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ACA Health Plans — Key considerations for staying relevant

Innovaare Compliance

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.

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Reduced Co-Insurance for Screening Colonoscopies

Medisys Compliance

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.

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CMS Includes MAOs in Data Exchange and Prior Authorization Requirements

Healthcare Law Blog

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule , “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is intended to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.

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Healthcare Reforms Under the IRA: Expanding Access to Care

Healthcare Law Blog

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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Health Provider News – January 27, 2023

Hall Render

California’s healthcare worker retention payments to start in February Julie Miller-Phipps to retire after 45-year career with Kaiser Permanente COLORADO By the numbers: How pandemic-induced staffing issues are leaving Colorado seniors out in the cold Colorado’s rural hospitals could get $3 million a year to end inpatient care.

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CMS BLOG: Medicare for All? Just another name for a government-run, single payer system

CMS.gov

Seema Verma, Administrator, Centers for Medicare & Medicaid Services . Ask yourself why proponents of ‘Medicare for All’ are advocating such a radical reform of health care just five years after the full implementation of the Affordable Care Act (ACA), often referred to as Obamacare. It is certainly not because the ACA has worked.