Medicare Advantage plans must comply with new network adequacy and health equity standards in 2025.
Payer Policy Updates
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.
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.
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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.
CMS will give less weight to call center metrics in future Medicare Advantage star ratings, according to a top CMS official.
Illinois voters have passed an advisory referendum aimed at requiring all health plans that cover pregnancy to also cover in vitro fertilization, or IVF, and other assisted reproductive treatments on an unlimited basis.