In this article, we outline actionable strategies for strengthening one of the most essential administrative data assets—encounter data—and explain how improving this resource can unlock the ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

CMS finalizes 2027 Medicare Advantage and Part D rule with changes to star ratings, supplemental benefits, and Part D coverage effective June 1.

This article is part of a Health Affairs Forefront featured topic, Medicaid Financing. The featured topic includes analysis, proposals, and commentary that will inform policies on the state and ...

In recent years, there have been numerous lawsuits from Medicare Advantage plans against the Centers for Medicare and Medicaid Services over Star Ratings, including from SCAN Health Plan, Humana and ...

Oklahoma lawmakers passed two measures that would put state questions before voters on Medicaid expansion, which could remove ...