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. The proposed rule would enhance CMS' authority to address and curtail bad behavior by agents and brokers, such as fraudulent changes to an enrollee's health care coverage. The proposed rule also includes updates to the risk adjustment program, medical loss ratio calculations, and essential community provider certification review process, among other changes. Notably, CMS proposed several updates that would help enrollees understand their costs and maintain coverage, such as updates to the standardized plan options and a new enrollee notification process around tax filing and advanced premium tax credits.

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The House Energy and Commerce Subcommittee on Health Feb. 11 hosted a hearing titled “Lowering Health Care Costs for All Americans: An Examination of the…
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The Centers for Medicare & Medicaid Services Feb. 9 released its 2027 proposed standards for the health insurance marketplaces, including the issuers and…
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A KFF survey published today found that people view prior authorization as the biggest challenge beyond costs when navigating the health care system. In terms…
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A KFF analysis released Jan. 28 found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase…
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The AHA Jan. 26 released a white paper on addressing challenges in implementing an advanced explanation of benefits, which requires coordination among multiple…
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The House Energy and Commerce Subcommittee on Health and Ways and Means Committee Jan. 22 hosted hearings on health care affordability that included…