Regulated Markets

Stay informed on the latest news and updates.

The world of Regulated Markets is constantly changing. You need a dependable information source that changes along with it.

Visit our site often to stay up to date on recent federal and state legislation, breaking news, current initiatives, thought leadership and upcoming events related to Medicare, Medicaid, Marketplace plans and EGWP.

legislation

White House Event Focuses on Lowering Cost of Health Care

On April 3, President Biden alongside Sen. Bernie Sanders (I-VT), delivered remarks on lowering health care costs for Americans at the White House. Sen. Sanders highlighted the Senate Committee on Health, Education, Labor, and Pensions (HELP) Committee’s investigation into the price of inhalers, with Sanders and Biden referencing three inhaler manufacturers’ commitments to capping the […]
read more >

May 1, 2024

EGWP marketplace medicaid Medicare

legislation

HHS Finalizes 340B Administrative Dispute Resolution Updates

On April 18, HHS finalized updates to the 340B Program’s administrative dispute resolution (ADR) process. These updates come after the 2020 final rule was successfully challenged by drug manufacturers. The updated ADR process loosens the standards for claims, making it more likely that there will be a substantial uptick in ADR filings. The rule also […]
read more >

marketplace

legislation

HHS Releases New List of Inflation-Capped Medicare Part B Drugs

On March 26, HHS announced 41 drugs available through Medicare Part B will have a lowered Part B coinsurance rate from April 1 – June 30, if the drug company raises prices faster than the rate of inflation. Beginning last April, as a result of the Inflation Reduction Act, people with Medicare started to see […]
read more >

legislation

HHS Secretary Testifies before House and Senate Committees on Budget Request

The Secretary of the Department of Health and Human Services (HHS), Xavier Becerra, testified twice before Congress on the 2025 Budget Request for HHS. However, these hearings are rarely limited to the budget request because members often take the opportunity to highlight their own health policy priorities or ask questions on top-of-mind issues. During the […]
read more >

EGWP marketplace medicaid Medicare

legislation

Washington First State to Pass a Version of Uniform Law Commission’s Telehealth Model Act

Washington Gov. Jay Inslee (D) signed into law Senate Bill 5481, Washington’s modified version of the Uniform Telehealth Act (UTA). While the new law has widespread support in the telehealth community, it was amended to exclude the model act’s telehealth registration section, which would have allowed a provider licensed in another state, and in good […]
read more >

EGWP medicaid Medicare

Guidance

HHS and CMS Extend Marketplace SEP for Individuals Losing Medicaid

On March 28, CMS issued guidance on the Temporary Special Enrollment Period (SEP) for Consumers losing Medicaid or Children’s Health Insurance Program (CHIP) coverage due to unwinding of the Medicaid Continuous Enrollment Condition Operations for plan year 2024. CMS announced the Unwinding SEP end date will be extended to Nov. 30. Under the updated guidance, […]
read more >

marketplace medicaid Medicare


Recent happenings in the regulated markets space, including updated regulatory guidance and policy changes.

legislation

White House Event Focuses on Lowering Cost of Health Care

On April 3, President Biden alongside Sen. Bernie Sanders (I-VT), delivered remarks on lowering health care costs for Americans at the White House. Sen. Sanders highlighted the Senate Committee on Health, Education, Labor, and Pensions (HELP) Committee’s investigation into the price of inhalers, with Sanders and Biden referencing three inhaler manufacturers’ commitments to capping the […]
read more >

May 1, 2024

EGWP marketplace medicaid Medicare

legislation

HHS Finalizes 340B Administrative Dispute Resolution Updates

On April 18, HHS finalized updates to the 340B Program’s administrative dispute resolution (ADR) process. These updates come after the 2020 final rule was successfully challenged by drug manufacturers. The updated ADR process loosens the standards for claims, making it more likely that there will be a substantial uptick in ADR filings. The rule also […]
read more >

May 1, 2024

marketplace

legislation

HHS Releases New List of Inflation-Capped Medicare Part B Drugs

On March 26, HHS announced 41 drugs available through Medicare Part B will have a lowered Part B coinsurance rate from April 1 – June 30, if the drug company raises prices faster than the rate of inflation. Beginning last April, as a result of the Inflation Reduction Act, people with Medicare started to see […]
read more >

May 1, 2024

legislation

HHS Secretary Testifies before House and Senate Committees on Budget Request

The Secretary of the Department of Health and Human Services (HHS), Xavier Becerra, testified twice before Congress on the 2025 Budget Request for HHS. However, these hearings are rarely limited to the budget request because members often take the opportunity to highlight their own health policy priorities or ask questions on top-of-mind issues. During the […]
read more >

May 1, 2024

EGWP marketplace medicaid Medicare

legislation

Washington First State to Pass a Version of Uniform Law Commission’s Telehealth Model Act

Washington Gov. Jay Inslee (D) signed into law Senate Bill 5481, Washington’s modified version of the Uniform Telehealth Act (UTA). While the new law has widespread support in the telehealth community, it was amended to exclude the model act’s telehealth registration section, which would have allowed a provider licensed in another state, and in good […]
read more >

May 1, 2024

EGWP medicaid Medicare

Guidance

HHS and CMS Extend Marketplace SEP for Individuals Losing Medicaid

On March 28, CMS issued guidance on the Temporary Special Enrollment Period (SEP) for Consumers losing Medicaid or Children’s Health Insurance Program (CHIP) coverage due to unwinding of the Medicaid Continuous Enrollment Condition Operations for plan year 2024. CMS announced the Unwinding SEP end date will be extended to Nov. 30. Under the updated guidance, […]
read more >

May 1, 2024

marketplace medicaid Medicare

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