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Policy Updates

Algorithms and artificial intelligence-powered software tools can be used to support Medicare Advantage plans in making coverage decisions for members, but payers are still bound by CMS' internal benefits requirements and nondiscrimination rules under the ACA, the agency said in…

Florida is challenging rules from CMS that require states keep eligible children enrolled in Medicaid and CHIP for a full 12 months, even if their families do not pay premiums. 

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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.

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