It's been a busy year in the regulatory space.
Most of the top-read health insurance stories from Fierce Healthcare this year involve new policies from the Biden administration or action in Congress. A top concern for our readers has been Medicare Advantage (MA), as the market continues to expand.
In the most-read payer story of 2022, Robert King details the Centers for Medicare & Medicaid Services' (CMS') policies for MA plans in 2023, including a rate hike. Our No. 2 story also focused on MA regulation, this time on new guidance from CMS to increase oversight of TV advertising.
Medicare Part D and drug coverage topics are also in the mix for our top stories of the year.
Other stories that resonated with you this year? Health insurance giant Anthem launched a corporate rebrand over the summer and now operates as Elevance Health. We have the details on why along with what exactly "Elevance" means.
And there was plenty to talk about in the insurtech space. One of our top stories of 2022 digs into Alignment Healthcare's plans for expansion.
Here's the list of our 10 most-read stories this year:
1. CMS finalizes 8.5% rate hike for Medicare Advantage, Part D plans in 2023
In April, CMS finalized an 8.5% increase for MA rates, which was slightly higher than what the administration initially proposed. The agency made the change in response to comments urging it to adjust the rate. The final rule was released as the program was under fire for allegations of upcoding to juice payouts.
2. CMS to restrict Medicare Advantage TV ads, scrutinize brokers and agents amid high complaints
Beginning in 2023, insurers will be required to secure approval from the feds for television advertising. The policy update is one of the early steps taken by CMS to address concerns around MA as complaints continue to rise. Senate leaders are also investigating marketing practices in the MA program.
3. UnitedHealthcare rolls out new virtual physical therapy program
UnitedHealthcare, the country's largest insurer, teamed with Kaia Health to roll out a virtual physical therapy offering for eligible members with musculoskeletal conditions. The program aims to provide 24/7, on-demand exercise feedback to members, including those who are recovering from surgery or an injury.
4. House passes bill to cap insulin copays at $35 a month for Medicare, private plans
In March, the House of Representatives passed a bill that aimed to cap copayments for insulin in Medicare and in certain private insurance at $35 per month. Drug pricing reform has been a key focus for both legislators and regulators in the Biden administration.
5. Anthem unveils corporate rebrand as Elevance Health
Over the summer, Anthem announced plans for a corporate rebrand as Elevance Health, which is a portmanteau of "elevate" and "advance." Individual Anthem Blue Cross Blue Shield plans continue to operate under that name, but executives said the rebrand highlights the company's ambitions to be more than just a health insurer to members.
6. Health bill brings new liabilities to Part D plans but possible boon on drug costs, experts say
The Senate OK'd a bill this summer that paves the way for Medicare to negotiate prices on certain drug products, a long-sought Democratic policy. While there are still regulatory decisions to be made on this policy, experts say negotiation could lead to significantly lower drug costs for health plans.
7. Judge strikes down CMS' Medicaid copay rule, handing PhRMA major win
A federal judge in May handed the pharmaceutical industry a major victory by striking down a rule that would require drugmakers to include copayment assistance, such as coupons, in Medicaid rebates. The Pharmaceutical Research and Manufacturers of America sued the Department of Health and Human Services in 2021 over the rule.
8. Senate Democrats release deal on drug price negotiations, Part D and Medicare Advantage cap
In another step on the path to securing drug negotiation powers for Medicare, the Senate narrowly reached a deal on the policy change. The legislation would also repeal the Trump administration's controversial Part D rebate rule and would install a monthly cap on cost-sharing for Part D and Medicare Advantage.
9. Alignment Healthcare expanding into 2 new states for 2023
MA insurer Alignment Healthcare went public in March 2021 and since then has planned to build out its reach using the new influx of cash. For 2023, the insurer said it plans to enter two new states, which will enable it to reach 1.1 million potential new members. It will also grows its footprint in the states it already serves.
10. UnitedHealth closes acquisition of Change Healthcare
The Department of Justice (DOJ) sued to block UnitedHealth Group's acquisition of Change Healthcare in early 2022, and a federal judge ruled in favor of the deal, allowing it to close in early October. DOJ is planning an appeal, however, so the legal scuffle over the acquisition will carry into 2023.