States Seek To Mitigate Impact Of Expiring Subsidy Enhancements
A handful of states have taken action to mitigate the impact of expiring subsidy enhancements in the Exchanges. The states include New Mexico, California, Maryland, Colorado, Connecticut, Arkansas, Texas, and Wyoming.
Most states passed appropriations to replace some of the federal subsidy losses, while others passed premium realignment laws.
#exchanges #coverage #healthcare
https://www.beckerspayer.com/payer/aca/how-states-are-responding-to-expiring-aca-subsidies/
At Least 16 Health Systems Drop MA
At least 16 health systems are dropping Medicare Advantage (MA) plans in 2026. Some big-name systems are included, and many are targeting big MA plans.
#hospitals #healthplans #medicareadvantage
OIG Calls Out Payments For Deceased Enrollees
The Health and Human Services’ Office of Inspector General (HHS OIG) says that state Medicaid agencies have made an estimated $289 million in improper capitation payments to managed care organizations on behalf of deceased enrollees since 2016. This comes from a series of audits.
The One Big Beautiful Bill Act (OBBBA) passes some critical reforms in this area, including requiring all states to check the Social Security Administration’s Death Master File at least quarterly starting January 1, 2027.
#fwa #medicaid #healthplans #managedcare
Those Leaving MA Have More Mental Health Visits in FFS
A study in the American Journal of Managed Care finds that switching from Medicare Advantage (MA) to traditional Medicare was associated with increased mental health visits. The study also found a shift toward nurse practitioners and away from emergency and internal medicine specialists.
Researchers from Johns Hopkins Bloomberg School of Public Health examined mental health utilization patterns 12 months before and 12 months after beneficiaries switched from MA to traditional Medicare in 2018.
The authors noted that prior research finds that more than two-thirds of MA plans included less than 25% of local Medicare-accepting psychiatrists in their networks. MA network restrictions may create barriers to mental healthcare access, the authors argue.
#medicareadvantage #mentalhealth #healthplans #providers #networks
— Marc S. Ryan
