Maryland becomes the first State to mandate over-the-counter contraceptive coverage; Missouri plans to increase Medicaid asset limitations by 500% by 2021; and HHS' final rule extends protections against sex discrimination to...more
5/18/2016
/ Affordable Care Act ,
Contraceptive Coverage Mandate ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Health Insurance Exchanges ,
Medicaid ,
Opioid ,
Religious Accommodation ,
SCOTUS ,
Sex Discrimination ,
Zubik v Burwell
CMS's sweeping final rule aligns Medicaid and CHIP managed care with QHP and Medicare Advantage regulations; New York's DSRIP is enabling change in the State's Medicaid delivery system; and Medicaid expansion reduces...more
Best Practices for Using Social Media in Healthcare: Maximizing Impact, Mitigating Risk -
Editor's note: In a generation more likely to seek health information online than see a doctor, social media is playing an...more
11/23/2015
/ Affordable Care Act ,
Ann Taylor ,
Federal Trade Commission (FTC) ,
Form 1095 ,
FTC Endorsement Guidelines ,
HCQIA ,
Health Information Technologies ,
Health Insurance Exchanges ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Hyundai ,
IRS ,
Licensing Boards ,
Marketing ,
NC Board of Dental Examiners v FTC ,
Peer Review ,
Reporting Requirements ,
SCOTUS ,
Social Media ,
State Action Immunity
Iowa's largest insurer joins the State's Marketplace for coverage year 2017; carrier changes are announced for Marketplaces in Kentucky, Oklahoma and Wyoming; and South Dakota's Governor convenes the Health Care Solutions...more
10/14/2015
/ Affordable Care Act ,
Blue Cross ,
Blue Shield ,
Health Care Providers ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
Healthcare.gov ,
HIV ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Open Enrollment ,
Public Health Insurance Marketplace ,
Qualified Health Plans
The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more
9/23/2015
/ Affordable Care Act ,
Bundled Payments ,
Burwell v Hobby Lobby ,
Census Bureau ,
Centers for Medicare & Medicaid Services (CMS) ,
Contraceptive Coverage Mandate ,
Department of Health and Human Services (HHS) ,
GAO ,
Governor Bentley ,
Governor McCrory ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Long-Term Care ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Medicaid Reimbursements ,
Medicare ,
OIG ,
Pending Legislation ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
Religious Accommodation ,
SCOTUS ,
State Budgets ,
State Medicaid Programs
The GAO reports an increase in choice of plans both on and off Marketplaces; Hawaii submits the first 1332 waiver application, with a focus on substituting the employer mandate and SHOP provisions with pre-existing State...more
9/16/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Employer Mandates ,
GAO ,
Health Insurance Exchanges ,
Healthcare Reform ,
Healthcare.gov ,
Medicaid ,
Public Health Insurance Marketplace ,
SHOP Program ,
State Health Insurance Exchanges
Increased plan choice on HealthCare.gov is linked to lower premium growth; Arizona seeks changes to Medicaid expansion; and California and New York release detailed Marketplace and Medicaid enrollment reports....more
8/5/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
Exemptions ,
Health Insurance ,
Health Insurance Exchanges ,
Health Savings Accounts ,
Healthcare ,
Healthcare Costs ,
Healthcare.gov ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Open Enrollment ,
Public Health Insurance Marketplace ,
State Health Insurance Exchanges
Montana’s Medicaid expansion waiver seeks monthly premiums and a “third party administrator”; Rhode Island’s Medicaid working group recommends pursuing a DSRIP waiver; and Utah’s Medicaid expansion discussions are put on hold...more
Topping the news, last week's King v. Burwell ruling preserved subsidies for the 6.7 million people receiving them through the federal marketplace.
In other news, President Obama pledged renewed efforts to work with...more
7/1/2015
/ Affordable Care Act ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Health Insurance Exchanges ,
King v Burwell ,
Medicaid ,
Medicaid Expansion ,
Public Health Insurance Marketplace ,
SCOTUS ,
Standard of Review ,
State Health Insurance Exchanges
With the King v. Burwell ruling expected by the end of the month, Congressional Republicans continue to offer contingency plans in the event of a ruling for the plaintiffs; and the Mississippi Insurance Commissioner proposes...more
6/17/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare.gov ,
Insurance Commissioners ,
King v Burwell ,
Medicaid ,
Mitigation ,
Obama Administration ,
Penalties ,
Pending Legislation ,
Public Health Insurance Marketplace ,
SCOTUS ,
State Health Insurance Exchanges ,
Subsidies
With an eye toward the imminent King v. Burwell ruling, Delaware submits a Supported State-based Marketplace blueprint to CMS and South Carolina’s governor says the State will not establish a State-based Marketplace. In...more
Washington and Iowa report surges in insurer participation in Marketplaces for 2016; Maine considers legislation to maintain premium subsidies regardless of King v. Burwell.
KING V. BURWELL ACTIVITY:
Maine:...more
This week Montana became the 30th state to expand Medicaid, and the battle over Medicaid expansion and uncompensated care reached a breaking point in Florida. Meanwhile, as the King v Burwell decision looms, Congress and...more
5/6/2015
/ Affordable Care Act ,
Catholic Church ,
Contraceptive Coverage Mandate ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
Hospitals ,
King v Burwell ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
SCOTUS
CMS releases new redetermination regulations and links uncompensated care funds to expanding Medicaid, and New York becomes the second state to launch the Basic Health Program.
...more
This week, Alaska’s Governor introduced Medicaid expansion bills in both the House and Senate after failing to get approval in his budget. Colorado determined that non-ACA-compliant plans cannot be sold in 2016, a year ahead...more
FEDERAL NEWS:
More than 8 in 10 Federal Marketplace Enrollees Receive Tax Credits -
According to data released by CMS, 7.7 million consumers, or 87 percent of those on the Federally-facilitated Marketplace with...more
King v. Burwell speculation has been rampant since the Supreme Court heard oral testimony on Wednesday. All eyes are on Justices Kennedy and Roberts, who are likely to wield the deciding votes. In other news, CMS approved a...more
3/11/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Enrollment ,
Health Insurance Exchanges ,
King v Burwell ,
Medicaid ,
Medicaid Expansion ,
Pregnancy ,
SCOTUS ,
State Budgets ,
Subsidies ,
Tax Incentives
Wrapping up the 2015 enrollment period, Healthcare.gov and State-based Marketplaces in seven states have announced special enrollment periods (SEPs) for people who were uninsured in 2014 and discover they owe a “shared...more
Although the official February 15th enrollment deadline has now passed, the 2015 open enrollment period isn’t over for the Federally-facilitated Marketplace (FFM) and many State-based Marketplaces (SBMs).While the FFM...more
HHS ramps up for the final week of open enrollment. Families buying into CHIP in Pennsylvania are granted tax relief, and though Medicaid expansion efforts seem to have hit a wall in Tennessee and Wyoming, Arkansas assures...more
The President’s budget reveals the healthcare agenda for his Administration’s penultimate year. Medicaid expansion proposals advance in Arkansas and Wyoming; California’s Marketplace reports 9 out of every 10 enrollees remain...more
This week, the IRS announces relief for some taxpayers who received excess advanced premium tax credits; Indiana and Arkansas make major announcements on Medicaid expansion and Iowa’s Governor announces a shift towards...more
1/28/2015
/ Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Congressional Budget Office ,
Drug Testing ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
IRS ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Reimbursements ,
SCOTUS ,
Tax Credits
This week, leadership changes at CMS continue, Montana’s Governor introduces Medicaid expansion legislation, and the California Marketplace allows new health plan entrants into the individual and SHOP Marketplaces for the...more
This week’s highlights include movement in states’ Marketplace and Medicaid leadership positions; Idaho takes a hard look at Medicaid expansion, and federal officials help Marketplace enrollees prepare for the 2014 tax...more
Enrollment and coverage expansion tops the new this week. Federal officials announced 6.5 million people have enrolled through the Federally-facilitated Marketplace and released the first in a monthly series of detailed...more