New Hampshire lawmakers are moving to address surprise ambulance billing with proposed legislation that would prohibit insurers from charging patients the balance between what their insurance covers and what ambulance services bill. The bill would mandate that insurers reimburse for…
Payer Policy Updates
The trade group representing insurers is warning budget legislation could lead to ‘unprecedented’ coverage losses. In a May 22 statement, AHIP President Mike Tuffin said that proposed budget legislation would increase uninsured rates and could raise premiums in the individual…
In a reversal, Colorado will continue to cover GLP-1s for state employees who already have prescriptions, the Colorado Sun reported May 20. Copays for those individuals will increase from $30 to $120 in July, and the state’s health plan will…
CMS will audit every Medicare Advantage plan for potential overpayments annually, in what the agency called an “aggressive” plan to step up oversight. According to a May 21 news release, the agency plans to audit each of the more than…
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,…
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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…
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.…