GNYHA has developed a brief survey to help inform our advocacy regarding Anthem’s new Facility Administrative Policy: Use of a Nonparticipating Care Provider. Under a policy that applies to commercial plans and became effective July 1, 2026, Anthem can impose a 7.5% administrative penalty on in-network facility claims when a nonparticipating provider is involved in...

The US Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a “Dear Colleague” letter to remind HHS funding recipients of their obligations under Title VI of the Civil Rights Act of 1964 and the nondiscrimination provisions of Section 1557 of the Affordable Care Act to administer their programs and...

The New York State Department of Financial Services (DFS) has approved 2027 premium rate increases for New York’s individual and small-group health insurance markets. The approved average increase for the individual market is 6.0%, and the approved average increase for the small-group market is 8.0%. These average increases reflect 71% and 66% reductions from insurers’...

New York State Governor Kathy Hochul has announced $76 million in Rural Community Health Integration (RCHI) initiative awards to 56 organizations as part of the State’s Rural Health Transformation Program (RHTP). The announcement also noted that the State will use an additional $1 million to increase the number of school-based health centers in rural areas....

The New York State Department of Health (DOH) has rescinded the attached “Dear Administrator Letter (DAL #26-13),” which informed nursing home (NH) administrators that starting on September 30, DOH would begin disenrolling undocumented non-citizens aged 65 or older who have been permanently placed in NHs for at least three consecutive months from their mainstream Medicaid...

The New York State independent dispute resolution (IDR) process for out-of-network emergency and surprise bills has changed, effective August 26, 2026. The changes were part of the State fiscal year 2027 budget, and the Department of Financial Services (DFS) recently issued a Circular Letter and emergency regulations with implementation guidance. In addition to timing and...

GNYHA recently submitted the attached comments on the Centers for Medicare & Medicaid Services (CMS) calendar year (CY) 2027 home health (HH) prospective payment system (PPS) proposed rule . Our comments focused on CMS’s proposals to modify Medicare provider enrollment processes that apply to all provider types and to apply a temporary -3.0% Patient-Driven Grouping...

GNYHA submitted the attached comments on Senator Bill Cassidy’s (R-LA) 340B Drug Pricing Integrity and Affordability for Patients Act discussion draft (the 340B Patients Act). Attempts by multiple stakeholders to erode the 340B program have intensified over the past few years. Manufacturers like Lilly are demanding claims data as a condition of accessing 340B pricing....