CMS will move ahead with Medicare Advantage risk adjustment changes payers and some provider groups opposed, but the agency will phase in the model over three years.
Payer Policy Updates
After more than three years, the nation's continuous Medicaid enrollment policy has come to an end, setting off a pivotal redetermination period that will present unprecedented challenges for payers, health systems, and state Medicaid agencies alike.
Clear data collection standards will help advance health equity, the Blue Cross Blue Shield Association says.
HHS Secretary Xavier Becerra told the Senate Finance Committee that proposed Medicare Advantage rate changes will not lead to cuts in benefits.
CMS has instructed all independent dispute resolution entities to resume issuing No Surprises Act payment determinations involving out-of-network services and items.
Cigna is moving forward with an updated version of a paperwork demand it paused last year amid criticism from medical groups, the California Medical Association said March 16.
CMS laid out more details on how it plans to implement the first-ever negotiation process of drug prices under Medicare, which will first apply in 2026.
Leaders of the North Carolina House and Senate have agreed on a Medicaid expansion plan, radio station WUNC reported March 2.
As the end to the nation's COVID-19 public health emergency looms, hospitals and health systems are prepping for an unprecedented period — the unwinding of federal policy that led to a complete transformation of care delivery operations, including billing processes,…
California lawmakers are mulling legislation to allow immigrants without legal status to purchase health insurance on Covered California, the state's ACA Exchange, the Sacramento Bee reported Feb. 24.