Insurance News
Regulatory updates in plain English
Stay current with the latest from CMS, state departments of insurance, NAIC, the Federal Register, and Congress — rewritten so you can actually understand what it means for your practice.
Fact Sheet: Pledges from Medicaid Technology Companies to Support Community Engagement Implementation and Related Medicaid System Improvements
Several health technology companies have made commitments to help states implement new Medicaid community engagement requirements. This change affects Medicaid and CHIP programs as they adapt to the Working Families Tax Cut legislation. The companies listed have pledged to support states with their ...
Medicaid Technology Companies Pledge $600M in Savings to Support Community Engagement and Related State Medicaid System Improvements
Ten health technology companies have pledged over $600 million in savings to help states implement new community engagement requirements for Medicaid. This initiative aims to modernize Medicaid systems and improve the experience for beneficiaries by providing discounted technology products and servi...
Fact Sheet: Pledges from Medicaid Technology Companies to Support Community Engagement Implementation and Related Medicaid System Improvements
Several health technology companies have made commitments to the Centers for Medicare & Medicaid Services (CMS) to assist states in meeting new Medicaid community engagement requirements. This change affects Medicaid programs as they prepare to implement these new rules under the Working Families Ta...
CMS Takes Bold New Approach to Stewarding Medicaid Demonstration Project Spending
The Centers for Medicare & Medicaid Services (CMS) is changing how it oversees Medicaid demonstration projects to ensure they don't cost taxpayers more money. Starting January 1, 2027, any new or renewed demonstration projects must be certified as budget neutral by the CMS Chief Actuary, meaning the...
CMS Issues Guidance to Implement New Limits on Federal Medicaid and CHIP Funding for Certain Noncitizens
The Centers for Medicare & Medicaid Services (CMS) has announced that starting October 1, 2026, states will have new limits on claiming federal funds for Medicaid and CHIP for certain noncitizens. This change affects individuals who are not U.S. citizens or nationals, as well as specific noncitizen ...
CMS Moves to Rein In Misused Medicaid Dollars and Reward Quality Care
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules to limit how states pay for Medicaid services, aiming to save taxpayers over $775 billion in the next decade. These changes will cap excessive payments that states have been making, which are often higher than Medicare rates, ...
Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments Proposed Rule (CMS-2449-P)
The Centers for Medicare & Medicaid Services (CMS) is proposing new rules for Medicaid payments that will affect both managed care and fee-for-service systems. Starting from July 4, 2025, certain Medicaid payments will be limited to a maximum of 100% or 110% of Medicare payment rates, depending on w...
CMS Launches Nationwide Framework to Implement Medicaid Work Requirements
The Centers for Medicare & Medicaid Services (CMS) has introduced a new rule that requires certain adult Medicaid applicants and enrollees to work at least 80 hours a month to qualify for Medicaid. This rule aims to help people gain skills and become more independent through work, education, or comm...
Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC)
Starting June 1, 2026, certain adults on Medicaid will need to work or engage in qualifying activities for at least 80 hours a month to keep their benefits. This rule affects non-pregnant adults aged 19 to 64 who are not on Medicare and are enrolled in Medicaid. Some individuals, like pregnant women...
Medicaid Program; Community Engagement Requirement for Certain Individuals
The Medicaid program has introduced a new requirement for certain individuals to engage with their community. This means that individuals must confirm their status at least once a year. Additionally, the agency must follow all federal privacy laws when handling personal data related to this verifica...
Medicaid Program; Community Engagement Requirement for Certain Individuals
The Medicaid program is introducing a new community engagement requirement that affects certain applicants and beneficiaries. Starting January 1, 2027, individuals will need to show that they are participating in community activities to qualify for Medicaid. This rule outlines what activities count,...
Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments
The proposed rule changes how Medicaid payments are managed, specifically for managed care and fee-for-service programs. It aims to adjust payment limits and requirements to ensure that payments are fair and support quality care. This affects Medicaid providers and managed care organizations. Agents...
Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request
The government is seeking public feedback on its process for collecting information related to Medicaid and the Children's Health Insurance Program (CHIP). This process allows for quicker approval of information requests that are generally easy to manage and do not involve major policy changes. Insu...
Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Nationwide Temporary Moratorium on Enrollment of Hospices
The government has announced a temporary halt on enrolling new hospices in the Medicare program for the next six months. This change affects hospices that want to provide care to Medicare patients. Insurance agents should stay informed about this moratorium and be ready to advise clients accordingly...
Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Nationwide Temporary Moratoria on Enrollment of Home Health Agencies (HHAs)
There is a new 6-month pause on enrolling home health agencies in Medicare across the country. This affects home health agencies that want to join the Medicare program. Insurance agents should be aware of this moratorium and inform their clients accordingly.
Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January through March 2026
The Centers for Medicare & Medicaid Services (CMS) have released a quarterly update that includes new instructions and regulations for Medicare and Medicaid programs. This update covers changes made from January to March 2026. Insurance agents should review this information to stay informed about th...
Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request
The government is seeking public feedback on its process for collecting information related to Medicaid and the Children's Health Insurance Program (CHIP). This process is designed to make it easier for agencies to get approval for collecting information that is generally simple and not controversia...
Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request
The Office of Management and Budget (OMB) is seeking public feedback on a new process for collecting information related to Medicaid and CHIP. This process is designed to make it easier for agencies to get approval for collecting information that is generally simple and not controversial. They want ...