CMS for the first time on Oct. 12 approved a state’s request to provide gender-affirming care as an essential health benefit (EHB) in the individual and small-group health insurance markets. Colorado’s new EHB-benchmark plan will offer transgender individuals access to a wider range of services than what is currently covered by their health plans, such as eye and lid modifications, face tightening, facial bone remodeling for facial feminization, breast/chest construction and reductions, and laser hair removal. Effective Jan. 1, 2023, Colorado is also adding EHBs in its benchmark plan to include mental wellness exams and expanded coverage for 14 prescription drug classes.

Humana Inc. is expanding its use of Cohere Health’s digital prior authorization platform for musculoskeletal services, the Boston-based digital health company said on Oct. 13. As part of its initial implementation of Cohere Health’s platform, Humana in January 2021 had rolled out the digital solution to 12 states and has since “made significant progress toward achieving its vision to reimagine and modernize processes for prior authorization by reducing approval times, increasing provider satisfaction, and improving delivery of care, all while preserving important benefits such as safety, predictability, and reducing waste,” according to a press release.

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