Payer Policy Updates

How Medicaid redeterminations reshaped states' policies: 3 notes

Most states are implementing strategies to increase the number of automatic renewals for Medicaid beneficiaries, according to a survey from KFF. The research organization published its annual survey of state Medicaid directors April 1. Every state except Florida responded to…

Senate report scrutinizes Medicare Advantage marketing spend, broker practices

Medicare Advantage insurers are spending an increasing amount on fees and commissions paid to brokers, a report from the office of Senate Finance Committee Ranking Member Ron Wyden found. Mr. Wyden said he planned to open an investigation into five…

States consider crackdowns on AI in prior authorization

Several states are considering regulating how insurers can use AI in prior authorization. In January, a California law took effect that prohibits payers from making coverage decisions based solely on artificial intelligence algorithms. The law requires any denial, delay or…

Texas bill looks to reduce preventive care coverage requirements

Texas lawmakers have introduced legislation that would allow employers to offer health coverage that does not include certain state-mandated health benefits, such as childhood vaccines, hearing screenings, cancer screenings, mental health coverage and diabetes services. The bill was introduced March…

Idaho passes Medicaid managed care, work requirements legislation

Idaho lawmakers have passed legislation aimed at transitioning the state’s Medicaid program to a managed care system while introducing work requirements for able-bodied adults and providing tax credits to help individuals purchase coverage on the state’s ACA exchange.

Minnesota bill would require coverage for weight loss drugs

Minnesota lawmakers have introduced a bill that would require health insurance coverage for the management and treatment of obesity, including GLP-1s.

CMS pitches shortening ACA enrollment period: 5 things to know

CMS is proposing a set of new regulations for ACA marketplaces, including shortening the annual enrollment window and rescinding eligibility for DACA recipients.

UnitedHealthcare to cut prior authorization by 10%

UnitedHealthcare plans to cut prior authorization requirements by around 10% in 2025.

Ohio lawmakers pitch tax credit for small businesses offering ICHRAs

Ohio lawmakers have introduced a new bill that would offer a tax credit to small businesses that provide employees with individual coverage health reimbursement arrangements, or ICHRAs.

Trump's new price transparency executive order: 6 notes for payers

President Donald Trump has signed an executive order aimed at cracking down on price transparency requirements for hospitals and insurers.