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…
Policy Updates
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…
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…
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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…
The Department of Labor’s Employee Benefits Security Administration has concluded that a proposed health plan sponsored by the Idaho Farm Bureau Federation qualifies as an employee welfare benefit plan under the Employee Retirement Income Security Act, according to an advisory…
For years, prior authorization has remained among the most contentious pressure points between payers and providers, but those tensions may finally be seeing tangible improvement. Over the last year, health insurers have made multiple voluntary commitments to reduce their requirements,…
As states float prior authorization reform, some are specifically targeting AI use with prior authorization and claims review. A May 6 KFF issue brief broke down where these policies stand and the role the federal government could play. Here are…