Here are ten payer policy moves physicians should know that Becker's has reported on since March 15:
- The Congressional Budget Office said a proposal to add work requirements for Medicaid eligibility would have "a negligible effect on employment status or hours worked by people who would be subject to the work requirements."
- CMS proposed two new rules April 27 that would establish national standards of care provided through fee-for-service Medicaid/CHIP and managed care plans, along with a requirement to publicly disclose provider payment rates online.
- The American Medical Association and more than 100 physician and healthcare organizations asked Cigna to reconsider a policy they say will add administrative costs and burdens and potentially negatively affect patients.
- House Republicans' Medicaid work requirement proposal would result in an estimated 600,000 people losing coverage.
- HHS unveiled its proposed rule that, if finalized, would expand healthcare coverage access to an estimated 129,000 previously uninsured Deferred Action for Childhood Arrivals program recipients.
- CMS issued a final rule April 5 that, among other things, aims to streamline Medicare Advantage and Part D prior authorizations and clamp down on misleading marketing practices.
- CMS will move ahead with Medicare Advantage risk adjustment changes payers and some provider groups opposed, but the agency will phase in the model over three years.
- HHS Secretary Xavier Becerra told the Senate Finance Committee that proposed Medicare Advantage rate changes will not lead to cuts in benefits.
- CMS instructed all independent dispute resolution entities to resume issuing No Surprises Act payment determinations involving out-of-network services and items.
- CMS laid out more details on how it plans to implement the first-ever negotiation process of drug prices under Medicare, which will first apply in 2026.