Medicare covers short-term skilled nursing care but excludes long-term custodial care in nursing homes. Insurance professionals must understand coverage nuances, eligibility, and alternative financing options including Medicaid and long-term care insurance.
Rhode Island's health insurance marketplace faces sharp premium increases and enrollment declines after expiration of federal Enhanced Premium Tax Credits. State officials urge congressional action to restore subsidies and maintain affordable coverage.
The MAHA Commission's new strategic report outlines a multi-agency approach to reduce childhood chronic diseases by enhancing hospital nutrition standards, clinical trial engagement, and advancing price transparency regulations.
California health insurance premiums are projected to rise by up to 50% next year, posing affordability challenges and risk of coverage loss for many families. Regulatory and policy measures are critical to address this market instability.
The Trump administration expands eligibility for affordable 'copper plans' on ObamaCare exchanges, aiming to reduce premiums and increase insurance coverage nationwide.
New algorithmic approaches improve fairness in Medicare Advantage payment models, promoting equitable spending for minority beneficiaries without reducing predictive accuracy.
The Medicare program will start an AI-driven prior authorization pilot for certain procedures in traditional Medicare, aiming to improve cost efficiency and coverage decisions. This initiative launches in six states with plans for potential expansion.
North Carolina employers are shifting toward transparent pharmacy benefit managers to address rising drug costs and compliance risks. Learn how alternative PBMs impact insurance affordability and market dynamics.
The AMA's new Mental Health Parity Index reveals gaps in insurance coverage and payment for mental health services, promoting transparency and policy action to improve parity compliance.
Yakima County healthcare providers warn of financial and service strains due to new Medicaid eligibility rules in a federal health insurance bill, impacting coverage and rural hospitals' viability.
