On October 24, 2018, North Carolina received approval from the federal Centers for Medicare & Medicaid Services (CMS) of its 1115 waiver for a five-year demonstration period. The waiver provides the North Carolina Department...more
Alabama receives federal approval for its Medicaid transformation waiver, while Michigan's Governor submits a Medicaid waiver on behalf of Flint residents; CMS announces $7.7 billion in reinsurance payments; and Vermont seeks...more
2/18/2016
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Medicaid Expansion ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
Reinsurance ,
SHOP Program ,
State Medicaid Programs ,
Waivers
CMS details requirements for Kentucky's transition to HealthCare.gov; a new special enrollment period is established for subsidy-eligible individuals who failed to file their 2014 taxes; and President Obama sends his final...more
Virginia submits a $1 billion DSRIP application; Michigan's Governor will request authority to extend Medicaid coverage to Flint residents aged 21 and under; and Hawaii reinstates small business tax credits in its updated...more
Guidance from HHS and Treasury sets a high bar for 1332 waiver approvals; Kentuckians support Medicaid expansion and their State Marketplace despite plans to change course; and South Dakota's executive budget includes funds...more
12/16/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Co-Op ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
IRS ,
Managed Care Contracts ,
Medicaid Expansion ,
Public Health Insurance Marketplace ,
Shared Responsibility Rule ,
State Health Insurance Exchanges ,
U.S. Treasury ,
Waivers
A flurry of support for Medicaid expansion this week…with Virginia hospitals backing a provider assessment, Wyoming's Governor putting forth a budget initiative, and Arkansas announcing plans to extend its waiver. Meanwhile,...more
12/10/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Conflicts of Interest ,
Enrollment ,
Governor Pence ,
Healthcare Costs ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
State Budgets ,
Waivers
HHS proposes significant new network adequacy standards and surprise billing protections for 2017 QHPs; Louisiana's Governor-elect reiterates his intent to expand Medicaid on "Day One"; and California considers pursuing a...more
Kansas legislators supportive of Medicaid expansion are pulled from committee; Montana’s Medicaid expansion is off to a strong start; and New Mexico sees declines in uncompensated care since ACA implementation....more
11/18/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Healthcare.gov ,
Legislative Committees ,
Managed Care Contracts ,
Medicaid Expansion ,
Medicaid Reform ,
Request for Proposals ,
State Health Insurance Exchanges ,
Waivers
Montana receives approval to expand Medicaid beginning 2016; California’s $6.2 billion Medicaid waiver receives pre-approval; and HHS proposes broadening circumstances under which states receive enhanced federal matching...more
11/5/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Co-Op ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare.gov ,
Medi-Cal ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Native American Issues ,
Open Enrollment ,
Proposed Amendments ,
Public Health Insurance Marketplace ,
State Health Insurance Exchanges ,
Waivers
HHS announces average premium price increases of 7.5% across HealthCare.gov; Michigan and Illinois launch the country’s first joint cloud-based, real-time Medicaid information management system; and the Marketplace carrier...more
10/28/2015
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Enrollment ,
GAO ,
Health Insurance ,
Healthcare ,
Healthcare.gov ,
Insurance Industry ,
Medicaid ,
Premiums ,
Prescription Drugs ,
Public Health Insurance Marketplace ,
Tax Credits ,
Waivers
Editor’s note: Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs into the nation’s largest health insurer. Medicaid’s 50th birthday is a fitting time to...more
10/27/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Eligibility ,
Enrollment ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance ,
Healthcare ,
Healthcare Costs ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Tax Credits ,
Value-Based Purchasing ,
Waivers
Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more
10/21/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Co-Op ,
Co-payments ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
DSRIP ,
Enrollment ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
OIG ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
State Health Insurance Exchanges ,
Tax Credits ,
Waivers
Congress passes a bill to give states greater flexibility in defining “small businesses”; South Dakota seeks to offset Medicaid expansion costs in part with increased use of the fully federally-funded Indian Health Service;...more
10/7/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
Co-Op ,
DSRIP ,
Enrollment ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Healthcare.gov ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Pending Legislation ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
Small Employers ,
Waivers
Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs to the nation’s largest health insurer. The occasion of Medicaid’s 50th birthday is a fitting time to...more
9/30/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Enrollment ,
Health Insurance ,
Information Technology ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Waivers
Colorado’s uninsured rate is down 9 percentage points in four years; Michigan requests increased cost-sharing for its Medicaid expansion population above the federal poverty line; and, HHS’s proposed guidance strengthens...more
9/10/2015
/ Affordable Care Act ,
Anti-Discrimination Policies ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Disability Discrimination ,
Draft Guidance ,
Federal Health Insurance Exchanges ,
Gender Discrimination ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
NPRM ,
Proposed Regulation ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
Sex Discrimination ,
Sexual Orientation Discrimination ,
State Health Insurance Exchanges ,
Tax Credits ,
Transgender ,
Waivers
CMS offers a special enrollment period for HealthCare.gov enrollees whose incomes were miscalculated due to system error; California Marketplace announces two new insurers; and Connecticut’s budget reduces eligibility levels...more
7/29/2015
/ CCIIO ,
Centers for Medicare & Medicaid Services (CMS) ,
DSRIP ,
Enrollment ,
Fast Track Process ,
Health Insurance ,
Healthcare Reform ,
Healthcare.gov ,
IRS ,
Medicaid ,
Medicare ,
Public Health Insurance Marketplace ,
State Budgets ,
Tax Credits ,
Waivers