In December, CMS proposed to streamline prior authorizations; surgeons are skeptical
Claire Wallace | May 22, 2023 In December, CMS submitted a 134-page proposal designed to improve prior authorizations for Medicare and Medicaid patients through automating the process and improving workflows. The proposal requires certain payers to address the administrative hassles of prior authorization by requiring the implementation of an automated process, meeting shorter time frames for decision-making…
Progressives reintroduce ‘Medicare for All’ bill
Paige Minemyer | May 18, 2023 Key progressives in the House and Senate have revived the fight in Congress over “Medicare for All,” a single-payer health system based on the Medicare program. Sen. Bernie Sanders, I-Vermont, and Reps. Pramila Jayapal, D-Washington, and Debbie Dingell, D-Michigan, reintroduced the Medicare for All Act, with 14 Senate Democrats…
Insurers set to pay $1.1B in premium rebates this year
Frank Diamond | May 18, 2023 COVID-19 led to huge declines in care utilization, and insurers are still feeling the effects as they must dole out more than $1 billion in premium rebates this fall. Payers will need to shell out about $1.1 billion in rebates, according to an analysis by the Kaiser Family Foundation…
CMS raises cap on nonstandard plans in final ACA exchange rule
Paige Minemyer | April 18, 2023 The Biden administration is giving insurers a bit more breathing room to offer nonstandardized plans on HealthCare.gov next year. The Centers for Medicare & Medicaid Services (CMS) finalized its annual Notice of Benefit and Payment Parameters rule late Monday, and the regulation’s final version allows insurers to offer four…
CMS proposes 2.8% hospital payment bump for 2024; lobbies decry rise as ‘woefully inadequate’
Rebecca Pifer | April 11, 2023 Dive Brief:The CMS is proposing a 2.8% pay increase for hospitals in 2024, which would result in $3.3 billion in additional funding that year. Hospitals say it’s not enough. The Biden administration released its annual Medicare payment rule for inpatient hospitals and long-term care facilities, which also includes a…