Reps. Jan Schakowsky, D-Ill., and Mark Pocan, D-Wis., introduced a resolution opposing a Trump administration initiative that they said would “force recipients of traditional Medicare to receive prior authorization, including through the use of artificial intelligence, before being able to…
Policy Updates
Two prior authorization reform bills have passed the California legislature and are headed to Gov. Gavin Newsom’s desk. The California Medical Association, which supported the legislation, said in a Sept. 11 news release the bills “aim to dramatically streamline the…
Sen. Richard Blumenthal is urging Cigna to rescind a new policy he said will create “onerous administrative burdens for physicians, needlessly raises costs for healthcare providers and jeopardizes patient care.” Beginning Oct. 1, Cigna’s new Evaluation and Management Coding Accuracy…
Massachusetts’ Division of Insurance and Department of Public Health has issued a bulletin Sept. 3 requiring insurance carriers to cover vaccines as outlined by the state, not just the CDC. “We won’t let Donald Trump and Robert Kennedy get between…
Montana has submitted an application to HHS to add work requirements and enhanced cost-sharing to its Medicaid expansion program. Under the proposal, “working-age, able-bodied adults” with incomes up to 138% of the federal poverty level will be required to complete…
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The House Committee on Oversight and Government Reform is investigating CVS Health over reports of the company using confidential patient information to lobby against a bill under consideration by the Louisiana legislature. Chairman James Comer, R-Ky., and Subcommittee on Federal…
CMS is expanding eligibility for catastrophic health coverage on the ACA marketplace in 2026. The agency issued new hardship exemption guidance on Sept. 4 aimed at individuals projected to be ineligible for advance premium tax credits or cost-sharing reductions due…
The California and Texas medical associations are urging Cigna to rescind a new policy they say will increase administrative burdens and create a barrier to appropriate reimbursement. Beginning Oct. 1, Cigna’s new Evaluation and Management Coding Accuracy policy will review…
Aetna is rolling out new claims cost control measures under its Claim and Code Review Program, beginning Sept. 1. The new claims editing policy applies to commercial, Medicare and student health members, the company said in June. Aetna may trigger…
HHS and CMS are establishing a panel of experts tasked with providing recommendations on how to “improve how care is financed and delivered” across Medicare, Medicaid, the Children’s Health Insurance Program and the ACA’s exchanges. Members of the Healthcare Advisory…