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Health Plan Accountability Update - June 2025
HHS announces initiative with insurers to streamline prior authorizations.
TAKE ACTION: Contact Your Representative Ahead of Jan. 22 House Hearings Focused on Commercial Health Insurers’ Role in Health Care Affordability
Please contact your representative prior to the Jan. 22 House hearings to share with them how some commercial insurer policies and practices delay, deny and disrupt care for patients.
Should You Automate to Resolve Health Claim Denials?
Absent commercial health insurance companies fulfilling a recent promise to reform their prior authorization (PA) and claims-paying behaviors, what can hospitals and health systems do to combat increasing claim denials and their growing threat to clinical and financial sustainability?
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.
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.
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.
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.