Balanced billing or “surprise billing” has been getting increased attention at both the federal and state level. Balance bills arise when a payor covers out-of-network care, but the provider bills the patient for amounts...more
The most recent MA Call Letter, “Announcement of Calendar Year (CY) 2018 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter and Request for Information” (Call Letter)...more
California became the first state to set limits on how long HMO patients must wait to see a physician when the California Department of Managed Health Care (“DMHC”) adopted certain “timely access” regulations in 2010, based...more
This past May, the Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin,...more
8/5/2016
/ Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Contraceptive Coverage Mandate ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Federal Funding ,
Final Rules ,
Gender Identity ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
LGBTQ ,
Medicaid ,
Medicare ,
Non-Discrimination Rules ,
Section 1557 ,
Sex Discrimination ,
Sexual Orientation Discrimination ,
Transgender
Earlier this month, the Centers for Medicare and Medicaid Services (CMS) passed an interim final rule that amends regulations governing Consumer Operated and Oriented Plans (Co-ops) and tightens restrictions on special...more
Three states—Kansas, Louisiana and Texas—filed a complaint in federal court on October 22, 2015 challenging the constitutionality and legality of the Affordable Care Act’s health insurance providers fee.
The health...more
Perhaps putting added pressure on insurers as they prepare to set rates for 2015, new evidence suggests that people enrolled in health plans under the Affordable Care Act have higher rates of serious health conditions than...more