Health Care Reform Implementation Update - January 23, 2013

by Cozen O'Connor

In the past week, the health insurance exchanges were rebranded as “health insurance marketplaces;” HHS extended the deadline for states to opt into administering their own marketplaces and announced $1.5 billion in new grants to states for building them; and CMS released a proposed rule that details eligibility standards for marketplaces, Medicaid and CHIP.


On Monday (1/14), Sec. Sebelius announced that the deadline for states to opt into administering marketplaces (exchanges) under the Affordable Care Act would be waived or extended. The administration said it is trying to encourage states to share the responsibilities of running the marketplaces, supervising health plans and assisting consumers.

CMS released a proposed rule on Monday (1/14) that provides further detail on state marketplaces, Medicaid and the Children's Health Insurance Programs (CHIP). Sec. Sebelius said the rule is intended to “give states more flexibility to implement the law in a way that works for them.” The rule details options for coordinating Medicaid, CHIP and marketplace communications regarding eligibility to consumers.

On Thursday (1/17), HHS announced $1.5 billion in new grants to states building insurance exchange marketplaces under the Affordable Care Act. The states that received funding are California, Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon and Vermont.

CMS announced that physicians who were excluded from the meaningful use program because of the way they process Medicare claims (assigning reimbursement and billing to critical access hospitals) are now eligible to participate in the electronic health record meaningful use program.

On Thursday (1/17), the HIPAA omnibus rule was posted on the Federal Register public inspection desk. The package substantially modifies HIPAA privacy, security and enforcement rules and increases penalties for noncompliance. The final rule will be effective in March 2013.

On Wednesday (1/16), HHS kicked off an effort to raise awareness of the individual mandate with a website relaunch and a switch in the name of health insurance exchanges to health insurance marketplaces.


A coalition of 21 hospital associations sent a letter to the White House asking it to help fight a provision of the Affordable Care Act. The provision at issue allows hospitals in Massachusetts to dramatically boost their Medicare payments at the expense of other states. In their letter, the hospital associations argue that “scarce Medicare funding should reward value and efficiency in healthcare, not be diverted based on manipulation of obscure payment formulas.”

On Tuesday (1/15), the new nonprofit coalition, Enroll America, launched and announced its campaign to ensure that those who are eligible sign up for new insurance under the Affordable Care Act. Enroll America is an outgrowth of various Affordable Care Act support groups, especially Families USA.


On Tuesday (1/15), HHS and other named agencies appealed the preliminary injunction that was granted by U.S. District Judge Reggie Walton, to Tyndale House Publishers, a Christian publishing company, in November. Tyndale does not want to provide its employees with contraceptives as required by the Affordable Care Act.

Written by:

Cozen O'Connor

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