review Organization, known as IPRO, and Network Medical Review Company — according to a Nov. 4 update from CMS. Under…
Democrats swept both chambers of Congress in the Nov. 3 midterm elections, leaving the health insurance industry with a new set of looming political headwinds on affordability and oversight alongside the possibility of restored ACA subsidies and a reversal of…
UnitedHealthcare will stop requiring prior authorization for more than 2,000 pediatric care codes for members under 18 starting Dec. 1. The payer published the full list of CPT codes Nov. 2. The codes span common services, diagnostic imaging, sleep studies,…