Healthcare Dive
JULY 29, 2022
The bill, part of a more than $300 billion package, extends enhanced ACA premiums and allows Medicare to negotiate select prescription drug prices starting in 2026.
Healthcare Dive
APRIL 3, 2024
Starting in 2026, plans sold in state-based exchanges will be required to meet time and distance standards for provider access that are already applied to plans sold federally.
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Innovaare Compliance
APRIL 27, 2023
A perspective on recent industry shifts influencing ACA plan operations in states, which are yet to adopt ACA Medicaid expansion Health Exchange plans covered under ACA (Accountable Care Act) witnessed 36% enrollment growth between 2021 and 2023. This is the sharpest rise in ACA enrollment since inception. ACA plans).
Medisys Compliance
JULY 27, 2022
Section 4104 of the Affordable Care Act (ACA) defined the term ‘preventive services’ to include ‘colorectal cancer screening tests’ and, as a result, it waives any coinsurance that would otherwise apply under Section 1833(a)(1) of the Social Security Act for screening colonoscopies. Background for Reduced Co-Insurance.
Healthcare Law Blog
DECEMBER 15, 2022
Specifically, CMS proposes that, beginning January 1, 2026, impacted payers would be required to: Implement and maintain a FHIR PARDD API using technology conformant with certain standards and implementation specifications in 45 CFR 170.215. CMS is not proposing to apply these requirements to drugs that are covered by the MAO.
Center for Health Insurance Reform
FEBRUARY 7, 2025
The Notice of Benefit & Payment Parameters prescribes standards and rules that govern insurers and Marketplaces under the ACA. This annual regulation, that went into effect January 15, represents a final set of health insurance policies from the Biden administration focusing on quality and affordability.
Healthcare Law Blog
AUGUST 25, 2022
The first list of up to 10 Part D negotiation-eligible drugs will be published in 2026, the earliest “price applicability date” at which the Program takes effect. The drug publication date for 2026 will be chosen by September 1, 2023. Additional updates of note include: ACA Premium Tax Credit Eligibility. Other Updates.
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