This month, Alabama enacted HB300, a law that requires health plans to cover breast exams without a deductible, copay or coinsurance. Diagnostic breast exams include mammography, MRIs, ultrasounds and molecular imaging used for detecting and understanding abnormalities. Health plans must…
Policy Updates
Iowa Republican Gov. Kim Reynolds signed a bill March 25, originally introduced March 13, that would tax HMOs 0.95% on money flowing through the plan to build out a healthcare fund. The tax will encompass HMOs, including Medicaid managed care…
For the first time, payers must publicly post data on how often they deny prior authorization requests, how quickly they process them and how often denials are overturned on appeal. The first reports are due March 31 under a rule…
The CDC estimates that over three-quarters of American adults have at least one chronic condition, forcing healthcare leaders to strategize around system strain, quality of life and costs. In a March report, AHIP outlined approaches payers can take to address…
The city of Boston will implement utilization management for its employees, according to a March 26 news release from Mayor Michelle Wu’s office. The Public Employee Committee voted to pass the agreement with unanimous consent. The city expects to save…
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A March analysis from KFF aims to shed light on CMS’ upcoming BALANCE model for GLP-1 coverage — highlighting financial requirements, operational mandates and unresolved policy questions — ahead of its 2027 launch. The model, announced in December, builds on the…
CMS approved New York’s efforts to roll back Essential Plan coverage for New Yorkers with incomes between 200% and 250% of the federal poverty level, according to a March 23 news release from New York State of Health, the state’s…
New York Attorney General Letitia James reported $1.53 million in restitution and savings in 2025 through her office’s healthcare helpline, according to a March 23 news release. The helpline acts as a resource for New Yorkers seeking clarity on bills,…
CMS has finalized a rule to phase out faxing and mailing for healthcare claims documentation, which it estimates will save the healthcare industry $781 million annually. Four things to know: 1. The Administrative Simplification; Adoption of Standards for Health Care…
A Democrat-led bill that would create a $200 million trust fund for health coverage cleared a Connecticut state Senate committee, according to a March 19 news release. The money would move from the state’s emergency federal response fund into the…