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Health Plan Accountability Update: October 2025
The AHA May 29 submitted a letter to the Centers for Medicare & Medicaid Services responding to a request for information regarding Medicare Advantage data, urging CMS to increase oversight of the program.
AHA encourages MedPAC to refine analysis of MA enrollment impacts on patients, providers
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on hospitals, which found that increased enrollment is not statistically associated, on average, with all-payer hospital margins.
Holding Commercial Health Insurers Accountable
“Trust but verify” is a phrase often associated with President Reagan and the need to ensure that treaties enacted with the Soviet Union were being upheld.
Study finds Medicaid beneficiaries most likely to lose coverage due to work requirements have worse health
A JAMA study published yesterday analyzed the health characteristics of individuals projected to lose Medicaid coverage due to work requirements included in the budget reconciliation bill (H.R. 1).
CMS releases updated guidance to states on federal financing for emergency Medicaid services
The Centers for Medicare & Medicaid Services Sept. 30 released guidance to states clarifying its interpretation of a provision that authorizes federal financing to pay for emergency Medicaid services for undocumented patients ineligible for full Medicaid benefits.
Analysis: Health Insurance Marketplace premiums would more than double if enhanced premium tax credits expire
An analysis published Sept. 30 by KFF found that Health Insurance Marketplace enrollees who currently benefit from the enhanced premium tax credits would pay more than double their current premium payments if the EPTCs expire at the end of this year.
Administration announces agreement with Pfizer to lower drug costs
President Trump today announced the first agreement with a major pharmaceutical company, Pfizer, to bring American drug prices in line with the lowest paid by other developed nations — wh
Supporting Resident Wellness: Inside Boston Medical Center’s Innovative Approach
Medical residency is one of the most demanding stages in a physician’s career. Long hours, intense learning and new responsibilities often push trainees to deprioritize their own health.
AHA provides recommendations to HHS, CMS for insurers to adhere to prior authorization pledge
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure insurance plans adhere to the agencies’ health insurer pledge to reform prior authorization processes.