In what can only be described as “out of the box” thinking, the Centers for Medicare and Medicaid Services (CMS) is proposing to pay physicians for virtual check-ins, and for asynchronous interactions with patients in which...more
On June 19, 2018, the Trump administration took the first step in a three-part effort to expand affordable health plan options for consumers when the U.S. Department of Labor (DOL) finalized a proposed rule designed to make...more
Section 1332 of the Affordable Care Act (ACA) is a powerful policy tool for states in the Trump era. The provision authorizes states to waive certain ACA provisions and receive federal funding for state programs, provided...more
A provision included in the recently enacted budget law will now make it much easier for Medicare Advantage (MA) plans to offer a wide array of supplemental benefits within their plans. This will create new opportunities for...more
In what may be the first enforcement action taken by a state regulator against an “Obamacare” health plan for provider network problems, the Washington State Office of the Insurance Commissioner imposed a fine and suspended...more
On Friday, October 27, the Centers for Medicare and Medicaid Services (CMS) published its draft annual Proposed Notice of Benefits and Payment Parameters for Calendar Year 2019. This proposal follows on the heels of a Request...more
Last week, the Senate unveiled the Graham-Cassidy Bill, Republican legislators’ latest attempt to repeal the Affordable Care Act (ACA). Crafted by Sens. Bill Cassidy, R-LA, Lindsey Graham, R-SC, Dean Heller, R-NV, and Ron...more
As efforts to make sweeping legislative changes to the Affordable Care Act (ACA) at the federal level have stalled, states are increasingly looking to stabilize and reform their own health insurance markets. Section 1332 of...more
On June 30, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule covering the second and future years of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program. The...more
On June 22, the Senate unveiled its counterpart to the House of Representatives’ American Health Care Act (AHCA) — the Better Reconciliation Act (BCRA) — and Republican leaders have reportedly indicated a desire to vote on...more
Since last November’s election, the future of the Affordable Care Act (ACA) has been very much in doubt. It can be debated whether the health insurance exchanges (Exchanges) are in a “death spiral” as President Trump...more
On May 30, the Department of Justice (DOJ) announced that it reached a settlement with commonly-owned Freedom Health Inc. and Optimum Healthcare, Inc. (Freedom Health) — two Tampa, Florida, managed care plans — to settle...more
On April 13, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized its Marketplace Stabilization Rule. This is the first Trump administration regulation that applies to the health insurance markets remade by...more