Health Care Reform Implementation Update - May 6, 2013

by Cozen O'Connor
Contact

Last week the Centers for Medicare & Medicaid Services (CMS) issued new proposed regulations on FY 2014 payment updates and regulatory policy changes for inpatient and long term care hospitals, skilled nursing facilitates, hospices and inpatient rehabilitation facilities; the Internal Revenue Service (IRS) released a proposed rule on the minimum value of coverage employers must provide to their employees; the Center for Consumer Information and Insurance Oversight (CCIIO) issued guidance explaining the role agents and brokers will play in health insurance marketplaces; Hill leadership, while technically out of session, was busy debating how federal employees will interact personally with insurance marketplaces; and the Department of Health and Human Services (HHS) shortened the application for health coverage in response to concerns that initial enrollment forms were too long. 

ON THE HILL

A provision of the Affordable Care Act (ACA) requires lawmakers and their staff to participate in the health-insurance marketplaces. At the end of last week, questions were raised about whether, under the ACA, congressional employees will be able to continue having their health insurance premiums subsidized by the government, or whether they will have to pay 100 percent of their premiums in 2014. Congressional leaders are discussing possible exemptions for Capitol Hill staffers but are sensitive to the potential for political backlash from a decision to exempt them.

On May 1, House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and Senate Finance Committee Ranking Member Orrin Hatch (R-Utah) released Making Medicaid Work, a blueprint to modernize the Medicaid program.  

IN THE WHITE HOUSE

Speaking at a news conference at the White House on April 30, President Obama said the Affordable Care Act is already benefitting most Americans, even if they do not know it. Major provisions of the Affordable Care Act, however, do not take effect until 2014.

AT THE AGENCIES

CMS announced that the application for health coverage has been simplified and significantly shortened. The application for individuals without health insurance has been reduced from 21 to three pages, and the application for families was reduced by two-thirds. Also, CMS announced that for the first time consumers will be able to fill out one simple application to see their entire range of health insurance options, including plans in the Health Insurance Marketplace, Medicaid, the Children’s Health Insurance Program (CHIP) and tax credits that will help pay for premiums.

This week, CMS, as is usual, issued proposed rules for FY 2014 for inpatient and long term care hospitals, skilled nursing facilitates, hospices and in-patient rehabilitation facilities.  In general, the rules propose modest positive updates and appear to be in line with initial expectations, notwithstanding some novel policy proposals. As always, the rules are proposed and will not be finalized until later this summer. Cozen O’Connor Public Strategies has evaluated the inpatient and long term care hospital rule, and a summary is available here. We will be writing similar summaries of the other rules in the days ahead. Please be advised that there is ample opportunity to comment on these proposals before they go into effect on October 1.

On April 30, the IRS released a proposed rule on the health insurance premium tax credit enacted by the Affordable Care Act. Under the Affordable Care Act, some employees will be eligible for premium tax credits if the coverage provided by the employer does not provide “minimum value.” The rule spells out how to determine the value of coverage an employer must provide in order not to trigger the employer mandate penalty by proposing inputs that will be used to determine whether minimum value has been met.

The Center for Consumer Information and Insurance Oversight (CCIIO) issued a document explaining the role agents and brokers will play in the health insurance marketplaces. The guidance suggests that agents and brokers, including web brokers, will be a major source of marketplace assistance for individual consumers using the marketplaces.

On April 30, the Food and Drug Administration (FDA) eased requirements for purchase of Plan B emergency contraception. Those who are 15 years and older will not need a prescription to get this emergency contraception, which lowers the current age restriction by two years.  

IN THE STATES

House Bill 818 passed through the Pennsylvania House by a vote of 144-53.  The bill is designed to prevent health plans on Pennsylvania’s insurance exchange, when the law kicks in, from including abortion services. The bill reads, “No qualified health plan offered in this Commonwealth through the health insurance exchange shall include coverage for the performance of any abortion.” The Pennsylvania Senate will consider the bill soon.

On April 24, a Louisiana house health panel voted along party lines to defeat a measure that would expand the state’s Medicaid program. A parallel discussion took place in the state Senate Health and Welfare Committee. The senators moved to delay a vote on the bill because they would like to have a representative from the Department of Health and Hospitals answer questions first.

Legislation that would let optometrists, pharmacists and nurse practitioners perform medical tasks currently reserved for doctors passed through the California Senate Business, Professions and Economic Development Committee on April 29.

The dominant insurer in Maryland, CareFirst BlueCross BlueShield, says proposed premiums for new policies for individuals are going to rise by 25 percent on average next year. 

IN THE COURTS

On May 2, a group of small business owners and self-employed individuals from six states filed a lawsuit against the federal government arguing that the IRS did not have the authority to impose an employer coverage requirement or the associated penalties in those states with a federally facilitated exchange. The lawsuit was filed in D.C. District Court. 

IN THIRD PARTIES

A new study from the Brookings Institution, Bending the Curve, outlines reforms designed to reduce health care spending by improving care and promoting value-based payments.

Forty-two percent of those surveyed in a new Kaiser Family Foundation poll did not know that the Affordable Care Act continues to be the law. Some responded that it had been repealed by Congress; others said it was overturned by the Supreme Court.

A new study from The New England Journal of Medicine, The Oregon Experiment – Effects of Medicaid on Clinical Outcomes, received a lot of press attention this week. The study compares thousands of low-income people in Oregon receiving Medicaid with an identical population that did not. The study shows that those with Medicaid coverage spent more on health care, but were not, however, healthier. A 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided a unique opportunity for this randomized-controlled trial.  

---------

To view our compilation of recent health care reform implementation news, click here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Cozen O'Connor | Attorney Advertising

Written by:

Cozen O'Connor
Contact
more
less

Cozen O'Connor on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Privacy Policy (Updated: October 8, 2015):
hide

JD Supra provides users with access to its legal industry publishing services (the "Service") through its website (the "Website") as well as through other sources. Our policies with regard to data collection and use of personal information of users of the Service, regardless of the manner in which users access the Service, and visitors to the Website are set forth in this statement ("Policy"). By using the Service, you signify your acceptance of this Policy.

Information Collection and Use by JD Supra

JD Supra collects users' names, companies, titles, e-mail address and industry. JD Supra also tracks the pages that users visit, logs IP addresses and aggregates non-personally identifiable user data and browser type. This data is gathered using cookies and other technologies.

The information and data collected is used to authenticate users and to send notifications relating to the Service, including email alerts to which users have subscribed; to manage the Service and Website, to improve the Service and to customize the user's experience. This information is also provided to the authors of the content to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

JD Supra does not sell, rent or otherwise provide your details to third parties, other than to the authors of the content on JD Supra.

If you prefer not to enable cookies, you may change your browser settings to disable cookies; however, please note that rejecting cookies while visiting the Website may result in certain parts of the Website not operating correctly or as efficiently as if cookies were allowed.

Email Choice/Opt-out

Users who opt in to receive emails may choose to no longer receive e-mail updates and newsletters by selecting the "opt-out of future email" option in the email they receive from JD Supra or in their JD Supra account management screen.

Security

JD Supra takes reasonable precautions to insure that user information is kept private. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. However, please note that no method of transmitting or storing data is completely secure and we cannot guarantee the security of user information. Unauthorized entry or use, hardware or software failure, and other factors may compromise the security of user information at any time.

If you have reason to believe that your interaction with us is no longer secure, you must immediately notify us of the problem by contacting us at info@jdsupra.com. In the unlikely event that we believe that the security of your user information in our possession or control may have been compromised, we may seek to notify you of that development and, if so, will endeavor to do so as promptly as practicable under the circumstances.

Sharing and Disclosure of Information JD Supra Collects

Except as otherwise described in this privacy statement, JD Supra will not disclose personal information to any third party unless we believe that disclosure is necessary to: (1) comply with applicable laws; (2) respond to governmental inquiries or requests; (3) comply with valid legal process; (4) protect the rights, privacy, safety or property of JD Supra, users of the Service, Website visitors or the public; (5) permit us to pursue available remedies or limit the damages that we may sustain; and (6) enforce our Terms & Conditions of Use.

In the event there is a change in the corporate structure of JD Supra such as, but not limited to, merger, consolidation, sale, liquidation or transfer of substantial assets, JD Supra may, in its sole discretion, transfer, sell or assign information collected on and through the Service to one or more affiliated or unaffiliated third parties.

Links to Other Websites

This Website and the Service may contain links to other websites. The operator of such other websites may collect information about you, including through cookies or other technologies. If you are using the Service through the Website and link to another site, you will leave the Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We shall have no responsibility or liability for your visitation to, and the data collection and use practices of, such other sites. This Policy applies solely to the information collected in connection with your use of this Website and does not apply to any practices conducted offline or in connection with any other websites.

Changes in Our Privacy Policy

We reserve the right to change this Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our privacy policy will become effective upon posting of the revised policy on the Website. By continuing to use the Service or Website following such changes, you will be deemed to have agreed to such changes. If you do not agree with the terms of this Policy, as it may be amended from time to time, in whole or part, please do not continue using the Service or the Website.

Contacting JD Supra

If you have any questions about this privacy statement, the practices of this site, your dealings with this Web site, or if you would like to change any of the information you have provided to us, please contact us at: info@jdsupra.com.

- hide
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.
Feedback? Tell us what you think of the new jdsupra.com!