Tag: health insurance program.

Prior Authorization in Medicare Advantage

Prior Authorization in Medicare Advantage : Lawmakers Call for Streamlined Process

CMS has proposed a rule to simplify prior authorization in government-sponsored health insurance programs. However, some lawmakers are urging the agency to do more. A bipartisan coalition of 233 representatives and 61 senators have written a letter to CMS requesting that the proposed rules be expanded and that the changes be finalized quickly to enhance […]
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13 recent CMS actions

CMS recently released new data on hospital changes of ownership, a health equity plan and said it would end a legal battle with Texas over Medicaid. Becker’s has reported on the following 13 CMS moves since April 8. Finance No hospitals received price transparency notices in April, CMS says CMS issued no additional warning notices […]
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$2B in Provider Relief Fund Payments Heading to Providers

The Provider Relief Fund payments are part of the Phase 4 General Distribution announced in December. HHS, through the Health Resources and Services Administration (HRSA), is doling out another $2 billion in Provider Relief Fund payments to healthcare providers impacted by the COVID-19 pandemic. More than 7,600 providers across the country will get the payments […]
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AHA Calls for Medicare Advantage Inclusion in Prior Authorization Rule

The American Hospital Association (AHA) has asked CMS to include Medicare Advantage organizations in its proposed rule that would streamline the prior authorization process and reduce patient care delays. In December 2020, CMS released a notice of proposed rulemaking about improving prior authorization, following past administrative and clinician struggles. If the rule is finalized, there […]
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Affordable Care Act Marketplace Sees Boost in Diversity, Savings

HHS has announced that 2.8 million people gained health insurance coverage through the Affordable Care Act marketplace during the special enrollment period. This influx of enrollees raised marketplace enrollment to 12.2 million, the highest enrollment level that these marketplaces have ever seen. “It’s clear that when health coverage is accessible and affordable, people sign up, […]
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The CMS provides additional ARP funding to states to promote insurance affordability

The Centers for Medicare and Medicaid Services and the Biden Administration have earmarked $452 million in federal funding through the ARP  funding to Health insurance program for efforts to lower costs and improve health insurance access in 13 states. Due to the changes made to the ARP, states with 1332 reinsurance waivers will have more […]
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