The Labor Department finalized a rule to promote transparency as pharmacy benefit managers work with large self-insured group health plans, shared during an Oct. 29 event. The Wall Street Journal initially reported on the final rule one day ahead of…
Policy Updates
The Coalition Against Surprise Medical Billing and the ERISA Industry Committee sent letters to federal officials in late October, calling for more rigorous scrutiny of independent dispute resolution arbitrators under the No Surprises Act. Collectively, the groups represent employers, unions…
Physicians and practices win most No Surprises Act payment disputes. Collecting on those wins is another matter. Two federal appeals courts have now ruled that providers cannot sue insurers to enforce unpaid independent dispute resolution awards, and the Supreme Court…
Under a forthcoming Labor Department rule, pharmacy benefit managers would need to tell their employer clients more about how they get paid, according to an Oct. 28 report from The Wall Street Journal. The department is sharing more details Oct.…
House Democrats introduced a bill Oct. 22 that would lower Medicare’s eligibility age to 50 from 65. The bill comes from Reps. Pramila Jayapal of Washington, Chris Deluzio of Pennsylvania, Debbie Dingell of Michigan and Pat Ryan of New York.…
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Ghost networks have long been a point of frustration, with health plan members sometimes left scrambling to check if a provider is in network — or available at all. Several health insurers — including Elevance Health and Blue Shield of…
Connecticut will start distributing health insurance subsidies worth up to $1,200 annually to early childhood educators on Jan. 1. According to the Connecticut Office of Early Education, the subsidy is available to all early childhood educators eligible for coverage through…
A New Jersey bill that advanced in the state Senate on Oct. 1 would require health coverage for public employees displaced when their agencies use vendor AI tools that evaluate or monitor workers. Under the bill, all public employees losing…
Amazon, Axon, Google, Meta and Oracle are asking the insurers and third-party administrators that run their health plans to expand electronic prior authorization upgrades, first promised under a 2025 federal pledge, to the self-funded market. CMS and the Labor Department…
A newly introduced House bill is targeting the methodology behind Medicare Advantage star ratings, adding more pressure to a program that has seen years of litigation from insurers. The Medicare Advantage Strengthening Transparency and Accountability in Rating Systems Act, or…