The Centers for Medicare and Medicaid Services (CMS) have finalized a rule that imposes new standards for the Affordable Care Act (ACA) individual market for the federal and state exchanges in 2026.
The rule is meant as a consumer protection, preventing policy coverage from being swapped without authorization from the policy...White Papers, E books, Reports and more
A new report from Kaiser Family Foundation (KFF) that used claims data from the Centers for Medicare and Medicaid Services (CMS) on appeals and denials for non-group qualified health plans offered through the Affordable Care Act (ACA) federal marketplace found that nearly one-fifth of in-network claims were denied and 72% of reported...Arizona News
Earlier in the year payers and providers worried that putting an end to the practice of silver-loading would destabilize Affordable Care Act (ACA) exchanges. The Trump administration announced last week that it would continue to allow the practice on the individual market for the next year.
Silver-loading enabled insurers to...Arizona News
Two studies highlight the role of health plans in driving up out-of-pocket prescription drug costs for 2019 individual Affordable Care Act (ACA) exchange enrollees, while insurers continue to file lawsuits against the federal government for unpaid cost-sharing reduction payments (CSRs).
Multiple insurers filed status reports in...Arizona News
Various insurers, hospitals, and state regulators are encouraging the Centers for Medicare and Medicaid Services to continue a practice dubbed "silver loading" in fear that ending the rule would destabilize Affordable Care Act (ACA) exchanges.
Health insurers typically raise premiums on silver-level exchange plans to recover the...
