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CMS says 9.7 Million Americans were added to Medicaid rolls in 2020 Medicaid enrollment rose sharply during the coronavirus pandemic, with nearly 10 million Americans joining the public health coverage program for the poor through January, a government report released Monday shows. Eighty million people—more than ever before in the program’s history—now carry Medicaid coverage, for which states and the federal government share the cost. The new figures demonstrate the program’s increasingly important role not just as a safety net, but as a pillar of American health coverage, with fully a quarter of the population covered under it. The Affordable Care Act transformed Medicaid from a targeted health care benefit meant to help certain groups of people — expectant mothers, for example, and […]

U.S. Supreme Court Rejects Latest Challenge to the Affordable Care Act On June 17, 2021, the Affordable Care Act survived a third major challenge as the Supreme Court, in a 7-to-2 vote, turned aside the latest effort by Republicans to kill the health care law. Chief Justice John G. Roberts Jr., who had cast the decisive vote to save the law in 2012, was in the majority. So was Justice Clarence Thomas, who had dissented in the earlier decisions. “Whatever the act’s dubious history in this court,” Justice Thomas wrote in a concurring opinion, “we must assess the current suit on its own terms. And, here, there is a fundamental problem with the arguments advanced by the plaintiffs in attacking the act—they […]

AMA House of Delegates Calls for Greater Flexibility on Information-Blocking Rules New federal information-blocking regulations stemming from the 21st Century Cures Act require physicians to release health information even when they believe that doing so could emotionally or psychologically harm the patient, says a resolution presented at the AMA Special Meeting. There are exceptions to the regulation for information that physicians believe might lead to a patient’s physical harm, but not so for other kinds of harm. Meanwhile, the information-blocking rules that took effect in April impose burdens on physician practices already slammed by the financial and other strains of the COVID-19 pandemic. With these facts in mind, delegates took action by calling for the AMA to: Advocate to the Office for […]

AMA House of Delegates Calls on Medicare Advantage to Align Prior Authorization Policies with Medicare Fee-for-Service   The American Medical Association (AMA) House of Delegates issued a statement saying that Medicare Advantage plans shouldn’t override physician judgment. According to a resolution presented at the AMA Special Meeting, more than 62 million Americans are covered by Medicare Advantage plans, yet such plans may not follow Medicare guidelines for hospital admissions, diagnostic testing, medication, and procedures, putting many—especially those with “long COVID”—at risk for being denied treatment. To ensure that patients covered by Medicare Advantage plans are not denied necessary treatment, delegates directed the AMA to: Ask the CMS to further regulate Medicare Advantage plans so that the same treatment and authorization […]