UnitedHealthcare is rolling out new reimbursement limits on five categories of lab tests across its commercial, ACA, Medicare Advantage and Medicaid plans. The five policies cover allergen testing, liver fibrosis testing, in vitro chemotherapy sensitivity assays, testosterone blood tests and…
Policy Updates
CMS on July 31 finalized its Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System rule for fiscal 2027, setting a 2.3% payment increase for acute care and long-term care hospitals and locking in the first mandatory, nationwide…
Payer policy changes that are not reflected in contracts are the leading source of revenue leakage for providers, according to a July 29 report from Trek Health in partnership with the Healthcare Financial Management Association. The report is based on…
Senate Democrats want more information on how to enact private health insurance reforms, including feedback on establishing a federal public option. The 86-page RFI, published July 30, asks stakeholders and policy experts for their input on dozens of potential policy…
CMS will discontinue the Part D premium stabilization program at the end of this year, returning the standalone prescription drug plan market to what the agency called “traditional market conditions.” CMS said July 28 its analysis of 2027 bids indicated…
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As HHS hosts payers and medical associations in Washington, D.C., it will introduce a pledge July 29 to advance mental health and addiction care nationwide. Optum CEO Patrick Conway, MD, told Becker’s on July 27 that his company will be…
A handful of state legislatures have passed laws this year that limit how health insurers use artificial intelligence when making coverage or reimbursement decisions. Seven state laws enacted this year:
Committees in the House and Senate each advanced healthcare price transparency legislation this week, both aiming to expand disclosure requirements for hospitals, insurers and other healthcare providers. Both measures would expand the existing hospital and payer price transparency rules, bring…
Since the beginning of 2026, federal lawmakers have been pitching reforms that touch every corner of the payer space, from government-run programs to how insurance companies conduct business. Here are eight bills from 2026 that payers should keep on their…
Sen. Andy Kim, D-N.J., introduced his “MediKids” bill July 21, which would promise healthcare coverage for those up to 26 years old. The law would amend the Social Security Act to make everyone under 26 eligible for Medicaid and to…