The Centers for Medicare & Medicaid Services issued a sweeping rule to strengthen oversight of the Affordable Care Act exchanges for plan year 2027 by lowering user fees, tightening eligibility verification and giving states greater authority over plan oversight.
Health Insurance Newsletter
The Alliance for Medicare announced its official launch and introduced its flagship initiative, the Coalition to Improve Medicare Advantage.
The moratorium will not impact current enrollments, and existing providers can continue to deliver services to Medicare beneficiaries.
Rethinking the ways employers manage benefits risk
Employers who are waiting for benefits costs to stabilize may be misunderstanding what is happening in the market.
GLP-1s: Rewriting the relationship between pharmacy benefits and stop-loss
GLP-1s are forcing the conversations about pharmacy benefits and stop-loss strategy.
Big health systems blamed for affordability crisis
America’s health care affordability crisis is driven by unchecked health care consolidation, particularly among hospitals, according to a report released by Families USA.
How hospital outpatient departments increase the cost of care
Two shifts in care are bringing more people to hospital outpatient departments, and these hospital departments are more expensive than independent physician offices for the same service.
Nearly eight in 10 employers report that GLP-1s are driving an increase in their company’s health care costs, leaving many to consider some difficult choices in balancing costs and care.
Medicare Advantage: What agents in the field are seeing
The economics are straightforward, and they’re ugly.
Although no rule has been issued on the use of AI in Medicare enrollment, associations representing health agents are paying close attention to the possibility.
Health-related risks can disrupt a client’s retirement
Health-related risks are among the most underplanned and financially disruptive factors in retirement — often outweighing market volatility, inflation or recessions.
What’s behind skyrocketing hospital prices
The chairman of the House Ways and Means Committee told hospital system CEOs that hospital consolidation and mergers “are fueling the borderline extortionary prices hospitals charge patients.”
The agenda featured topics including developments in the vision care services marketplace, and the use of genetic testing in life insurance underwriting.
Slim chances of major health care legislation passing this year
Health care affordability is a top priority for Washington lawmakers, but election-year politics, the Senate filibuster and a slim Republican majority cloud the outlook for passage of any major health care legislation this year.
AI is coming to Medicare claims
Artificial intelligence can process a prior authorization request in mere seconds, cross-referencing thousands of variables without fatigue.
More than 50 health plans announced a new initiative to accelerate patient access to care and reduce administrative burdens for providers.
LTD claims: What advisors and clients must know
Disability insurers evaluate risk at two critical points: before issuing a policy and after a claim is filed.
Health insurers used hidden online tracking tools, lawsuits allege
In less than a year, four claims filed against major health insurers allege the companies used hidden tracking tools on their websites to record users’ most sensitive health queries in real time, then transmitted that data to third-party firms.
Why benefits advisors should revisit HSAs, FSAs and HRAs with clients
Tax-advantaged health accounts can play a meaningful role in helping employers control costs while maintaining strong employee benefits.
