Payer Policy Updates

Average Medicare Advantage premiums and Medicare Part D premiums will decrease in 2024, CMS said Sept. 27. 

CMS is providing states new guidance to ensure states comply with required Medicaid services for children. 

States must be in full compliance with all of CMS' Medicaid renewal requirements by the end of 2026.  

Deregulating the individual insurance market would be part of former President Donald Trump's healthcare agenda in a second term, according to his running mate, Sen. JD Vance.

Optum Rx will join the other major pharmacy benefit managers and exclude Humira from some formularies. 

Insurers and employers are pushing back on new rules that would toughen requirements for mental health parity. 

The Biden administration has finalized new requirements for health plans to strengthen mental health parity laws for 175 million Americans.

Cigna will remove Humira from its largest commercial formularies in 2025. 

Aetna will cover intrauterine insemination as a medical benefit for eligible plans, a move the insurer called a "landmark policy change." 

A California bill aimed at improving and enforcing the accuracy of insurer's provider directories has died in a state Senate committee.