Nearly 50 health insurance companies signed onto a pledge with the federal government to streamline prior authorizations on Monday. The new practices will apply across all forms of private health insurance.
For years, private insurance companies have weathered criticism of the prior authorization process as providers and patients...
According to a study by America's Health Insurance Plans (AHIP), a national trade association and political advocacy group for health insurers, in 2021 Medicare Advantage (MA) enrollees received higher quality care and have higher rates of use across a wide range of preventive services than those enrolled in fee-for-service (FFS)...
America's Health Insurance Plans' new report details the vital role of employer-provided coverage (EPC) in America's healthcare system and highlights its provision of affordable (really!), high-quality care to more than 180 million people, including nearly 3.3 million in Arizona.
The July report, Employer-Provided Health...White Papers, E books, Reports and more
Earlier this year, the American Medical Association (AMA) released the Value-based Care Playbook in partnership with America's Health Insurance Plans (AHIP) and the National Association of Accountable Care Organizations (NAACOS).
The Playbook illustrates best practices for value-based care arrangements in order to encourage adoption...National News
This week, America's Health Insurance Plans (AHIP), the American Medical Association (AMA), and the National Association of ACOs (NAACOS) released a playbook on voluntary best practices as part of their efforts together to advance the adoption of value-based care arrangements in the private sector to improve the quality, equity, and...
On Monday, the Centers for Medicare and Medicaid Services (CMS) finalized the Rate Announcement for Medicare Advantage (MA) and Medicare Part D programs for Calendar Year (CY) 2025 which includes a rate increase of 3.7% in addition to finalized Part D rules.
The final rule didn't deviate much from the CMS proposed payment rate issued...
Last Friday, the Medicare Payment Advisory Committee (MedPAC) sent its recommendations to Congress, including updates for the 2025 Medicare payment systems. In its recommendations, the committee warned that Medicare Advantage policies are increasingly costly to the Medicare program.
At the top, it recommended a 1.5% raise for hospital...Arizona News
Last Wednesday, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that will truncate the timeline for prior authorization processes to 72 hours for people who receive health coverage from insurers participating in Medicare Advantage, Medicaid managed care, or the Affordable Care Act exchange.
The CMS...National News
The joint commitment among the five founding members aims to leverage learned lessons from the COVID-19 pandemic response into actionable strategies that will strengthen the partnership between healthcare and public health systems.
In March 2023, the Common Health Coalition (CHC) was formed by AHIP, the American Medical Association...National News
Capitol Hill has turned its eye to pharmacy benefit managers (PBMs), culminating in a new package of measures introduced by leaders of the Senate Health, Education, Labor and Pensions (HELP) Committee that seeks to bring PBMs under more careful regulatory authority.
In February, the Federal Trade Commission (FTC) enforced the very...National News
Most traditional Medicare beneficiaries have a Medicare Supplement plan, or Medigap, according to a new report by AHIP. But the program's salesforce has recently drawn the ire of Senator Elizabeth Warren, who alleges that Medigap salespeople are incentivized to sell subpar plans in exchange for perks.
The AHIP report, the State of...
Health insurance lobbyists and plans have put a ton of work into defending the Medicare Advantage (MA) program from proposed cuts and rule changes by the Centers for Medicare and Medicaid Services (CMS), but this week traditional Medicare gets community support of its own. And one insurer breaks from the pack to support the rule...
Medicare Advantage's unprecedented market growth is attributable in part to the high volume of dually eligible beneficiaries in special needs plans (D-SNPs), but some plans are concerned that the proposed advanced notice will hurt vulnerable beneficiaries enrolled in these plans.
According to data released by the Centers for Medicare...Arizona News
With the Great Unwinding looming at the end of spring, insurers are now speaking up about their role in Medicaid redeterminations and a special enrollment period (SEP) for enrollees who may lose coverage in the process.
In a memo released at the end of January, the Centers for Medicare and Medicaid Services (CMS) announced that the...
The Centers for Medicare and Medicaid Services (CMS) has issued a final rule that will increase the amount federal authorities can recoup from Medicare Advantage organizations (MAOs) that were overpaid due to incorrect diagnostic coding.
The Medicare Risk Adjustment Data Validation (RADV) final rule means that CMS will also stop...
Last week, the Health Care Payment Learning and Action Network (LAN) published its 2022 Methodology and Results report, which is the result of a data collection survey of health plans and states for an account of how money moves through alternative payment models and how these programs function in terms of barriers and access.
In...
America's Health Insurance Plans has a vision. After engaging with its member organizations to evaluate the current state of access for patients and identify current challenges with mental health and substance abuse care access and delivery, they also worked with members to discover innovative approaches to support broader access,...National News
Over the weekend, Senate Democrats came together to pass the massive Inflation Reduction Act, which includes a proposal to give Medicare the power to negotiate certain drug prices, as well as a three-year extension of Affordable Care Act (ACA) subsidies to insurers in the form of tax credits that were initially passed as part of the...White Papers, E books, Reports and more
America's Health Insurance Plans published an issue brief with several key policy recommendations to deliver a "strong, stable market that works for all Americans."
After assurances from lawmakers that the reconciliation package will extend American Rescue Plan subsidies for the next three years, AHIPs first recommendation is a quick...National News
American Health Insurance Plans (AHIP) teamed up with the Blue Cross Blue Shield Association (BCBSA) to provide the data on commercially insured patients in the first two months of 2022.
Most of the No Surprises Act's provisions took effect at the beginning of 2022, applying to those enrolled in health insurance coverage or a group...
