Author: Scott Welch
To improve the accessibility of price information for commercial health care consumers and other stakeholders, the departments of Health and Human Services, Labor, and Treasury implemented the Transparency in Coverage Final Rule (hereafter, the Insurer Price Transparency Rule) in October 2020. The rule has two key provisions for all insurers offering individual and group commercial health insurance ...
The Biden administration is proposing to increase Medicare Advantage (MA) and Part D plan payments by 1.03% for 2024 amid other changes to the programs’ risk adjustment model. The Centers for Medicare & Medicaid Services (CMS) released the advance notice of methodological changes for MA capitation rates and payment policies for MA and Part D. ...
As part of its new virtual primary care service, CVS Health is expanding telehealth-based mental health care to include appointments with licensed therapists and psychiatrists. The retail drugstore giant announced its virtual care offering last May to give consumers access to primary care, on-demand care, chronic condition management and mental health services. CVS executives say the virtual primary care offering is ...
President Joe Biden intends to end the Covid-19 national and public health emergencies on May 11, the White House said Monday. That means that many Americans could have to start paying for Covid-19 testing and treatment after the declarations cease.
California’s decision last month to cancel the results of a long-planned bidding competition among commercial health plans in its Medicaid program has some industry insiders and consumer advocates wondering whether the state can stand up to insurers and force improvements in care for millions of low-income beneficiaries.
Speaker Kevin McCarthy (R-Calif.) said on Thursday that House Republicans will not target Medicare or Social Security in their negotiations over the debt ceiling.
The $1.7 trillion spending package Congress passed in December included a two-year extension of key telehealth provisions, such as coverage for Medicare beneficiaries to have phone or video medical appointments at home. But it also signaled political reluctance to make the payment changes permanent, requiring federal regulators to study how Medicare enrollees use telehealth.
In 2021, the U.S. spent 17.8 percent of GDP on health care, nearly double the average of 9.6 percent for high-income countries, according to a new report from The Commonwealth Fund. Health care spending per capita in the U.S. was three or four times greater than for countries like South Korea, New Zealand and Japan. Researchers ...
With pharmaceutical companies hiking prices on nearly 1,000 drugs in January, some consumers might experience sticker shock next time they pick up prescriptions. The price increases come as a new federal law requires companies to pay Medicare a rebate if they increase prices above the rate of inflation. Other Inflation Reduction Act provisions — such as capping Medicare recipients’ out-of-pocket ...
The Biden administration on Monday finalized an oft-delayed plan to step up audits of Medicare Advantage insurers in order to identify and recover overpayments. Why it matters: Studies and audits have identified billions of dollars of excess payments to health plans that weren’t supported by patients’ medical records, but federal officials in the past backed off many ...