Thursday, March 23, 2023: Payers

California Governor Gavin Newsom is tapping federal health care funding to cover rent for homeless people and those at risk of losing their housing. States are barred from using federal Medicaid dollars to pay directly for rent, but California’s governor is asking the...

Tuesday, March 21, 2023: Payers

The Medicaid and CHIP Payment and Access Commission (MACPAC) released proposals for Congress as part of its March report last week and included a recommendation that would give states the power to not pay full prices under Medicaid for drugs approved under the Food...

Monday, March 20, 2023: Payers

A group of House lawmakers is hoping to outlaw the use of spread pricing by pharmacy benefit managers (PBMs) in the Medicaid program. The Drug Transparency in Medicaid Act, reintroduced Friday, is the latest PBM reform bill launched by this Congress. The bipartisan...

Thursday, March 16, 2023: Payers

As the public health emergency ends, Medicaid enrollees and the health insurance companies that cover them face major disruptions in the coming months as states resume removing people who no longer qualify for the program. A Modern Healthcare article states that an...

Tuesday, March 14, 2023: Payers

Thousands of patients have called on a federal court to reverse a landmark ruling allowing a UnitedHealth Group subsidiary to develop mental and substance abuse coverage guidelines they allege deviate from clinical standards. The American Medical Association, the...

Thursday, March 2, 2023: Payers

Health insurers’ margins in Medicare Advantage were more than double those seen in other markets in 2021, reinforcing the way the program can produce strong financial returns for plans, a new Kaiser Family Foundation analysis shows. Private Medicare plans are...