CMS has logged nearly 40,000 complaints alleging potential violations of federal health insurance law since the agency began tracking them in 2022, with the vast majority of closed complaints related to the No Surprises Act, according to an enforcement report…
Policy Updates
Prior authorization reforms in Massachusetts went into effect June 5. Democratic Gov. Maura Healey finalized the regulations in May, following through on her earlier plan to tackle prior authorization. Here are six things to know about the reforms: 1. The…
Federal employees will soon need to verify the eligibility of any dependent they add to their health plan under a new rule finalized by the Office of Personnel Management. The rule, published June 2, implements the FEHB Protection Act of…
Colorado Democratic Gov. Jared Polis signed a bill in early June to move forward with funding for the state’s health insurance affordability efforts. Colorado’s health insurance affordability enterprise — which collects fees from health plan carriers and hospitals to support…
The Trump administration has finalized an overhaul of the No Surprises Act’s independent dispute resolution process, establishing a centralized disputes gateway, creating a new federal payer registry, and reducing administrative fees. The final rule, issued jointly by HHS, the Labor…
Advertisement
Seventeen Democratic senators are proposing to add home care coverage to Medicare for the first time, along with an expansion of Medicaid home- and community-based services. The proposed framework, published May 20, centers on creating a Medicare “home care guarantee,”…
Massachusetts will impose the strictest limits on health insurance cost-sharing in the country beginning in 2027, Gov. Maura Healey said May 18. Payers will be required to limit increases in member cost-sharing, including deductibles and copays, to no more than…
Maryland’s Prescription Drug Affordability Board has voted to place an upper payment limit on Ozempic for state and local government health plans, a first for the nation, and a move supporters said could save about $5.8 million annually. The board…
From the Oval Office to Congress, fraud has become one of the loudest rallying cries of the federal government’s healthcare agenda this year. Minnesota was an early target of the Trump administration’s healthcare fraud crackdown, but the scrutiny has since…
Iowa Republican Gov. Kim Reynolds signed a law May 13 that enacts prior authorization reforms and prohibits insurers from penalizing providers for out-of-network referrals, according to the Iowa Hospital Association. Under the law, while initial prior authorization reviews can be…