Health Insurance Centers for Medicare & Medicaid Services

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

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

Health Care Update - July 2015 #3

ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more

Washington Healthcare Update

This Week: CMS Releases Guidance on Fast Track Process for 1115 Waivers for Medicaid and CHIP... Healthcare.gov CEO Sends Letter to State Insurance Commissioners Concerning 2016 Premium Decisions... Medicare Board of Trustees...more

Non-Group Health Plan MMSEA Section 111 Reporting Updates

The Centers for Medicare and Medicaid Services (CMS) recently made several announcements regarding Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 reporting for Non-Group Health Plans (NGHPs). Originally...more

Also In The News - Health Headlines - July 2015

CMS Reopens Attestation Period For First-Time Hospitals Until August – CMS recently announced that eligible hospitals participating in the Medicare Electronic Health Record Incentive Program for the first time in 2015 may...more

Health Update - July 2015

Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace - Editor's Note: As marketplaces prepare for the third open enrollment period, consumers are...more

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

In quick succession, governors in Alaska and Utah announce Medicaid expansions this week; Iowa is transitioning its expansion away from the Marketplace to Medicaid managed care, for now; and, HHS extends its exception to...more

Washington Healthcare Update

This Week: 21st Century Cures Legislation Passes House in Bipartisan Vote... CMS Releases Proposed CY 2016 Home Health Prospective Pay Rule... CMS Releases Final CY 2016 Hospital Outpatient Prospective Payment System (OPPS)...more

Manatt on Health Reform: Weekly Highlights - July 2015 #2

Montana’s Medicaid expansion waiver seeks monthly premiums and a “third party administrator”; Rhode Island’s Medicaid working group recommends pursuing a DSRIP waiver; and Utah’s Medicaid expansion discussions are put on hold...more

Delivery System Reform 2.0: Scaling Alternative Payment Models is the New Normal

For some health care providers, a pair of recent announcements made by the Obama Administration to implement mandatory alternative payment models (APMs) for home health value-based purchasing and bundled payments for hip and...more

Health Care Update - July 2015 #1

In This Issue: - Recent Mandatory APMs Signal Evolution in Delivery Reform Efforts - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Upcoming...more

Telehealth Roundup: Federal Bill Seeks to Expand Medicare Use of Telehealth; Delaware and Connecticut Update Telemedicine Laws

On July 7th, the House introduced much anticipated bipartisan telehealth legislation. The Medicare Telehealth Parity Act of 2015, introduced by Representative Mike Thompson (D-CA) and co-sponsored by Representatives Gregg...more

Health Care Update - July 2015

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

Thirteen Years of the Same Rules and Now Big Proposed Changes to the Regulation of Medicaid Managed Care Plans

On May 25, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published a newly proposed rule that would change the way the agency regulates Medicaid managed care plans, the first regulation of its kind since 2002. ...more

Proposed Managed Care Rules Leave State Obligations for CHIP Largely Unchanged

The Centers for Medicare & Medicaid Services’ (CMS) proposed rule (“Rule”) that updates Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems, leaves state obligations largely...more

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

Washington Healthcare Update

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

Medicaid managed care proposed rule expands program integrity obligations

On June 1, 2015, the US Centers for Medicare & Medicaid Services (“CMS”) published its proposed rule on Medicaid managed care (CMS-2390-P). As noted in our two earlier advisories, which provided an overview of the proposed...more

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

With the King v. Burwell ruling expected by the end of the month, Congressional Republicans continue to offer contingency plans in the event of a ruling for the plaintiffs; and the Mississippi Insurance Commissioner proposes...more

CMS Finally Releases Proposed Rules for Medicaid Managed Care

On Friday, Mintz Levin Health Law and ML Strategies posted an advisory on CMS’s proposed Medicaid Managed Care rules. This advisory provides contextual background, a helpful overview of the rule’s contents, and an in-depth...more

Washington Healthcare Update

This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more

Medicaid Managed Care Proposed Rules: The Intersection of Private Insurance and Government Programs

Approximately a quarter of all Medicaid expenditures is spent on the more than half of all beneficiaries (approximately 39 million by 2011 figures cited in the 2014 MACPAC Report) currently accessing part or all of their...more

CMS Releases Proposed Rules on Medicaid and CHIP Managed Care

On Tuesday, May 26, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released the pre-publication proposed rule that updates Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations. In the...more

CMS Issues Broad-Reaching Proposals to Better Align Medicaid Managed Care with the Commercial and Medicare Markets

On May 26, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) containing the first proposed revisions to the Medicaid managed care (“MMC”) program’s regulations in more than...more

CMS Releases Medicaid Managed Care Proposed Rule

On May 26, 2015, CMS issued a proposed rule that aims to update Medicaid and Children's Health Insurance Program (CHIP) managed care plans (Proposed Rule). The Proposed Rule is the first major update to Medicaid and CHIP...more

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