New Hampshire Gov. Kelly Ayotte has signed legislation banning surprise ground ambulance billing and establishing reimbursement rates insurers must pay for services. Beginning Jan. 1, 2026, ambulance providers — whether in-network or out-of-network — will be prohibited from billing patients…
Payer Policy Updates
Aetna is rolling out a new inpatient reimbursement policy for its Medicare Advantage and Special Needs Plans, effective Nov. 15. “Our goal is simple: We want to help you get reimbursed faster for inpatient admissions that are initially denied. You’ll…
The Trump administration has no current plans to require payers to provide coverage for in vitro fertilization services, despite a campaign pledge to do so, The Washington Post reported Aug. 3. Five things to know: 1. During his 2024 presidential…
New Hampshire Gov. Kelly Ayotte has signed a bill that requires insurers to notify the state’s insurance department at least 90 days in advance before discontinuing a line of business, including Medicare Advantage plans. The bill specifically mandates that insurers…
Oregon health officials are weighing a potential cap on commercial health insurance payments to hospitals in an effort to address rising costs, the Oregonian reported July 15. According to the report, the state’s Committee on Health Care Affordability has been…
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On July 4, President Donald Trump signed the “One Big Beautiful Bill Act,” which includes major changes for employee benefits. Six notes: 1. Starting January 1, individuals enrolled in bronze and catastrophic ACA plans will be eligible to contribute to…
Groups representing insurers are urging the House of Representatives to rollback steep Medicaid cuts passed by the Senate. The “One Big Beautiful Bill Act, a 1,000+ page budget reconciliation package, passed the Senate July 1. The Senate version would cut…
Louisiana Gov. Jeff Landry has vetoed a key provision from the state’s budget plan that would have required coverage of weight loss medications for state employees and their dependents for the upcoming fiscal year, citing concerns over long-term costs. The…
A bipartisan group of lawmakers is introducing legislation that would allow the Department of Veterans Affairs to bill Medicare Advantage plans for care provided to members, the Wall Street Journal reported June 23. A study published in Health Affairs in…
CMS will raise limits for payments to Medicare Advantage brokers for 2026. According to a notice from CMS published June 18, plans can pay brokers up to $694 for new enrollments in MA plans, and $347 for renewing existing members.…