CMS will sunset the Medicare Advantage Value-Based Insurance Design Model at the end of 2026, citing "unprecedented" costs to the Medicare trust fund.
Payer Policy Updates
CMS has moved the deadline to enroll in federally facilitated marketplace coverage from Dec. 15 to Dec. 18 for benefits that begin in the new year.
Medicare Advantage plans must comply with new network adequacy and health equity standards in 2025.
Centene executives do not expect a second Trump administration to be able to push through major changes to Medicaid.
A federal judge has halted new regulations allowing individuals who are part of the Deferred Action for Childhood Arrivals program to enroll in ACA marketplace plans.
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Anthem Blue Cross Blue Shield has walked back a controversial policy capping the amount of time it would reimburse providers for anesthesia services.
An Illinois lawmaker has introduced legislation that aims to provide greater oversight of how insurers use artificial intelligence in decision-making processes.
CMS proposed major reforms on Nov. 26 for the Medicare Advantage and Part D programs for contract year 2026, including changes to prior authorization and weight loss drug coverage.
Changes could be coming for Medicaid in the next presidential administration.
Payer executives expressed confidence in the continuation of enhanced ACA subsidies in some form past 2025.