Health Plan Weekly

ACA Subsidies Could Expand, but Public Option Is Unlikely

With the new Congress largely in place, and the new presidential administration set to take power on Jan. 20, health care insiders are beginning to make sense of what legislation and rulemaking the Biden administrat...
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© 2024 MMIT

Payers Stop Funding Reps Who Didn’t Certify Election Results

Insurers and other health care organizations are halting or reconsidering donations to federal lawmakers who voted against certifying the results of the presidential election, in moves they say are designed to count...
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© 2024 MMIT

Tennessee’s ‘Aggregate Cap’ Medicaid Waiver Gets CMS OK

Continuing its spree of approving ambitious waivers before the end of the Trump administration, CMS on Jan. 8 gave Tennessee its blessing to become the first state in the nation to cap its Medicaid funding in exchan...
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© 2024 MMIT

News Briefs

✦ On Jan. 15, CMS finalized a rule that compels Medicaid, CHIP and Affordable Care Act (ACA) exchange plans to streamline their prior authorization processes. The regulation, which the administration proposed in D...
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© 2024 MMIT

Centene, UnitedHealth Start New Year With Acquisitions

Although 2021 has just begun, major health insurers appear to be wasting no time when it comes to spending the influx of cash that they’ve collected as a result of reimbursing lower-than-normal medical claims duri...
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McCarran-Ferguson Repeal Is Unlikely to Change Status Quo

Editor's Note: President Donald Trump signed the Competitive Health Insurance Reform Act into law on Jan. 13. In December, Congress repealed some federal antitrust exemptions for insurers, over the objection of s...
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Study of N.J. System Sheds Light On Federal Surprise Billing Fix With Chart: New Jersey Arbitration System Tends to Favor Providers

An arbitration system to resolve payment disputes between insurers and out-of-network providers over surprise medical bills in New Jersey has resulted in payments that are much higher than prevailing in-network rate...
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National Health Care Expenditures Grew Steadily in 2019

Total U.S. health care spending increased 4.6% to reach $3.8 trillion in 2019, according to CMS’s Office of the Actuary. Medicare spending experienced a higher growth rate in 2019 than in 2018, increasing by 6.7% ...
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Insurers Sound Off on Recent Proposed Rules From CMS

While CMS has been busy issuing health care regulations in the Trump administration’s final days, industry trade groups have likewise been churning out comment letters that detail their position on those proposals...
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© 2024 MMIT