Policy Updates

CMS is upping its proposed number of non-standard ACA plans payers can offer in each region from two to four. 

HHS has removed seven drugs from its initial list of 27 drugs subject to inflation rebates. 

CMS issued a final rule April 5 that, among other things, aims to streamline Medicare Advantage and Part D prior authorizations and clamp down on misleading marketing practices. 

Two Senators are introducing legislation aimed at reducing Medicare Advantage overpayments. 

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. 

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.