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Health Care Policy and Legislation

commentary


Alex Sommer
Commentary
What Insurance Plans Need to Know About Biomarker Legislation
02/14/2024
Alex Sommer
Biomarker bills are merely the latest in what is likely to be a wave of legislation mandating coverage of new tests and therapies that are part of the growth in precision medicine. This will make it increasingly difficult for plans to control...
Biomarker bills are merely the latest in what is likely to be a wave of legislation mandating coverage of new tests and therapies that are part of the growth in precision medicine. This will make it increasingly difficult for plans to control...
Biomarker bills are merely the...
02/14/2024
First Report Managed Care
Headshot of Cory Busse, Icario
Commentary
2024 CMS Final Rule: Focus on the Health Equity Index Reward
05/04/2023
Cory Busse
In this commentary, Cory Busse, vice president, sales and strategic solutions, Icario, shares insight into the Health Equity Index (HEI) reward in the 2024 CMS Final Rule and what Medicare Advantage plans should do next.
In this commentary, Cory Busse, vice president, sales and strategic solutions, Icario, shares insight into the Health Equity Index (HEI) reward in the 2024 CMS Final Rule and what Medicare Advantage plans should do next.
In this commentary, Cory Busse,...
05/04/2023
First Report Managed Care
Headshot of Cory Busse, Icario
Commentary
2024 CMS Advance Notice: Impact to Star Ratings, Focus on Health Equity, Part D, and Inflation Reduction Act
02/07/2023
Cory Busse
In this commentary, Cory Busse, vice president, sales and strategic solutions, Icario, reviews key takeaways for health plans from the Centers for Medicare & Medicaid Services' 2024 Advance Notice.
In this commentary, Cory Busse, vice president, sales and strategic solutions, Icario, reviews key takeaways for health plans from the Centers for Medicare & Medicaid Services' 2024 Advance Notice.
In this commentary, Cory Busse,...
02/07/2023
First Report Managed Care
Icario logo
Commentary
How the Updated CMS Health Equity Framework Will Improve Member Experience in Light of SDoH
02/02/2023
The Icario team breaks down the latest CMS framework on health equity and offers insight on how health plans can make effective change in their latest blog.
The Icario team breaks down the latest CMS framework on health equity and offers insight on how health plans can make effective change in their latest blog.
The Icario team breaks down the...
02/02/2023
First Report Managed Care
Headshot of Troy Jelinek, Icario
Commentary
2024 CMS Proposed Rule: 5 Key Takeaways and Next Steps
01/03/2023
Troy Jelinek
In this commentary, Troy Jelinek shares key points from the Centers for Medicare & Medicaid Services' 2024 proposed rule, including measure changes that will impact Star Ratings and member engagement in the years to come.
In this commentary, Troy Jelinek shares key points from the Centers for Medicare & Medicaid Services' 2024 proposed rule, including measure changes that will impact Star Ratings and member engagement in the years to come.
In this commentary, Troy Jelinek...
01/03/2023
First Report Managed Care
Headshot of Kyle Probst, Coix Health
Commentary
State Reproductive Health Laws and Patient Privacy
12/22/2022
Kyle Probst
Kyle Probst, deputy general counsel and director of government relations, Ciox, details actions some states have taken to enact reproductive privacy laws and proposes considerations for providers to keep in mind as they seek to protect...
Kyle Probst, deputy general counsel and director of government relations, Ciox, details actions some states have taken to enact reproductive privacy laws and proposes considerations for providers to keep in mind as they seek to protect...
Kyle Probst, deputy general...
12/22/2022
First Report Managed Care
Headshot of Steve Wigginton, Icario
Commentary
Three Health Care Predictions for 2023: New Realities and Priorities for Health Plans
11/30/2022
Steve Wigginton
In this commentary, Steve Wigginton, CEO, Icario, predicts what 2023 may have in store for health plans, with a focus on the end of the public health emergency, member satisfaction, and social determinants of health.
In this commentary, Steve Wigginton, CEO, Icario, predicts what 2023 may have in store for health plans, with a focus on the end of the public health emergency, member satisfaction, and social determinants of health.
In this commentary, Steve...
11/30/2022
First Report Managed Care

Behind the Bill

Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care
BEHIND THE BILL
When Agencies Lose Power: How 3 Seismic Shifts are Transforming Pharmaceutical Regulation
05/07/2025
Katie Hayes, MJ
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months,...
05/07/2025
First Report Managed Care
Behind the Bill
The Medicare Paradox, Part 3: Strategic Trade Doesn’t Have to be a Zero-Sum Game
05/07/2025
Katie Hayes, MJ
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve...
05/07/2025
First Report Managed Care

Trending Articles

Commentary
Next-Generation Utilization Management: Managing Utilization and Cost Without Denial of Service​​​
03/01/2024
Amit Gupta, MD
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is...
03/01/2024
First Report Managed Care
Shannon Smith Headshot
Commentary
Adapting to Change: Navigating the New CMS Prior Authorization Guidelines in Health Care
04/02/2024

Shannon Smith, RN, BSN

Shannon Smith, RN, BSN
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry...
04/02/2024
First Report Managed Care
Conference Coverage
Rare Orphan, Oncology, and Specialty Drugs in Development: Review of Therapeutic Areas, Designations, and Launch Projections
05/01/2024
Danielle Sposato
The specialty pharmacy pipeline was the subject of one of many informative sessions at the annual Asembia Summit this year. Key insights were shared about current drugs in the pipeline according to their drug designations, the phase of each...
The specialty pharmacy pipeline was the subject of one of many informative sessions at the annual Asembia Summit this year. Key insights were shared about current drugs in the pipeline according to their drug designations, the phase of each...
The specialty pharmacy pipeline...
05/01/2024
First Report Managed Care
News
Using Mindfulness-Based Intervention to Improve Fatigue, Mood Challenges in Adolescents With Neuroimmune Disease
05/28/2024
Grace Taylor, MS, MA
Study examines the effectiveness of the Learning to BREATHE mindfulness-based intervention in improving fatigue and mood challenges in a adolescent population with neuroimmune disease.
Study examines the effectiveness of the Learning to BREATHE mindfulness-based intervention in improving fatigue and mood challenges in a adolescent population with neuroimmune disease.
Study examines the effectiveness...
05/28/2024
First Report Managed Care
Leyla Henderson
Conference Coverage
Strategies for Enhancing Infusion Patient Experiences
07/10/2024
Leyla Henderson
An NICA 2024 session speaker shares innovative strategies for enhancing patient satisfaction and improving outcomes in health care settings, emphasizing the importance of patient-centered care and individualized experiences.
An NICA 2024 session speaker shares innovative strategies for enhancing patient satisfaction and improving outcomes in health care settings, emphasizing the importance of patient-centered care and individualized experiences.
An NICA 2024 session speaker...
07/10/2024
First Report Managed Care

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