The Affordable Care Act (ACA) Marketplaces have nearly tripled their enrollment in their first decade of operation, from eight million people in 2014 to 21.4 million in 2024. At the national level, the ACA has helped cut the...more
The Centers for Medicare & Medicaid Services (CMS) released the final 2023 Notice of Benefit and Payment Parameters (NBPP), the annual rule outlining key policies for the individual and group health insurance markets for plan...more
On April 5, President Biden held an event at the White House celebrating coverage gains since the enactment of the Affordable Care Act (ACA). Joined by Vice President Harris and former President Obama, President Biden...more
In-home evaluations (IHEs) are an integral component of Medicare Advantage (MA) plans, giving MA plans a cost-effective way to identify and meet the medical and nonmedical needs of vulnerable beneficiaries in their own homes...more
States have always been the primary regulators of their local health care markets and have increasingly used All Payer Claims Databases (APCDs) as one tool to help them make data-driven policy decisions. Like much state...more
President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more
2/16/2022
/ Alternative Payment Models (APM) ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Beneficiaries ,
Physicians ,
Public Health Emergency ,
Public Health Insurance Marketplace ,
Surprise Medical Bills ,
Telehealth ,
Webinars
In July 2021, Governor Kate Brown signed into law HB 2010, which charges the Oregon Health Authority (OHA), in collaboration with the Department of Consumer and Business Services (DCBS), with developing a potential path for a...more
Oregon is committed to closing the remaining gap in health insurance coverage and doing so in a way that helps the State meet its goal of eliminating health inequities. According to the Oregon Health Insurance Survey,...more
In December 2021, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters for 2023. This proposal kicks off the annual rulemaking cycle for the Marketplaces and the...more
Executive Summary -
Employers sponsoring group health plans face the ever-growing challenge of rising health care costs, and the increasing expenses they place on the plans and their enrollees alike. To respond to these...more
In a New Webinar, Manatt and the Leukemia & Lymphoma Society Share the Obstacles Cancer Patients Face to Receiving Proper Treatment—and the Policies States and Plans Can Implement to Improve Network Adequacy and...more
8/2/2021
/ Best Practices ,
Cancer ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Insurance Regulations ,
Out of Network Provider ,
Out-of-Pocket Expenses ,
Patient Access ,
Physicians ,
State Health Plans ,
Webinars
In a new “Expert Perspective” prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health provides a midyear update on the public option at the federal and state levels. ...more
In a new report prepared in partnership with the Leukemia & Lymphoma Society (LLS), summarized below, Manatt Health reviews policy challenges that may hamper patients’ ability to navigate and obtain proper treatment for their...more
Blood cancer takes a demanding physical, mental and emotional toll on the 1.3 million patients living with this disease in the U.S. Many blood cancer patients also face the daunting task of managing their own care—obtaining...more
In recent years, state lawmakers have been considering and/or implementing policies to increase affordability for state consumers in the individual market. Since 2017, nearly a dozen states have considered or passed...more
How Can Mental Health and Substance Use Disorder (SUD) Parity Laws Help Battle the Overdose Epidemic? Learn the Answers—and Catch Up on the Most Recent State and Federal Developments—at a New Webinar from the AMA and...more
1/14/2021
/ Best Practices ,
Department of Insurance ,
Enforcement ,
Health Care Providers ,
Health Insurance ,
Insurance Commissioners ,
Insurance Industry ,
Medicaid ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NAIC ,
NQTLs ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Regulatory Oversight ,
Self-Insured Health Plans ,
State Insurance Administrations ,
Substance Abuse ,
Webinars
Section 9 of Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of...more
Technological innovation has always been at the center of the Affordable Care Act (ACA) Marketplaces and has never been more important than it is now. Changes brought on by the coronavirus pandemic have clearly illustrated a...more
Federal and state actions related to commercial health insurance are already underway—and healthcare stakeholders and state regulators will have to manage a rising tide of emerging developments and new regulations in the...more
Examine the Evolving Challenges That Lie Ahead for Healthcare Stakeholders and State Regulators—and What You Can Do Now to Prepare and Protect Your Organization—at a New Manatt Webinar.
Effective health insurance...more
4/10/2020
/ Affordable Care Act ,
Appeals ,
Audits ,
Billing ,
Compliance ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Employee Retirement Income Security Act (ERISA) ,
Enrollment ,
Extensions ,
Grace Period ,
Health Claims ,
Health Insurance ,
Healthcare Costs ,
Medical Testing ,
Out of Network Provider ,
Preemption ,
Premiums ,
Reporting Requirements ,
Risk Adjustment Formula ,
Risk-Based Approaches ,
Scope of Coverage ,
Stakeholder Engagement ,
State Regulators ,
Tax Credits ,
Utilization Review ,
Waivers ,
Webinars
Editor’s Note: In a new toolkit prepared for the Robert Wood Johnson Foundation, summarized below, Manatt Health helps insurance regulators understand the wide range of transparency and competition strategies available to...more
3/5/2020
/ Anti-Competitive ,
Antitrust Provisions ,
Benefit Plan Sponsors ,
Competition ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Department of Insurance ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Horizontal Mergers ,
Hospital Mergers ,
Medicaid ,
Medicare ,
Transparency ,
Vertical Mergers
State insurance regulators play many roles in making health insurance more available and affordable to consumers. Two that stand out are enhancing transparency and promoting competition. Every state department of insurance...more
As the 47 states, including the District of Columbia (DC), that conduct their own rate reviews continue their review processes, many have released at least some details about what insurers proposed in their rate filings for...more
The Affordable Care Act was designed in part to help bring stability to the individual health insurance market. But faced with a fluid federal regulatory environment, many states continue to encounter challenges, including...more
On July 11, the federal government announced approval of Alaska’s waiver request under Section 1332 of the Patient Protection and Affordable Care Act for funding in support of the Alaska Reinsurance Program (ARP). The ARP is...more