HHS issues report on behavioral health benefits of Medicaid expansion

 

On March 28, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE) issued a report entitled, “Benefits of Medicaid Expansion for Behavioral Health.” The report estimates that about 1.9 million low-income uninsured persons with mental illness or substance use disorders live in states that have not yet expanded Medicaid under the Affordable Care Act (ACA). [More]

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Supreme Court requests supplemental briefs in contraceptive case

 

On March 30, 2016, the Supreme Court garnered extensive media coverage after making what is described as an “unusual” request for supplemental briefs in the challenge to the contraceptive mandate contained in the Affordable Care Act (ACA). [More]

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Categories:Health and Human Services

 

CBO revises U.S. health care budget estimates

 

On March 24, 2016, the Congressional Budget Office (CBO) released a report entitled, “Federal Subsidies for Health Insurance Coverage for People under Age 65: 2016 to 2026.” The CBO report shows that the net costs of all Federal subsidies, taxes, and penalties related to health insurance coverage, for persons under age 65, will be $660 billion in 2016 (3.6 percent of the U.S. gross domestic product). [More]

 

Supreme Court set to hear oral argument on cases challenging ACA’s contraceptive mandate

 

On March 23, 2016, the U.S. Supreme Court was scheduled to hear oral argument on a set of seven cases challenging the mandate contained in the Affordable Care Act (ACA) that employers provide contraceptive services to their female employees. Two years before, in the case of Hobby Lobby v. Burwell, the Court decided (following a five to four vote) that the Federal government could not impose the mandate upon religiously objecting owners of closely held businesses. [More]

 

HHS releases report on growth in national health care spending

 

On March 22, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE) released a report showing that overall health care spending per person in the United States grew at a 4.3 percent rate in 2014. HHS indicates that the increase was largely the result of coverage expansions under the Affordable Care Act (ACA) and pent-up needs for care among previously uninsured and underinsured persons. [More]

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HHS releases report on results of ACA’s third open enrollment period

 

On March 11, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE) released a report detailing the Affordable Care Act’s (ACA) third open enrollment period numbers. From November 1, 2015 through February 1, 2016, 12,681,874 people enrolled in qualified health plans (QHPs) offered through Federally-facilitated Exchanges (FFEs) and State-based Exchanges (SBEs): 7,794,848 (61 percent) were re-enrollees and 4,887,026 (39 percent) new enrollees. The report shows that, FFEs accounted for the majority (76 percent) of all enrollees; about 68 percent of all enrollees selected “silver” level coverage (medium cost-sharing); and 83 percent qualified for advance premium tax credits (APTCs). [More]

 

HHS finalizes ACA benefit and payment parameters for 2017

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) finalized its “Notice of Benefit and Payment Parameters” for 2017 in the March 8, 2016 Federal Register. As in prior years, this annual rules notice adjusts a wide range of policy, operational, and information technology requirements applicable to health insurance coverage obtained through Exchanges under the Affordable Care Act (ACA). [More]

 

Supreme Court declines review of “Origination Clause” challenge to ACA mandates

 

On February 29, the U.S. Supreme Court declined to review the Fifth Circuit Court of Appeals’ decision that a physician and his employer lacked standing to challenge the individual and employer mandates of the Affordable Care Act (ACA) under the Origination Clause of the U.S. Constitution. Hotze v. Burwell, No. 15-622, cert. denied (U.S. Feb. 29, 2016). [More]

 

CMS proposes changes to Medicare ACO rules

 

On February 3, 2016, the Centers for Medicare and Medicaid Services (CMS) proposed regulations in the Federal Register on Medicare payments to accountable care organizations (ACOs) under the Medicare “shared savings” program (MSSP), which currently includes 434 ACOs, serving 7.7 million Medicare beneficiaries nationwide. Under the MSSP, Medicare Part A and Part B fiscal intermediaries and carriers pay ACOs on a traditional, fee-for-service basis. An ACO may qualify for a “shared savings” bonus if the ACO achieves CMS-specified Medicare savings targets while meeting CMS-specified quality of care performance metrics. [More]

 

CMS finalizes new Medicaid drug reimbursement rules

 

On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published final regulations in the Federal Register on Medicaid upper payment limits (UPLs) for covered outpatient drugs, as well as rebates that drug manufacturers must provide to states. State Medicaid agencies must take into account “average manufacturers’ prices” (AMPs) and other factors in calculating state Medicaid payments for covered outpatient drugs and dispensing fees to pharmacies that purchase medications, usually from wholesalers. Based on data in reports generated by state Medicaid agencies, drug manufacturers must calculate rebates to states under methods specified in the rule. [More]