News & Analysis as of

Cost-Sharing Dept. of Health and Human Services

Capitol Hill Healthcare Update

by BakerHostetler on

House Majority Leader Kevin McCarthy (R-Calif.) said lawmakers will vote this week on legislation to renew federal funding for the Children’s Health Insurance Program (CHIP), even amid unresolved partisan disagreements over...more

Health Care Reform Roundup – Issue 10

After months of failed attempts to pass any health care reform legislation, it appears efforts to pass a bipartisan bill to improve the Affordable Care Act (ACA) are picking up steam. Below is a summary of regent health care...more

Trump Administration Plan to Cut Off CSR Payments Withstands First Court Review

by Reed Smith on

A Department of Health and Human Services (HHS) decision to discontinue ACA cost-sharing reduction (CSR) payments to insurers offering policies through ACA exchanges has cleared its first legal hurdle, with a U.S. district...more

Assessing President Trump’s “Executive Order Promoting Health Care Choice and Competition”

by Epstein Becker & Green on

On October 12, 2017, President Donald Trump signed an executive order (the “Order”) designed to “promote healthcare choice and competition across the United States,” which in effect will allow many Americans to sidestep...more

Alexander, Murray Announce Bipartisan Proposal on Market Stabilization

by Baker Donelson on

On October 17, the Senate Health, Education, Labor and Pensions Committee Chair Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) announced they had agreed on a proposal for a narrow, short-term individual market...more

Window On Washington - This Week in the Nation's Capital - Vol. 1, Issue 31

by Clark Hill PLC on

Senate Adopts Budget Resolution Making Way for Tax Reform: The Senate on a party-line vote of 51-49 adopted its FY18 budget resolution that includes $5.1 trillion in spending reductions and instruction for reconciliation for...more

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

by 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

More ACA: President Trump’s Termination Of Cost-Sharing Reduction Payments

Late Thursday evening after President Trump issued an Executive Order earlier in the day directing various administrative agencies to take suggested actions for the hope of reducing the cost of health insurance, discussed...more

Blog: With Congress Stuck, Administration Starts Process Of Unwinding ACA

by Cooley LLP on

Last week, the Administration took two actions aimed at rattling the foundations of the Affordable Care Act (ACA). The President signed an Executive Order (EO) directing federal agencies to relax restrictions on insurance...more

Capitol Hill Healthcare Update

by BakerHostetler on

President Trump’s announcement Friday that he would stop cost-sharing payments to insurance companies triggered a firestorm on Capitol Hill, with lawmakers in both parties calling on Congress to restore the funding...more

President Trump Issues Far-Reaching Changes to the Affordable Care Act

by Baker Donelson on

On October 12, the Trump Administration announced that it would immediately terminate payments for Cost-Sharing Reductions (CSRs), which subsidize health coverage for low-income enrollees in the Affordable Care Act's (ACA)...more

Manatt on Health: October 2017

Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary - On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its...more

Capitol Hill Healthcare Update

by BakerHostetler on

With congressional Republicans’ efforts to repeal the Affordable Care Act (ACA) on hold at least for now, the bipartisan leaders of the Senate HELP Committee are seeking to rekindle their work to shore up the health law’s...more

Window on Washington - This Week in the Nation's Capital - Vol. 1, Issue 23

by Clark Hill PLC on

CBO Confirms Size of Breach of Defense Cap for FY18 Bills: The House FY18 Omnibus Appropriations Bill scheduled to be taken up in September would bust the Defense cap by $72 billion. This would cause the Office of Management...more

Significant Cuts Proposed to Medicare Payments for 340B Drugs

by McDermott Will & Emery on

As part of the CY 2018 proposed updates to the Medicare Hospital OPPS, the US Department of Health and Human Services has proposed to decrease Medicare Part B payments to hospitals for 340B drugs by almost 30 percent. The cut...more

Manatt on Health Reform: Weekly Highlights - June 2017 #3

Senate health reform bill to be made public Thursday; CMS Actuary releases its AHCA coverage and cost projections; and new analysis finds Marketplace rate increases are being driven by the Trump Administration’s lack of...more

Manatt on Health Reform: Weekly Highlights - June 2017 #2

CMS seeks input on potential market stabilization rulemaking; Iowa proposes a single standardized Marketplace plan and reinsurance program; and Centene will expand its Marketplace offerings for 2018, including adding new...more

Healthcare Weekly Preview from ML Strategies – June 2017

Welcome back everybody. With Congress returning from recess, we should expect an update on the progress of the Senate-version of the American Health Care Act. Despite the noise from GOP members about a timeline, one thing...more

Manatt on Health Reform: Weekly Highlights - May 2017

Florida, Maine and Ohio consider proposals to impose work requirements in Medicaid, Congress continues to debate the AHCA, and the uncertain future of cost-sharing reductions continues to generate concern....more

Manatt on Medicaid: Maine Releases Draft Waiver Request Proposing New Eligibility Requirements

On April 25, 2017, the Maine Department of Health and Human Services released for public comment a draft Section 1115 waiver application to implement new eligibility and coverage requirements for MaineCare, the State’s...more

HHS Finalizes Health Insurance Market Stabilization Rules

by Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) has finalized regulations designed to help stabilize the individual and small group health insurance markets and, in particular, the health insurance exchanges...more

Manatt on Health Reform: Weekly Highlights - April 2017 #2

HHS's position on cost-sharing reduction payments remains unclear as insurers seek certainty before Marketplace rate filing deadlines; states continue to finalize Medicaid budgets and seek waiver flexibility; and North...more

Manatt on Health Reform: Weekly Highlights - February 2017 #3

Congress moves forward on key healthcare appointments; the Administration takes steps to shore up the Marketplaces; and Governors prepare to gather in Washington as new reports document the ACA's impacts on states....more

Manatt on Health Reform: Weekly Highlights - January 2017 #4

The National Governors Association and National Association of Insurance Commissioners weigh in on ACA repeal and replace; CBO releases new Medicaid and Marketplace enrollment estimates; and Massachusetts proposes reinstating...more

New Year, New Resolutions, New Safe Harbors

by Akerman LLP on

As we welcome the new year and its endless possibilities, we also welcome some new Anti-Kickback Statute safe harbors and concomitant business possibilities. In December, the U.S. Department of Health and Human Services...more

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