Payer Policy Updates

CMS is looking to receive feedback from stakeholders on how Medicaid and the Children's Health Insurance Program can increase healthcare access. 

Forty senators penned a letter calling on HHS Secretary Xavier Becerra to implement more consumer protections against "junk insurance."

Michigan lawmakers passed a bipartisan bill Feb. 16 that seeks to increase the transparency of its pharmacy benefit managers in an effort to bring down prescription drug prices. 

Thirty-four U.S. senators issued a joint statement to the Biden administration Feb. 16  urging it to increase enforcement against payers who illegally deny birth control coverage.

CMS updated Medicaid's coverage of an early-detection lung cancer screening Feb. 10, a move that would expand coverage nationwide. 

The Federal Trade Commission will vote Feb. 17 whether to investigate the anticompetitive impacts of pharmacy benefit managers on independent pharmacies.  

America's Health Insurance Plans supported CMS' preliminary guidance on covering Aduhelm, Biogen's Alzheimer's disease treatment, calling its decision "the right approach."

Mississippi's House of Representatives passed an amendment to a bill that would bar the state from contracting Medicaid services to entities that have settled with the state for over $50 million — a move specifically targeting Centene — according to…

CMS released additional guidance Feb. 4 on how payers should best cover at-home COVID-19 tests. 

President Joe Biden's administration is no longer allowing several states to charge premiums to newly-eligible Medicaid enrollees — an undoing of Obama and Trump-era allowances, according to NPR.