Physician groups and American Enterprise Institute authors come out against ACA repeal without a replacement; Hawaii’s 1332 waiver is the first to receive federal approval; and North Carolina’s Governor moves to expand...more
On September 25, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled “Medicare Program: Medicare Clinical Diagnostic Laboratory Tests Payment System”. This proposed rule would...more
Overview - On September 9 Hawaii became the first state to post a draft 1332 waiver proposal for public comment. While Hawaii's waiver proposal is focused on the state's unique 40-year-old employer mandate, the 40-page...more
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
Before departing for the 2013 Thanksgiving holiday, the Obama administration released several new regulatory announcements and guidance relating to the implementation of the Affordable Care Act (ACA). The new guidance delays...more
Executive Summary: Earlier this year, the Obama Administration delayed implementation of the employer mandate, a major provision of the 2010 health care reform law (the Affordable Care Act or "ACA"). The delay of the...more
Over the years we have seen some employers, particularly small employers, choose to provide health coverage to their employees by paying all or part of the premium for individual insurance policies that the employees have...more
Health insurance exchanges (commonly called the MarketPlace or the Exchanges) are a complex and highly debated part of the Affordable Care Act (ACA). With the looming January 1, 2014, deadline to open the marketplace for...more
Final regulations required for October 1, 2013 open enrollment are largely unchanged from the proposed rule. On August 30, the Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human...more
On June 14, 2013, HHS released a proposed rule containing many provisions aimed at oversight of federally-facilitated exchanges (FFEs), state health insurance exchanges (State Exchanges), qualified health plan (QHP) issuers,...more
New marketing integrity and oversight provisions warrant review and comment. On June 14, the Centers for Medicare and Medicaid Services (CMS) in the U.S. Department of Health and Human Services (HHS) published its...more
Clearing up the Rumors around Health Reform Delays: What Really Happened, What Won’t and Steps Employers and Insurers Can Take Now - Rumors are flying in health policy circles that the Obama Administration might delay...more
The Department of Health and Human Services ("HHS") recently announced that full implementation of the SHOP component of the state-based health insurance exchanges created by the Affordable Care Act (the "ACA") run in full or...more
On March 11, 2013, the Department of Health and Human Services (HHS) published a proposed rule that would amend an earlier final rule related to health insurance exchanges and, more specifically, the Small Business Health...more
On March 1, 2013, CMS released a proposed rule, an interim final rule and a final rule—set for publication in the Federal Register on March 11, 2013—that implement the risk adjustment, reinsurance and risk corridor programs...more