Policy Updates

The Blue Cross Blue Shield Association submitted a wide-ranging letter to CMS on March 30 in response to the agency’s information request on its Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH, initiative.  Seven BCBSA recommendations: 1. CMS should notify…

The Congressional Budget Office estimated the CMS Innovation Center spent $7.9 billion from 2011 through 2020, a March 27 report from the Government Accountability Office said. While some models have been expanded beyond testing, the Innovation Center has seen mixed…

CMS published its final 2027 Medicare Advantage and Part D rule on April 2, enacting changes to star ratings, supplemental benefits administration, Part D coverage, and a series of deregulatory provisions. The rule is effective June 1 and applies to…

Health savings accounts have become one of the more active areas of federal health policy over the past year, with GOP lawmakers pushing to expand eligibility and use the tax-advantaged accounts as a vehicle for broader consumer-driven healthcare reform.  Four…

Cost Plus Drugs’ Mark Cuban recently voiced his support for the “Break Up Big Medicine Act,” introduced by Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo. Proposed in February, the bill would prevent companies from simultaneously owning a health insurer…

This month, Alabama enacted HB300, a law that requires health plans to cover breast exams without a deductible, copay or coinsurance. Diagnostic breast exams include mammography, MRIs, ultrasounds and molecular imaging used for detecting and understanding abnormalities. Health plans must…

Iowa Republican Gov. Kim Reynolds signed a bill March 25, originally introduced March 13, that would tax HMOs 0.95% on money flowing through the plan to build out a healthcare fund. The tax will encompass HMOs, including Medicaid managed care…

For the first time, payers must publicly post data on how often they deny prior authorization requests, how quickly they process them and how often denials are overturned on appeal. The first reports are due March 31 under a rule…

The CDC estimates that over three-quarters of American adults have at least one chronic condition, forcing healthcare leaders to strategize around system strain, quality of life and costs. In a March report, AHIP outlined approaches payers can take to address…

The city of Boston will implement utilization management for its employees, according to a March 26 news release from Mayor Michelle Wu’s office. The Public Employee Committee voted to pass the agreement with unanimous consent. The city expects to save…