The Centers for Medicare & Medicaid Services Oct. 4 released its proposed standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees, for 2026. The proposed rule would enhance CMS' authority to address and curtail bad behavior by agents and brokers, such as fraudulent changes to an enrollee's health care coverage. The proposed rule also includes updates to the risk adjustment program, medical loss ratio calculations, and essential community provider certification review process, among other changes. Notably, CMS proposed several updates that would help enrollees understand their costs and maintain coverage, such as updates to the standardized plan options and a new enrollee notification process around tax filing and advanced premium tax credits.

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A KFF analysis published May 19 examined early indicators of how the expiration of the enhanced premium tax credits has impacted effectuated enrollment levels…
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The Centers for Medicare & Medicaid Services May 15 released its 2027 final standards for the health insurance marketplaces, including the issuers and…
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A blog by Noah Isserman, AHA director of health insurance and coverage policy, explains why Anthem’s nonparticipating provider policy limits patients’ …
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Patients are best served when insurers act as transparent and reasonable partners, not when they invoke patient protection laws to justify payment strategies…
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The AHA shared the following statement with the media in response to a report released May 7 by Families USA.   “This report is long on rhetoric and…
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The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and…