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Triage Health Law

The Trump Administration Proposes Changes to Regulations Governing Insurance Subject to the Affordable Care Act

In its first major attempt to reform the Affordability Care Act (“ACA”), the Trump Administration issued a proposed rule on March 10, 2025 (“Proposed Rule”) amending regulations governing insurance coverages subject to the ACA.[1]   Public comments on the Proposed Rule will be accepted for consideration until April 11, 2025. In conjunction with the Proposed Rule,...… Continue Reading

March 2025 | Blog

Triage Health Law

CMS Finalizes a New Rule to Require Extensive API Implementation and Quicker Turnaround for Prior Authorization Decisions: What Payers Should Know

On January 17, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule regarding interoperability and prior authorization (the “Rule”). CMS-0057-F.  The Rule’s goals, according to CMS, are to facilitate the electronic exchange of health-care data, improve and expedite prior authorization processes, and reduce related burdens for payers, healthcare providers, and patients,...… Continue Reading

May 2024 | Blog

Triage Health Law

New Medicare Marketing Definition

On May 10, 2023, the Center for Medicare & Medicare Services (“CMS”) issued guidance to clarify the definition of “marketing” for Medicare Advantage Plans (“MA Plans”) and Prescription Drug Plans (“PDPs”).[1]  The new definition expands “marketing” to include activities intended to draw a consumer’s attention to an MA Plan or PDP, influence a consumer’s decision-making...… Continue Reading

July 2023 | Blog

Triage Health Law

Individuals that Lose Medicaid Coverage May Enroll in Medicare Part B Nationally and Medicare Supplement Coverage in Some States including Soon in Ohio

Pursuant to federal regulations that took effect on January 1, 2023, individuals who lose Medicaid coverage will be granted a special enrollment right to enroll in Medicare Part B coverage.[1]  This special enrollment right was created in part because the COVID health emergency order may soon end, resulting in many people losing Medicaid coverage.  In...… Continue Reading

January 2023 | Blog

Publication

Summer 2023 State Regulatory Update — NAIC Initiatives and Upcoming Elections

December 2022 | Americas