UnitedHealth Group is feeling “better than pretty good” about the potential for pharmaceutical tariffs and the resulting possible impact on its businesses. President Donald Trump has threatened tariffs on pharmaceutical imports, with U.S. Commerce Secretary Howard Lutnick saying April 13…
Payer Policy Updates
CMS’ payment increase of 5.03% in 2026 “will likely significantly support the recovery” of Medicare Advantage plans as they continue to face rising medical costs, according to Fitch Ratings. Increased government scrutiny, reduced base payments and rising utilization in the…
Medicare Advantage plans spent $38 billion on non-Medicare benefits in 2024, according to a Medicare Payment Advisory Commission report. The group, which advises Congress on Medicare issues, held a meeting April 10. According to a presentation, MA plans received $83…
At least 11 states are considering work requirements for their Medicaid programs. President Donald Trump backed Medicaid work requirements during his first administration. During Mr. Trump’s first term in office, 13 states chose to implement work requirements in their Medicaid…
California faces the biggest potential coverage losses if federal Medicaid work requirements are enacted, according to an April 14 analysis from the Urban Institute. About five million adults nationwide could lose Medicaid coverage next year under a federal work requirement…
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California lawmakers are allocating an additional $2.8 billion to Medi-Cal following rising costs, the Sacramento Bee reported April 10. Gov. Gavin Newsom’s administration said that the unexpected costs within the Medi-Cal program are due to expensive drugs, leftover COVID-19 era…
CMS will stop approving or extending Medicaid funding for certain state health programs that fund nontraditional or nonmedical services, the agency said April 10. Four things to know: 1. CMS notified states of the change April 10, which applies to…
Multiple states have introduced legislation in 2025 aimed at offering tax relief to small businesses that provide individual coverage health reimbursement arrangements, or ICHRAs, to their employees. The proposals would incentivize small employers to adopt ICHRAs by offering tax credits…
CMS will increase payments to Medicare Advantage plans by more than $25 billion in 2026. The agency published the final rate announcement for MA plans April 7. According to CMS, MA plans can expect a payment increase of 5.03% in…
Groups representing insurers praised CMS’s final rule for Medicare Advantage in 2026. In a statement published April 4, Better Medicare Alliance President Mary Beth Donahue called the rule the “right decision to protect seniors and the Medicare Advantage program.” “As…