Insurance News

Question: We have some older employees (and spouses) who are enrolled in Medicare but still participating in our health plan. Is there a permissible way to exclude them from our health plan or offer them incentives to not enroll? Answer: Older employees are staying in the workforce longer, which means that employers are more likely to […]

CMS removed seven drugs from its first list of Part B drugs whose prices rose faster than inflation, shortening the list of price-capped drugs from 27 to 20. As a reminder, the IRA instituted a penalty for drug manufactures that raises the price of a Part D drug faster than inflation. The first rebate period […]

The White House released President Biden’s $6.8 trillion budget request for the fiscal year 2024. The budget includes increased taxes for wealthier income brackets, enhanced tax credits and a plan to delay Medicare insolvency. As is normally the case with a president’s budget proposals, many aspects will probably not be taken up by Congress – […]

Drug manufacturer Eli Lilly & Company announced last week that it will be capping patient out-of-pocket costs for certain insulin products at $35 per month. The company’s announcement follows the passage of the Inflation Reduction Act (IRA), which instituted such a cap for Medicare beneficiaries. “While the current healthcare system provides access to insulin for […]

On February 10, the administration announced that federal agencies are evaluating and updating federal independent dispute resolution (IDR) guidance following a district court ruling. In the latest decision, U.S. District Judge Jeremy D. Kernodle vacated all of the revised regulations challenged by the association, including the rule that arbiters must primarily consider the qualifying payment amount (QPA). […]

Congress passed a $1.7 trillion omnibus package at the end of December. The massive spending package included two major NABIP-supported provisions regarding telehealth and long-term care. Individuals will now be able to use existing retirement accounts to pay for long-term insurance. More specifically, the provision will permit individuals to pay up to $2,500 each year […]

HHS released new guidance this week related to the surprise-billing ban included in the Consolidated Appropriations Act of 2021 (CAA). The CAA – which passed at the end of 2020 – included the No Surprises Act, which holds patients harmless from surprise medical bills, including from air-ambulance providers, by ensuring they are only responsible for their in-network […]

NAHU received clarification from CMS/CCIIO late last week regarding the implementation of the family-glitch final rule as it related to the upcoming open enrollment period that runs from November 1 through January 15. As a reminder, an employer’s plan is not considered affordable if the employee must contribute more than 9.5 percent (9.61 percent in […]

In this week’s news in the world of healthcare mergers and acquisitions: UnitedHealth Group has finalized its acquisition of Change Healthcare following a district court ruling in their favor, Walgreens finalized its majority stake in home healthcare company CareCentrix, and provider data management vendor Kyruus announced acquisition of patient engagement platform Epion Health. After a […]

On September 9, Representatives Kurt Schrader (D-OR), Gus Bilirakis (R-FL), Mike Thompson (D-CA), Lloyd Smucker (R-PA), Mikie Sherrill (D-NJ) and Tim Walberg (R-MI) introduced H.R. 8791, legislation that would create a one-time special enrollment period (SEP) for seniors enrolled in COBRA coverage to enroll in Medicare Part B without a penalty. This is an issue […]