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Health Plan Accountability Update: July 2023
CMS released a final rule that would increase oversight of Medicare Advantage plans and better align them with Traditional Medicare.
Health Care Plan Accountability Update: March 28, 2024 - July 8, 2024
The AHA May 29 submitted a letter to the Centers for Medicare & Medicaid Services responding to a request for information regarding Medicare Advantage data, urging CMS to increase oversight of the program.
Health Plan Accountability Update - October 2024
CMS released a new complaint process for providers seeking assistance from the agency in resolving Medicare Advantage claims issues.
Health Plan Accountability
Commercial health plan abuses must be addressed to ensure fair coverage for patients and providers. The AHA has worked to hold health plans accountable through letters, statements, white papers, member updates and earned media.
CMS issues proposed notice of benefit and payment parameters for 2026
The Centers for Medicare & Medicaid Services Oct. 4 released its proposed standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees, for 2026.
AHA supports policy, technical changes to Medicare Advantage, Part D for 2026
The AHA Jan. 27 voiced support for the Centers for Medicare & Medicaid Services proposed rule on policy and technical changes to Medicare Advantage and Part D for contract year 2026.
AHA Amicus Brief Challenges MultiPlan, Inc. Motion to Dismiss Antitrust Litigation
Commercial insurance reimbursements comprise the majority of many hospitals’ revenue. Moreover, because government programs like Medicare do not cover the costs of providing care, commercial reimbursements can be the difference between losing money, breaking even, or earning a sustainable margin.
Agencies release final rule requiring mental health coverage parity
The departments of Labor, Health and Human Services and the Treasury Sept. 9 released a final rule ensuring commercial health plans comply with the Mental Health Parity and Addiction Equity Act of 2008 and require mental health and substance use disorder benefits at the same level as medical and surgical benefits.
Real Affordability Solutions from the Front Lines of Caring
Hospitals and health systems are where the most complex care is provided for ill and injured patients. Yet spending on inpatient and outpatient care has grown more slowly than spending on other health services. Hospitals and health systems have worked hard to provide the best value to patients and their families. Read more below.