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Centers for Medicare & Medicaid Services (CMS) Health Insurance Public Health Insurance Marketplace

Manatt, Phelps & Phillips, LLP

CMS Proposed 2026 Notice of Benefit and Payment Parameters Rule Focuses on Marketplace Oversight

On October 4, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters (NBPP) for plan year 2026. This proposal begins the annual rulemaking cycle for the Marketplaces...more

Manatt, Phelps & Phillips, LLP

States Challenge CMS Rule Making DACA Recipients Eligible for Marketplace Subsidies

On August 8, a coalition of 15 state attorneys general sued CMS in the North Dakota federal court seeking to overturn a May 2024 CMS final rule making Deferred Action for Childhood Arrivals (DACA) recipients eligible for...more

Foley & Lardner LLP

CMS Changes Medicare Advantage and Part D Plans’ Agent/Broker/TPMO Compensation Landscape

Foley & Lardner LLP on

In its November 2023 Proposed Rule and in its recently issued Final Rule that will be published in the Federal Register later this month, the Centers for Medicare & Medicaid Services (CMS) addressed concerns related to agent...more

Sheppard Mullin Richter & Hampton LLP

CMS Promotes Health Equity through Marketplace Standards and More in New Proposed Rule

On November 24, 2023, the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule to modify certain Patient Protection and Affordable Care Act (“ACA”)...more

Nossaman LLP

Understanding the HHS 2023 Proposed Rule

Nossaman LLP on

The Department of Health and Human Services (HHS) released its Notice of Benefit and Payment Parameters for the 2023 Proposed Rule on Wednesday, January 5th 2022. ...more

Manatt, Phelps & Phillips, LLP

[Webinar] Levers of Change: Remapping the Health Care Landscape - March 9th, 1:00 pm - 2:00 pm ET

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

Manatt, Phelps & Phillips, LLP

Oregon Public Option Report: An Evaluation and Comparison of Proposed Delivery Models

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

Troutman Pepper

Another One Bites the Dust: CMS Quashes Ohio's Plan to Waive ACA Requirements, For Now

Troutman Pepper on

We have recently seen an uptick in state initiatives designed to skirt requirements under the Affordable Care Act (ACA). We last wrote about Idaho’s failed attempt to permit health insurers to sell noncompliant plans, which...more

Proskauer - Employee Benefits & Executive...

Health Care Reform Weekly Roundup – Issue 2

Below are key health care reform developments from the week of May 15th: ACA Repeal Efforts. Efforts to repeal and replace the Affordable Care Act (ACA) continue despite slowing down as the House of Representatives’...more

Ballard Spahr LLP

CMS, IRS Address Affordable Care Act Issues in Transition

Ballard Spahr LLP on

The Centers for Medicare and Medicaid Services (CMS) and the IRS have each published guidance on matters arising under the Affordable Care Act (ACA). It is too early to tell whether these measures—some of the first guidance...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - August 2016 #5

A federal report finds that Marketplace premiums are lower in expansion states; Massachusetts and Pennsylvania launch prescription drug monitoring systems; and Kentucky submits a slightly modified Medicaid expansion waiver to...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - August 2016 #4

HealthCare.gov plans an open enrollment pilot that will let consumers compare provider network breadth; new Medicaid enrollees reduce out-of-pocket spending on prescription drugs by nearly 60%; and Kansas’s Governor announces...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - August 2016 #2

CMS targets Medicaid managed care pass-through payments; California proposes “California Qualified Health Plans” for the undocumented; and a new study finds out-of-pocket costs were reduced by nearly a third for Medicaid...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2016 #4

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - May 2016 #4

Uninsurance hit a record-breaking low of 9.1% in 2015; Vermont legislators pass a bill to increase drug formulary and price transparency; and California rolls out its State-funded Medi-Cal expansion to undocumented children....more

Alston & Bird

A&B Healthcare Week in Review

Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On April 15, 2016, the Food and Drug Administration (FDA) issued a proposed rule entitled, “Applications for Approval and Combinations of Active Ingredients Under Consideration for...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - March 2016 #2

The IRS releases guidance on resolving Form 1095 conflicts; New Hampshire's Medicaid expansion renewal clears a hurdle in the State; and New York providers get $1.5 billion in long-awaited DSRIP capital and infrastructure...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - December 2015 #3

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

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - December 2015

CMS concludes no QHPs can be certified as comparable to CHIP coverage; California's Marketplace plans to connect consumers to vision coverage issuers; and states react to CMS's proposed HealthCare.gov user fee....more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - November 2015

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

Manatt, Phelps & Phillips, LLP

Manatt on Medicaid: Medicaid at 50—The Program’s Evolution and Future

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

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - October 2015 #3

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

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - October 2015

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

Manatt, Phelps & Phillips, LLP

Medicaid at 50: The Program’s Evolution and Future

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

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - September 2015 #5

New study shows Marketplace premiums parallel the employer market; Montana likely to select a private insurer to administer benefits to its Medicaid expansion population; and Washington’s Exchange customers will begin paying...more

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