The North Carolina Department of Health and Human Services announced the launch of the Children and Families Specialty Plan (CFSP), a statewide health plan to ensure access to comprehensive physical and mental health services for Medicaid-enrolled children, youth, and young adults currently and formerly served by the child welfare system. With approval from, and at…

Negotiated reimbursement rates vary substantially across all American Society of Addiction Medicine (ASAM) Levels of Care for facility-based services—even after standardizing codes and removing outliers, according to a recent analysis released by the National Association of Addiction Treatment Providers (NAATP). The variation in reimbursement rates existed within and across payer networks, reflecting a fragmented and inequitable reimbursement…

The Louisiana Department of Health (LDH) extended five of its six Medicaid managed care organization (MCO) contracts for the Healthy Louisiana program through December 31, 2026, at a cost of more than $17 billion. The five plans with a full-year extension are Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue, Humana Healthy Horizons…

During the 2026 Marketplace Open Enrollment Period (OEP), more than 22.8 million consumers signed up for health insurance coverage since November 1, 2025, according to a January 12, 2026, announcement by the Centers for Medicare & Medicaid Services (CMS). The number of enrollments was at least 1.2 million lower than the more than 24 million…

The American Psychiatric Association (APA) and the New York State Psychiatric Association sued New York-based health insurer EmblemHealth Inc. and EmblemHealth Plan, Inc. over its inaccurate directory of in-network mental health professionals. The complaint characterized this practice as presenting a “ghost network.” The complaint was filed on behalf of APA members and a proposed class…

Idaho Medicaid cut selected behavioral health services for people with serious and persistent mental illness (SPMI) as part of an effort to help the state avoid a budget deficit. The programs serve nearly 5,500 people with SPMI, according to the Idaho Association Of Community Providers (IACP). The programs include assertive community treatment (ACT), high acuity…

Anthem Blue Cross and Blue Shield in Virginia and Riverside Health, an integrated health network serving eastern Virginia, announced a new multiyear agreement that ensures Anthem members will continue to have uninterrupted, in-network access to Riverside’s hospitals, provider organizations, and outpatient care services across the region. Anthem Blue Cross and Blue Shield is the trade…

Nearly two-thirds (31) of state Medicaid and Children’s Health Insurance Program (CHIP) plans cover behavioral health therapy for children and youth whether or not the children/youth have a diagnosed behavioral health disorder. Nearly one-third of children ages 3-17 enrolled in Medicaid or CHIP plans as of 2021 reported having mental, emotional, developmental, and/or behavioral needs,…

Erickson Senior Living, which develops and manages continuing care retirement communities (CCRCs), announced its Medicare Advantage health plan, Erickson Advantage, has been awarded a 5-out-of-5-star overall rating from the Centers for Medicare & Medicaid Services (CMS) for the sixth year in a row. Each year, CMS measures the performance of Medicare Advantage plans using the…

While the Patient Protection and Affordable Care Act (ACA) requires private health insurers to cover recommended preventive services with no consumer cost-sharing, out-of-pocket (OOP) costs for which they should be exempt are still incurred, according to a recent study. Gaps in enforcing the cost-sharing exemption particularly affect those with chronic conditions, who pay higher OOP…