Health Insurance
The AHA filed an amicus brief June 5 in the U.S. District Court for the Eastern District of Pennsylvania in support of a provider seeking to obtain declaratory or injunctive relief from Aetna’s “level of severity” reimbursement policy. The policy, effective since January, is a new type of…
The Centers for Medicare & Medicaid Services has released an updated report on complaint data and enforcement of health insurance market reforms.
AHA Files Amicus Brief in Pennsylvania case seeking relief from Aetna’s Level of Severity Policy.
A survey released June 4 by the Commonwealth Fund on insurance coverage denials found that 1 in 5 privately insured U.S. adults reported that they or a family member experienced insurance company denials for care recommended by a doctor within the past year.
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…
The House Education and Workforce Committee May 21 unanimously passed the Transparency in Billing Act (H.R. 8684). The bill would require off-campus hospital outpatient departments to obtain a separate unique health identifier and include it on all claims for services billed to commercial group…
A KFF analysis published May 19 examined early indicators of how the expiration of the enhanced premium tax credits has impacted effectuated enrollment levels, plan selections and out-of-pocket costs for Health Insurance Marketplace enrollees in 2026.
Centers for Medicare & Medicaid Services (CMS) May 15 released its 2027 final standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees. Notably, the final rule allows for the certification of nonnetwork health plans as qualified health…
The Centers for Medicare & Medicaid Services May 15 released its 2027 final standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees.
A blog by Noah Isserman, AHA director of health insurance and coverage policy, explains why Anthem’s nonparticipating provider policy limits patients’ access to care and overreaches its enforcement. The blog also raises questions about Anthem’s motivation behind the policy and whether it is a…