Payer Policy Updates

Lawmakers are introducing a bill to crack down on inaccurate provider directories in Medicare Advantage. 

A group of U.S. senators and representatives are introducing legislation to provide Medicaid enrollees with a year of continuous coverage. 

A group of senators says CMS actions to crack down on misleading marketing of Medicare Advantage plans do not go far enough. 

The Better Medicare Alliance is recommending a set of policies to Congress and CMS to improve prior authorization, behavioral health access, equity and more in the program. 

Michigan has codified several provisions of the Affordable Care Act into state law, ahead of a Supreme Court case that could strike down the law's preventive care coverage requirements. 

Payers could soon face pressure to reconsider medical marijuana coverage policies following HHS' recommendation in August that the Drug Enforcement Administration reschedule the drug to a substance accessible through a prescription under federal law.

Federal lawmakers have been probing payers on a variety of issues in recent months, raising concerns on prior authorizations, Medicare Advantage costs, artificial intelligence and more. 

A government shutdown could cause hiccups in the unwinding of Medicaid continuous coverage requirements. 

Two lawmakers are introducing legislation that would expand the scope of supplemental benefits offered in Medicare Advantage. 

Payers and providers don't agree on much when it comes to the No Surprises Act dispute resolution process.