Biden Administration Extends ACA Coverage Eligibility to DACA Recipients
Under a new final rule, eligible DACA recipients will be able to enroll in a Qualified Health Plan through the ACA Marketplace or through a Basic Health Program.
What Health Plans Need To Know About QHPs Now That the ACA Is Here To Stay
Now that numerous calls for repeal and legal challenges brought against the ACA over the years have failed, health plans can finally invest confidently in this line of business.
Reducing Clinical and Staff Burnout with AI Automation
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.
Texas judge says mandate to cover HIV meds violates religious freedom
The judge’s ruling mentioned the Supreme Court decision in Burwell v. Hobby Lobby multiple times, which said that the chain of stores did not have to cover contraception since it violated the RFRA.
Insurers paid out $2B in rebates for last year’s claims
Insurers that didn’t meet medical loss ratio requirements have paid out a total of $2 billion in rebates to nearly 10 million people, split between people who received their insurance through individual market plans and group plans.
A preview of MedCity INVEST 2022: A return to in-person conferences
INVEST, scheduled for March 28-30, 2022 in Chicago, marks a return to in-person events for MedCity News. The conference, held in partnership with Mid-America Healthcare Investors Network, will spotlight healthcare innovation, investment trends, and share insights from healthcare executives.
In a first, Colorado gets CMS approval to make gender-affirming care an essential health benefit
All individual and small group health plans in Colorado's Affordable Care Act marketplace must cover a wide range of gender-affirming services, including breast/chest construction and reductions and laser hair removal, starting Jan. 1, 2023.
The Funding Model for Cancer Innovation is Broken — We Can Fix It
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
UnitedHealthcare to expand ACA exchange offerings to 7 new states
UnitedHealthcare is planning to participate in the ACA insurance exchanges in Alabama, Florida, Georgia, Illinois, Louisiana, Michigan and Texas. This will bring its total ACA marketplace footprint to 18 states.
CMS to fund 60 ACA navigator orgs next year
CMS will provide $80 million to 60 organizations that train ACA navigators — who help consumers find coverage on the federally funded marketplaces — in the 2022 plan year, up from 30 organizations that received $10 million this year.
Report: Uninsured rate holds steady at 11% during pandemic despite job losses
The increase in access to public health insurance coverage — via legislation like the Families First Coronavirus Response Act that prevents states from disenrolling Medicaid beneficiaries — helped offset the loss of employer-sponsored insurance, the report from Robert Wood Johnson Foundation shows.
Judge blocks HHS from requiring religious providers to perform gender-transition, abortion procedures
The permanent injunction prevents HHS from interpreting a section of the ACA, which bans discrimination, to include gender identity and pregnancy status. This move prohibits the federal agency from penalizing religious providers for refusing to perform or provide insurance coverage for gender-transition surgeries and abortions.
Health Executives on Digital Transformation in Healthcare
Hear executives from Quantum Health, Surescripts, EY, Clinical Architecture and Personify Health share their views on digital transformation in healthcare.
What insurers’ premium rate filings can tell us about predicted health utilization in 2022
An examination of health insurers' premium rate filings for 2022 shows that most are not factoring in additional costs or savings, which indicates that they expect health utilization to reach pre-pandemic levels.
Cano Health buys Doctor’s Medical Center for $300M
Senior-focused primary care provider Cano Health acquired Doctor's Medical Center for $300 million, which adds around 54,000 new members and 18 medical centers to its roster. This is the second major acquisition for Cano Health in less than a month. The company bought University Health Care for $600 million in mid-June.
CMS proposed rule aims to boost ACA enrollment, reinstate navigator duties
A new CMS proposed rule aims to make significant changes to Affordable Care Act marketplaces, including increasing the annual open enrollment period by a month and restoring the duties of navigators who help consumers from underserved populations enroll in plans on the federally facilitated exchange.
Meet the tech company focused on streamlining state-based insurance exchanges
IdeaCrew provides a state-based exchange technology solution that aims to make it easier for people to sign up for and retain healthcare coverage. The company works with states that are not using the federal marketplace platform and helps them provide a cost-effective, streamlined exchange to their residents.
Supreme Court upholds ACA, dismissing constitutional challenge
The Supreme Court upheld the Affordable Care Act, dismissing the lawsuit brought by Texas, 17 other states and two individuals on the grounds that they were not able to prove they were harmed by the law. Industry stakeholders celebrated the court's long-awaited decision.