Payer Policy Updates

New Jersey has signed the nation's most comprehensive prior authorization reform bill into law. 

CMS is seeking input on improving transparency in the Medicare Advantage program. 

Blue Cross Blue Shield of Massachusetts is pausing a controversial policy that went into effect Jan. 1 that limited coverage for the use of monitored anesthesia for certain gastrointestinal patients undergoing endoscopic, bronchoscopic or interventional pain procedures, including colonoscopies.

Medicare Advantage's annual enrollment period is over, but the marketing tactics used to sell older adults on the plans are still under scrutiny in Washington. 

A Georgia state lawmaker filed legislation Jan. 9 that would prohibit the use of artificial intelligence technology to determine insurance, health coverage, or public assistance award decisions.

HHS announced several new actions to protect and expand access to reproductive health services and reaffirmed the insurance industry's responsibility in maintaining that access. 

A proposed bill in Idaho would repeal Medicaid expansion if the state does not implement work requirements and enrollment limits in the program, Idaho Press reported Jan. 22. 

From the finalization of a rule CMS estimates will save $15 billion over 10 years to the implementation of another, here are four prior authorization updates Becker's has reported on since Dec. 29:

The Medicare Payment and Advisory Commission is considering standardizing the supplemental benefits Medicare Advantage insurers can offer, to make it easier for beneficiaries to compare plans. 

A group of Republican senators have introduced legislation that would ban the use of federal funding to expand state Medicaid benefits to undocumented residents.