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Centers for Medicare & Medicaid Services (CMS) Health Insurance Exchanges

McDermott+

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

McDermott+ on

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

Sheppard Mullin Richter & Hampton LLP

Health and Human Services Exchange Program Integrity Final Rule

On December 20, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on program integrity for Affordable Care Act (ACA) exchange plans. This rule implements a number of provisions from the ACA,...more

King & Spalding

Health Plan Responsibility to Pay for Hospital Inpatient Care When Members Await Placement at Post-Acute Facilities

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Hospitals that attempt to discharge a patient to a post-acute level of care but are not able to because they cannot find an appropriate accepting facility must continue providing care if the patient cannot be safely...more

Obermayer Rebmann Maxwell & Hippel LLP

TRANSPARENCY: Embracing CMS’s Push To Publicize Your Organization’s Performance

The Centers for Medicare and Medicaid Services (CMS) is launching new value-based programs with great fervor as a central strategy to bend the healthcare cost curve. Value-based reimbursement models linked to achieving the...more

Hogan Lovells

CMS releases annual health insurance exchanges final rule

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On 18 April 2019 the Centers for Medicare & Medicaid Services (CMS) released the Notice of Benefit and Payment Parameters final rule for 2020 (2020 Payment Notice) applicable to qualified health plans (QHPs) offered on health...more

Foley & Lardner LLP

Increased Interoperability of Health Information: Two New Proposed Rules

Foley & Lardner LLP on

The U.S. Department of Health and Human Services (HHS) recently proposed two new rules designed to increase patient and provider access to health records. As stated by HHS in its press release, the proposed rules “will...more

Sheppard Mullin Richter & Hampton LLP

No Longer in Suspense: CMS Issues Final Rule Announcing that Risk Adjustment Program Transfers for 2017 will be Distributed in...

The Final Rule. In a Final Rule posted by CMS last Tuesday, July 24, 2018, CMS announced that $10.4 billion in “risk adjustment transfers” (“Risk Transfers”) for benefit year 2017 (as calculated pursuant to the Affordable...more

Hogan Lovells

CMS releases annual health insurance exchanges final rule

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On April 9, 2018, the Centers for Medicare & Medicaid Services (CMS) released the Benefit and Payment Parameters final rule for 2019 (2019 Payment Notice) applicable to qualified health plans (QHPs) offered on health...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes “Wind Down” Plan for Federal Exchanges

Despite the Trump Administration’s unsuccessful attempts to fully repeal and replace the Affordable Care Act (the “ACA”), the Administration has continued to target the ACA. In the Administration’s latest salvo, the Centers...more

Snell & Wilmer

2017 End of Year Plan Sponsor “To Do” List (Part 1) Health & Welfare

Snell & Wilmer on

As 2017 comes to an end, we are pleased to present our traditional End of Year Plan Sponsor “To Do” Lists. This year, we are presenting our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 will cover...more

Bass, Berry & Sims PLC

Stabilizing the Exchanges: CMS Issues Final Rule

Bass, Berry & Sims PLC on

On April 18, 2017, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a final rule (the "Final Rule") aimed at stabilizing the individual and small group health insurance markets...more

Seyfarth Shaw LLP

Issue 108: HHS Moves Ahead In Face of ACA Uncertainty

Seyfarth Shaw LLP on

This is the one hundred and eighth issue in our series of alerts for employers on selected topics on health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of...more

Dorsey & Whitney LLP

CMS Proposes Affordable Care Act Exchange, Individual, and Small Group Insurance Market Changes

Dorsey & Whitney LLP on

Not relying on Congress to take action on the Affordable Care Act, the Centers for Medicare and Medicaid Services (“CMS”) has proposed new regulations intended to attract health insurance issuers back into ACA health...more

BakerHostetler

Reducing the Regulatory Stranglehold on Federally Facilitated Exchanges: Will It Work?

BakerHostetler on

The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule aimed at improving the individual and small group markets that have been plagued with instability as issuers continue exiting the Exchanges....more

Hogan Lovells

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

Hogan Lovells on

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

Ballard Spahr LLP

CMS, IRS Address Affordable Care Act Issues in Transition

Ballard Spahr LLP on

The Centers for Medicare and Medicaid Services (CMS) and the IRS have each published guidance on matters arising under the Affordable Care Act (ACA). It is too early to tell whether these measures—some of the first guidance...more

Carlton Fields

The Affordable Care Act: On the Fast Track to Repeal

Carlton Fields on

On January 20, hours after his inauguration, President Donald Trump issued an executive order directing the heads of all executive departments and agencies to “waive, defer, grant exemptions from, or delay the implementation...more

FordHarrison

President Trump Signs Executive Order on Affordable Care Act

FordHarrison on

On Friday January 20, 2017, President Trump signed an executive order titled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal.” The Order directs the Secretary of Health and...more

Epstein Becker & Green

Health Care Reform 2017: Substance, Process, and Timeline

Epstein Becker & Green on

President-elect Donald J. Trump campaigned on a promise to “repeal and replace” the Affordable Care Act (“ACA”). For several years, the newly reelected Republican majority in Congress has likewise identified ACA repeal as a...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2016 #4

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - April 2016 #4

CMS's sweeping final rule aligns Medicaid and CHIP managed care with QHP and Medicare Advantage regulations; New York's DSRIP is enabling change in the State's Medicaid delivery system; and Medicaid expansion reduces...more

Epstein Becker & Green

Doing the Cha-Cha on Exchange Rules: CMS Moves Forward on Standardized Plan Offerings but Steps Back from Instituting Minimum...

Epstein Becker & Green on

On March 8, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule titled “Patient Protection and Affordable Care Act; CMS Notice of Benefit and Payment Parameters for 2017” (“Final Rule”)[1] setting...more

BakerHostetler

The 2017 Exchange Regulations: Network Adequacy Challenges Remain

BakerHostetler on

The Centers for Medicare and Medicaid Services (CMS) recently issued the final 2017 Benefit and Payment Parameters Rule (Final Rule) and concurrently released a final 2017 Letter to Issuers (Letter to Issuers) in the...more

Alston & Bird

Health Care Advisory: Highlights of the OIG’s 2016 Work Plan

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On November 2, 2015, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued its Work Plan for Fiscal Year 2016 (“2016 Work Plan”).1 The 2016 Work Plan outlines the areas of...more

McGuireWoods LLP

Washington Healthcare Update

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Elections for Speaker of the House and Potential Changes at Ways and Means Committee - Rep. Paul Ryan (R-WI) announced Tuesday (Oct. 20) that he will run for the House Speaker position if the major House Republican...more

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