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Payer Policy Updates

Colorado Gov. Jared Polis signed legislation May 14 that directs the Colorado School of Public Health to research and draft model legislation for a universal healthcare system in the state. The Colorado School of Public Health will be tasked with…

House Republicans are looking to finalize the details of their budget reconciliation package by the end of the month, which would include major changes to ICHRAs. The insurance model allows employees to shop on the ACA marketplace for a health…

The nation’s largest Medicaid program could eliminate coverage of GLP-1 drugs for weight loss.  A proposed budget published by California Gov. Gavin Newsom would eliminate coverage for GLP-1 drugs for weight loss beginning in 2026. The proposal would save an…

House Republicans are looking to finalize the details of their budget reconciliation package by the end of the month, which would include major changes to health reimbursement arrangements and high deductible health plans. 10 notes: 1. Working seniors who are…

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The Center for Medicare and Medicaid Innovation is laying out a new strategy, including plans to require all alternative payment models to involve downside risk.  In a May 13 news release, Abe Sutton, director of the CMMI, wrote that the…

The nation’s uninsured rate is expected to rise exponentially if ACA premium tax credits expire and GOP lawmakers implement new Medicaid policies as part of a broader budget reconciliation package. In 2024, the U.S. uninsured rate across all ages was…

Health plans are backing a proposal from Connecticut Gov. Ned Lamont to cap the rates hospitals can charge for out-of-network services, the CT Mirror reported May 9.  The measure would bar providers from charging more than 240% of Medicare rates…

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