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BCBS Massachusetts extends telehealth coverage
Blue Cross Blue Shield of Massachusetts will continue reimbursing telehealth at the same rate as in-person services for primary and chronic care for now. -
Connecticut considers bill to reimburse insurers for pricey claims
Connecticut lawmakers are considering a proposal to reduce premiums by reimbursing insurers for the most costly claims, CT News Junkie reported Feb. 16. -
West Virginia considers Medicaid 'buy-in' program
West Virginia lawmakers are considering adding a Medicaid "buy-in" program to provide insurance to low-income workers making too much to qualify for the program, the News and Sentinel reported Feb. 16. -
HHS: Medicare Advantage audits, risk adjustment changes are not funding cuts
Medicare Advantage audits are "unequivocally not cuts" in funding, HHS says. -
Proposed 2024 Medicare Advantage rates could cut member benefits by $540 a year
Proposed changes to Medicare Advantage payments could cut benefits for members, according to a report commissioned by the Better Medicare Alliance. -
Five unanswered questions about CMS' new Medicare Advantage audit rule
In January, CMS said it will implement stricter auditing practices around Medicare Advantage plans, but payers and policy experts say they have a lot of questions about the next steps forward. -
'Mediscare': What proposed cuts to Medicare really mean
President Joe Biden has vowed to strike down any law that cuts Medicare spending — but cutting spending can come in many forms. -
AHIP has 'serious concerns' about changes to MA star ratings
AHIP, the trade association representing the insurance industry, is opposed to some of CMS' proposed changes to the Medicare Advantage star ratings program. -
AMA, provider groups praise CMS' proposed MA prior authorization changes
Provider groups are applauding CMS' proposed rule overhauling prior authorization in Medicare Advantage. -
The 20% Medicare cut coming for hospitals
As the U.S. prepares to end the COVID-19 public health emergency, hospitals are facing a major cut in Medicare payments used to treat patients diagnosed with the disease. -
New York lawmakers debate single-payer legislation
New York state legislators and stakeholders are debating a bill that would overhaul the state's health system and establish a single-payer system, Spectrum News reported Feb. 9. -
HHS lays out timeline for Medicare drug inflation rebates
Traditional Medicare and Medicare Advantage beneficiaries could begin seeing lower copays for certain Part B drugs beginning April 1, according to new guidance from HHS. -
What 7 payers said about Medicaid redeterminations
Payer executives are expecting to lose members in their Medicaid managed care contracts as states begin the redetermination process, but some are hopeful to convert some of these members to other lines of business. -
Viewpoint: CMS must stop harmful care denials in Medicare Advantage
As Medicare Advantage insurance companies continue to grow in popularity, it’s important for our nation’s health policy leaders to ensure that MA enrollees have access to the same level of medically-necessary coverage as traditional Medicare. Fortunately, CMS has proposed a rule to address this problem, and public comments are due Feb. 13. -
What 6 payers said about CMS' Medicare Advantage auditing crackdown
Payer executives are still taking stock of tougher Medicare Advantage auditing standards CMS unveiled Jan. 31. -
Federal judge rules against HHS — again — over surprise-billing arbitration rule
A federal judge in Texas has handed another win to the Texas Medical Association and medical providers nationwide against HHS over a challenge to the arbitration process between out-of-network providers and payers that was established under the No Surprises Act. -
Too soon to tell how Medicare Advantage changes will affect revenue, Cigna CEO says
Proposed Medicare Advantage plan rates introduced by CMS could have some impacts on revenue, but it's too early to see the full scope, Cigna CEO David Cordani told investors on a Feb. 3 call transcribed by Seeking Alpha. -
CMS proposes universal quality measures across all programs
CMS is looking to create a "universal foundation" of quality measures across all its programs, such as Medicare and Medicaid. -
CMS proposes small bump in MA payments, sweeping risk adjustment changes
CMS is expecting a small revenue bump of 1.03 percent on average for Medicare Advantage and Part D plans in 2024 as part of a slate of potential risk adjustment and star ratings changes that has some industry leaders concerned. -
New CMS Medicare Advantage audit rule lacks information, Humana execs say
CMS' new Medicare Advantage auditing standards did not include enough information about auditing methods to understand its full impacts, Humana executives said on a Feb. 1 investor call.
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