On July 4, President Donald Trump signed the “One Big Beautiful Bill Act,” which includes major changes for employee benefits. Six notes: 1. Starting January 1, individuals enrolled in bronze and catastrophic ACA plans will be eligible to contribute to…
Payer Policy Updates
Groups representing insurers are urging the House of Representatives to rollback steep Medicaid cuts passed by the Senate. The “One Big Beautiful Bill Act, a 1,000+ page budget reconciliation package, passed the Senate July 1. The Senate version would cut…
Federal lawmakers have introduced a handful of bills aimed at speeding up prior authorization and cracking down on upcoding in Medicare Advantage. None of the introduced bills have been heard in committee. Here are five proposals introduced in 2025 to…
Louisiana Gov. Jeff Landry has vetoed a key provision from the state’s budget plan that would have required coverage of weight loss medications for state employees and their dependents for the upcoming fiscal year, citing concerns over long-term costs. The…
A bipartisan group of lawmakers is introducing legislation that would allow the Department of Veterans Affairs to bill Medicare Advantage plans for care provided to members, the Wall Street Journal reported June 23. A study published in Health Affairs in…
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CMS will raise limits for payments to Medicare Advantage brokers for 2026. According to a notice from CMS published June 18, plans can pay brokers up to $694 for new enrollments in MA plans, and $347 for renewing existing members.…
CMS is implementing a final rule that will shorten the open enrollment period on the ACA exchange and create stricter eligibility verifications for enrollees. In a June 20 news release, the agency said the changes will lower individual premiums by…
The Trump administration and insurers appear to have their own changes to reimbursement practices in store, with announcements expected next week — adding to funding changes outlined in Congress’ budget reconciliation bills. The Wall Street Journal reported June 20 that…
A group of Democratic lawmakers has introduced legislation to create a public insurance option for individuals and employers. The Choose Medicare Act was introduced by Reps. Jimmy Gonzalez, Jared Huffman, LaMonica McIver and Eleanor Holmes Norton, and Sens. Jeff Merkley…
Three states that offer health coverage to undocumented immigrants are sunsetting or limiting those benefits. House Republicans’ proposed budget reconciliation package also includes provisions to penalize states financially if they provide Medicaid benefits to noncitizen residents by reducing their ACA…