Payer Policy Updates

CMS will extend a special enrollment period for ACA coverage with the goal of getting more people losing Medicaid insured. 

The Biden administration is cracking down on short-term 'junk' health plans that can leave members with poor coverage and large medical expenses.

CMS finalized new rules that are intended to eliminate barriers to Medicaid and CHIP access. 

A bipartisan group of senators is introducing legislation to require states to offer integrated Medicaid and Medicare plans to dual-eligible beneficiaries. 

The American Medical Association is asking for more flexibility and resources from the federal government for providers that continue to face disruptions from the Change Healthcare hack in late February.

The Biden Administration is doubling down on a proposal to create "Medicaid-like" coverage for low-income adults in states that have not expanded the program. 

Wegovy is now approved to be used to reduce the risk of heart attack, stroke and cardiovascular death, which could lead to broader payer coverage of the drug. 

Maryland legislators are considering a bill that would allow people to purchase insurance on Maryland's health insurance exchange, regardless of their immigration status. 

California legislators are putting a single-payer system back on the table, but it still faces long odds of becoming a reality, the Los Angeles Times reported Feb. 21. 

Colorado lawmakers are considering a bill that would prevent customers from incurring extra out-of-pocket costs if their insurer goes bankrupt in the middle of the year.