Bipartisan Senate Finance Committee Legislation Includes Enhanced Medicaid Pharmacy Pricing Survey Provision

On November 8, 2023, on an unanimous 26-0 vote, the Senate Finance Committee approved the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act.  The bill includes a number of Medicare and Medicaid provisions but also incorporates two sound Medicaid drug pricing provisions related to “spread pricing” in Medicaid managed care and to Medicaid pharmacy […]

Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q3 2023

The “Big Five” Medicaid managed care companies—Centene, CVS Health (Aetna), Elevance Health (formerly Anthem), Molina Healthcare, and UnitedHealth Group—have reported their Medicaid enrollment for the quarter ending September 30. The downward trend that began in Q2 continued for all of the companies except Molina, which experienced a small net increase (+16,000). Centene reported the largest […]

States Cannot Terminate CHIP Coverage for Non-Payment of Premiums Under 12-Months Continuous Eligibility Requirement

The Consolidated Appropriations Act, 2023 established a new requirement that all states provide 12-months continuous eligibility in Medicaid and the Children’s Health Insurance Program (CHIP) for children starting on January 1, 2024.  Currently, only about half of the states have taken up the option to provide 12-months continuous eligibility for children in both programs.  In […]

New Federal Rules Seek To Strengthen Mental Health Parity

By Maanasa Kona, Assistant Research Professor at the Center on Health Insurance Reforms On July 25, 2023, the Departments of Labor, Health and Human Services, and the Treasury (the tri-agencies) proposed a new rule to strengthen the enforcement of the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and ensure that patients can access mental health and substance […]