The Trump administration’s bid to rewrite how catastrophic plans are structured under the Affordable Care Act is raising legal and actuarial questions, even as some policy professionals applaud the creativity aimed at solving rising premiums. The Centers for Medicare & Medicaid Services released a proposed rule earlier this year that would allow catastrophic plans to design terms ...

The Blue Cross Blue Shield Association submitted a wide-ranging letter to CMS on March 30 in response to the agency’s information request on its Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH, initiative. Seven BCBSA recommendations: 1. CMS should notify Medicare Advantage plans in real time when it suspends payments to a provider over suspected ...

Following significant industry outcry over a proposal to keep Medicare Advantage rates largely flat in 2027, the Trump administration has bumped payments up slightly in the final policy. The Centers for Medicare & Medicaid Services initially proposed a 0.09% increase in rates as part of the MA and Part D Advance Notice. In the final rule, the increase ...

Weight loss is complex – and goes beyond counting calories, according to experts. Dr. Jason Fung, a kidney specialist and author of the recent book “The Hunger Code,” said lasting weight loss requires a shift in how people understand and respond to hunger. “Most of the time, we focus on eating less or what we’re eating, ...

The Trump Administration abruptly canceling – then perhaps reinstating or partially reinstating – federal health grants is creating overall “funding volatility” in state and local public health programs, officials told state lawmakers this week. The ongoing cuts and constant back-and-forth policy changes have confounded efforts to maintain state and local programs as well as retain ...

More than 10,000 people have enrolled in Nevada’s new public option health plans, which debuted last fall with the expectation that they would bring lower prices to the health insurance market. Those preliminary numbers from the open enrollment period that ended in January are less than a third of what state officials had projected. Nevada ...