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CMS announces flexibilities in response to Hurricane Idalia
Health and Human Services Secretary Xavier Becerra last week declared a public health emergency for Florida in response to Hurricane Idalia and waived or modified certain Medicare, Medicaid and Children’s Health Insurance Program requirements to ensure sufficient health care items and services are available.
CMS awards navigator grants for plan year 2024
The Centers for Medicare & Medicaid Services recently awarded 57 organizations $98.6 million in navigator grants to help consumers enroll in health coverage in the 29 states participating in the federal health insurance marketplace in plan year 2024
CMS puts states on notice regarding federal Medicaid, CHIP eligibility requirements
The Centers for Medicare & Medicaid Services sent to each state letters regarding compliance with federal requirements related to automatic eligibility renewals, known as “ex parte” renewals, under Medicaid and the Children’s Health Insurance Program.
Federal court revives benefits denial class action suit against UHC subsidiary
A three-judge panel in federal court last week partially revived a class action lawsuit against UnitedHealth Group subsidiary United Behavioral Health, reversing an earlier decision from 2020.
Inadequate Health Insurance Coverage Drives Medical Debt – Four Solutions to Address this Significant Problem
Trends in health insurance coverage are driving an increase in medical debt: these include inadequate enrollment in comprehensive health care coverage and high-deductible and skinny health plans that intentionally push more costs onto patients.
NAIC report calls for regulatory oversight of ACA preventive services requirement
A new report by the National Association of Insurance Commissioners’ Consumer Representatives calls for regulatory oversight to ensure insurers comply with the Affordable Care Act requirement to cover certain preventive services without cost-sharing.
CMS reinstates $50 fee to administer new No Surprises Act payment disputes
The Centers for Medicare & Medicaid Services today released a FAQ explaining how it will handle the administrative fee for out-of-network providers and group health plans that initiate payment disputes under the No Surprises Act’s independent dispute resolution process on or after Aug. 3, when a federal judge vacated nationwide a six-fold increase in the fee.
AHA op-ed: It’s time to hold commercial health insurers accountable
“Health insurance should be a bridge to medical care, not a barrier. Yet too many commercial health insurance policies often delay, disrupt and deny medically necessary care to patients,” writes AHA President and CEO Rick Pollack in an op-ed today in U.S. News & World Report.
A Strong Step on Enhanced Mental Health Parity Regulations
For years, many commercial health insurers treated coverage for mental health or substance use disorders (SUD) very differently than for medical and surgical benefits.
Proposed rule targets health plan mental health parity compliance
The departments of Labor, Health and Human Services and the Treasury released a proposed rule that seeks to ensure commercial health plans comply with the Mental Health Parity and Addiction Equity Act of 2008, which prohibits them from imposing more restrictive requirements on mental health or substance use disorder benefits than on medical and surgical benefits.