Virginia has banned payers offering coverage on the ACA marketplace from including a surcharge for tobacco use, effective Jan. 1.
Payer Policy Updates
Hospital and payer groups were broadly supportive of proposed changes to Medicare Advantage prior authorization and broker compensation regulations.
A new CMS rule aiming to streamline Medicare Advantage and Part D prior authorizations took effect Jan. 1.
New requirements for payers under CMS' Transparency in Coverage rule took effect Jan. 1.
Starting Jan. 1, California will become the first state to offer Medicaid coverage to all eligible undocumented individuals, Cal Matters reported Dec. 28.
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A pair of senators are asking CMS to require Medicare Advantage plans to cover stays in long-term care facilities at the same rate as traditional Medicare.
CMS will implement new risk adjustment payment rates, prior authorization requirements and network standards for Medicare Advantage plans in 2024.
The federal government will cap drug copays and premiums for Medicare beneficiaries and expand eligibility for financial assistance for medications in 2024.
Massachusetts' Medicaid program, MassHealth, is expanding coverage of doula services to pregnant, birthing and postpartum beneficiaries beginning in spring 2024.
The House Energy and Commerce Committee advanced 19 pieces of legislation Dec. 7, including bills aimed at increasing Medicare Advantage transparency.