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Centers for Medicare & Medicaid Services (CMS) Reinsurance

Locke Lord LLP

CMS Issues Final Quota Share Reinsurance Rule

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As we reported in our QuickStudy on February 13, 2020, CMS filed and made available for public inspection on February 5, 2020, a new proposed rule (the “Proposed Reinsurance Rule”) under the authority of Section 1855(b)(1) of...more

Manatt, Phelps & Phillips, LLP

CMS Proposes Modifications to Medicare Advantage Reinsurance Rules

In its 2021 Proposed Rule for the Medicare Advantage program, the Centers for Medicare & Medicaid Services (CMS) proposes to alter the rules under which Medicare Advantage Organizations (MAOs) may obtain reinsurance. The...more

Locke Lord LLP

CMS Acknowledges Value of Quota Share Reinsurance for MAO Plans and Proposes New Rule to Establish Reinsurance Standards

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The Proposed New Reinsurance Rule - Readers of our prior QuickStudies on this topic are aware that since 2017, the long-standing use of quota share reinsurance by Medicare Advantage Organizations (“MAOs”) with respect to...more

Locke Lord LLP

Troubling and Conflicting Signs from CMS Over the Continued Use of Quota Share Reinsurance by MAO Plans

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As we previously reported in our Quick Study dated April 4, 2017, CMS, on April 3, 2017, announced that it had reconsidered its position that quota share reinsurance arrangements are not a statutorily permitted form of...more

Mintz - Health Care Viewpoints

Part D Payment Modernization Model Aimed at Reducing Medicare's Catastrophic Phase Spending

On January 18, 2019, CMS announced the Medicare Part D Payment Modernization Model, aimed at incentivizing Part D sponsors to reduce catastrophic phase federal reinsurance subsidy spending. The model, which will begin January...more

Mintz - Health Care Viewpoints

New Jersey’s Pending 1332 Reinsurance Waiver

At the end of July, CMS approved two Section 1332 State Innovation Waivers submitted by Wisconsin and Maine for the purpose of establishing state reinsurance programs. There has been a flurry of 1332 waiver activity recently...more

Mintz - Health Care Viewpoints

Recent 1332 Waiver and Reinsurance Activity

States are increasingly looking for ways to improve stability in their individual insurance marketplaces. One way is through reinsurance programs – systems in which multiple insurance companies share risk by purchasing...more

Locke Lord LLP

CMS Reconsiders Its Position Prohibiting Quota Share Reinsurance For Medicare Advantage Organizations

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We previously reported on February 13, 2017 that the Centers for Medicare & Medicaid Services (CMS), on February 1, 2017, in connection with its 2018 Advance Notice (Notice), advised that quota share reinsurance arrangements...more

Locke Lord LLP

No Quota Share Reinsurance For Medicare Advantage Organizations, Says CMS

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On February 1, 2017, the Centers for Medicare & Medicaid Services (CMS), in connection with its 2018 Advance Notice (the Notice), advised that quota share reinsurance arrangements are not a statutorily permitted form of...more

Manatt, Phelps & Phillips, LLP

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

The incoming Trump Administration selects HHS and CMS leadership; Alaska moves forward with its proposed 1332 waiver for its ACA reinsurance program; and a new Manatt Health report considers the role of Medicaid supplemental...more

Manatt, Phelps & Phillips, LLP

Health Update - November 2016

Post-Election Analysis: Healthcare Antitrust in a Trump Administration - In a Republican sweep of all the elected branches of the federal government, Donald Trump won the presidential election and Republicans retained...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2016

Massachusetts extends coverage of Hepatitis C treatments and New Hampshire extends substance use disorder coverage to more Medicaid enrollees; Alaska’s Medicaid expansion now moves ahead uncontested; and CMS reports...more

Alston & Bird

A&B Healthcare Week in Review

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I. REGULATIONS, NOTICES, & GUIDANCE - On March 15, 2016, the Centers for Disease Control and Prevention (CDC) issued voluntary guidelines entitled, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - February 2016 #3

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

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2015

Ohio passes a budget mandating that the State request a waiver to implement Medicaid Health Savings Accounts; in Nevada, Marketplace enrollees who experienced technical difficulty obtaining coverage are eligible for a...more

Mintz - ML Strategies

Health Care Update - July 2015

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In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - June 2015 #4

This week...no clear consensus has emerged among congressional Republicans on how to manage potential King v. Burwell fallout; California will expand Medicaid to undocumented children; and New York is poised to become the...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

This Week: Leading Up to the SCOTUS King v. Burwell Decision... House Votes to Repeal the Medical Device Tax... CMS Announces It Will Bolster Transitional Reinsurance Payments... MedPAC Releases June Report to Congress....more

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