Federal lawmakers have reintroduced the “Improving Seniors’ Timely Access to Care Act,” a bipartisan bill that aims to streamline the prior authorization process for Medicare Advantage enrollees. The proposal would establish an electronic prior authorization process for Medicare Advantage plans,…
Payer Policy Updates
Medicare could face nearly $500 billion in cuts over the next decade under Republicans’ “One Big Beautiful Bill Act,” which also proposes significant reductions to Medicaid and other healthcare programs. According to a May 20 report from the nonpartisan Congressional…
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…
Three states that offer health coverage to undocumented immigrants are sunsetting or limiting those benefits following expenses that were greater than anticipated. House Republicans’ proposed budget reconciliation package also includes provisions to penalize states financially if they provide Medicaid benefits…
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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…
California Gov. Gavin Newsom is proposing freezing enrollment for undocumented immigrants in the state’s Medicaid program as it faces large budget shortfalls. A proposed budget published May 14 would freeze enrollment of undocumented immigrants ages 19 and older in Medi-Cal.…
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…
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…