Highmark now covers all diagnostic breast studies and breast MRIs at 100% without copays or deductibles for members of its Blue Cross Blue Shield plans in Pennsylvania, New York, West Virginia and Delaware. The policy was effective Jan. 1 and…
Policy Updates
Laws in North Dakota, Nebraska and Alaska focused on accelerating insurer response times for prior authorizations went into effect Jan. 1. North Dakota Gov. Kelly Armstrong signed the state’s bill in April. The legislation requires plans to decide on nonurgent…
HHS has finalized updated cervical cancer screening guidelines that will require most health insurers to cover self-collection testing and additional screening procedures beginning in 2027. The guidelines were published by the Health Resources and Services Administration on Jan. 5 and…
The New York State Conference of Blue Cross and Blue Shield Plans voiced affordability concerns over three payer-focused mandates that went into effect Jan. 1. The mandates include first-in-the-nation scalp-cooling coverage for chemotherapy patients, EpiPen out-of-pocket caps and expanded access,…
A Colorado law equalizing behavioral and physical health in insurance coverage went into effect Jan. 1, preventing carriers in the state from limiting the “medically necessary treatment” of behavioral, mental health and substance use disorders. The law was passed in…
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An Arkansas law has expanded coverage for bariatric surgery, but not weight-loss drugs. Under Act 628, the state’s Medicaid program and commercial plans must cover bariatric surgery — along with its preoperative and post-operative care — for individuals with “severe…
Health insurers face a wave of regulatory and policy changes in 2026, from the expiration of enhanced ACA premium tax credits to tighter prior authorization rules and new state coverage mandates. Here’s a rundown of major federal and state payer…
Fourteen House lawmakers are calling on federal officials to investigate Elevance Health’s new policy that will penalize hospitals that use out-of-network providers, arguing the approach is anti-competitive and undermines the No Surprises Act. On Dec. 18, the bipartisan group of…
CMS shared plans Dec. 23 for its voluntary “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” — or BALANCE — model. The announcement comes weeks following the White House’s agreements with Eli Lilly and Novo Nordisk to apply most-favored-nation…
The American Hospital Association and Federation of American Hospitals are calling on Elevance Health to rescind a new policy that would penalize hospitals for using out-of-network providers. In a Dec. 17 letter to Elevance President and CEO Gail Boudreaux, AHA…