Affordable Care Act

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1. Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process. Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach. Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

Health Insurance Markets Remain Highly Concentrated

The health insurance market was highly concentrated in 42 of the 50 states in 2019 and 2020 – the continuation of a trend identified in 2010 that has persisted ever since, according to a new report by the U.S. Government Accountability Office. The GAO considers a market concentrated if three or fewer insurers in a state have 80 percent of that market. Using Centers for Medicare & Medicaid Services health insurance enrollment data, the GAO looked at three distinct aspects of markets – individual policies, small group policies, and large group coverage – and found that Each of the three [...]

admin2022-11-10T06:00:51+00:00November 10, 2022|Affordable Care Act, Uncategorized|

Federal Health Policy Update for Monday, August 8`

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, August 8. Some of the language used below is taken directly from government documents. Congress On Sunday, the Senate passed the Democrats’ health care, climate, and tax bill, H.R. 5376, The Inflation Reduction Act, by a vote of 51-50, with Vice President Harris casting the tie-breaking vote. Health care provisions in the reconciliation bill include: allowing Medicare to negotiate prescription drug prices limiting out-of-pocket prescription drug costs for Medicare enrollees to $2,000 a year extending for three years enhanced Affordable Care Act [...]

admin2022-08-08T16:12:06+00:00August 8, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, deficit reduction, Medicaid, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for Tuesday, August 2

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 2. Some of the language used below is taken directly from government documents. White House The White House has announced two new actions to address the youth mental health crisis: it will award nearly $300 million from the FY 2022 bipartisan omnibus agreement to expand access to mental health services in schools and it will encourage governors to invest more in school-based mental health services. Learn more about this effort, including the individual funding components of the $300 million in new [...]

admin2022-08-02T16:39:35+00:00August 2, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care|

Transparency Comes to Health Insurer Payments

When the calendar turned to July, health insurers came under a new federal requirement that they post on web sites the price they pay to every provider with which they contract for every service they cover. The mandate, which traces its origins to the Affordable Care Act and was introduced in a 2019 executive order, was designed to enable consumers to compare what different insurers pay different providers for different services and possibly help them shop for more affordable services for themselves. Doing so, however, will be a challenge for consumers at least at first because insurers will be posting [...]

admin2022-07-06T13:42:45+00:00July 6, 2022|Affordable Care Act, hospitals|

Federal Health Policy Update for Thursday, April 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 7. Some of the language used below is taken directly from government documents. White House The administration is proposing to address a flaw in the Affordable Care Act often referred to as the “family glitch.” Under the ACA, people who do not have access to “affordable” health insurance through their jobs may qualify for a premium tax credit to purchase coverage on the ACA’s health insurance marketplaces. Current regulations define employer-based health insurance as “affordable” if the coverage for the employee [...]

admin2022-04-07T17:12:01+00:00April 7, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Medicaid as a Tool for Addressing Racial Health Inequities

Medicaid can be an important tool for addressing racial health inequities, the Kaiser Family Foundation suggests in a new issue brief. Among the measures involving Medicaid that might be undertaken to address racial health inequities and addressing social determinants of health, the brief suggests (in words taken directly from the issue brief): One significant action that would help close coverage disparities for people of color is adoption of the ACA Medicaid expansion in the 12 non-expansion states. Other expansions of Medicaid eligibility could also address racial disparities in coverage and access to care. Making it easier for eligible people to [...]

admin2022-03-25T06:00:31+00:00March 25, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, Medicaid, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for Wednesday, January 19

The following is the latest health policy news from the federal government as of 2:45 p.m. on Wednesday, January 19. Some of the language used below is taken directly from government documents. Public Health Emergency Declaration Renewed HHS Secretary Xavier Becerra has renewed his department’s declaration of a public health emergency in response to the COVID-19 pandemic. The renewal took effect on January 16 and extends the declaration for three months. Find the declaration here. Free COVID-19 Tests and Masks Upon request, the federal government is now providing four free monthly home COVID-19 tests to every household. Order those tests [...]

admin2022-01-19T17:47:33+00:00January 19, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for Tuesday, January 11

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, January 11. Some of the language used below is taken directly from government documents. Provider Relief Fund HHS has updated its FAQ for reconsideration requests involving Phase 4 and rural hospital payments. Find the updated FAQ here. Department of Health and Human Services COVID-19 HHS announced that beginning January 15, individuals with private health insurance coverage who purchase an over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the FDA will be able to have those test costs covered by their insurance. [...]

admin2022-01-11T17:32:41+00:00January 11, 2022|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Monday, June 28

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, June 28. Some of the language used below is taken directly from government documents. Supreme Court Decision in Affordable Care Act Case The Supreme Court has declined to hear an appeal of a case in which insurers unsuccessfully sued to recover reductions in their Affordable Care Act federal cost-sharing reduction payments. White House The White House has posted a transcript of the June 22 press briefing given by its COVID-19 response team and public health officials. Department of Health and Human Services [...]

admin2021-06-28T17:33:25+00:00June 28, 2021|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid managed care, Medicare, MedPAC|