California ACA Exchange announces limited negotiated rate increase for 2016 plans


On July 28, 2015, several national and many local media outlets reported coverage of an announcement by California officials that the state’s health insurance exchange negotiated a 4 percent average rate increase for its 2016 Affordable Care Act (ACA) plans. [More]

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Categories:Health and Human Services


HHS Proposes New Medicare/Medicaid Standards for Long Term Care Facilities


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register on July 16, 2015 which would update Medicare/Medicaid certification requirements for long term care facilities (LTCFs). The proposed rule offers the most comprehensive update in these requirements since 1991. [More]

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Categories:Health and Human Services


HHS Proposes Medicare Home Health Value-Based Purchasing Program


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register on July 10, 2015 which would update Medicare payment methods and rates under the home health prospective payment system, update home health quality reporting requirements, and launch the home health value-based purchasing (HH VBP) model beginning in January 2016. [More]


Kaiser report estimates 4.4 percent increase in Exchange premiums for 2016


The Henry J. Kaiser Family Foundation (Kaiser) has released a June 2015 report entitled, “Analysis of 2016 Premium Changes and Insurer Participation in the Affordable Care Act’s (ACA’s) Health Insurance Marketplaces.”  Kaiser’s report shows that insurer participation in health insurance exchanges (Exchanges) is continuing to grow and that competition among insurers may be helping to contain premiums to about a 4.4 percent increase on average for 2016.  [More]


U.S. Supreme Court upholds Affordable Care Act in KING v. BURWELL by 6 to 3 vote


On Thursday, June 25, 2015, the U. S. Supreme Court by a 6 to 3 vote upheld the federal government’s interpretation (i.e., the regulation of the Internal Revenue Service) of the Affordable Care Act (ACA) that the subsidies awarded under provisions of the ACA could be provided regardless of whether the states granting the subsidies had a state health benefits exchange or a federal exchange operating therein. [More]


HHS approves three additional state-based Exchanges


The U.S. Department of Health and Human Services (HHS) notified the Governors of Arkansas, Delaware, and Pennsylvania on June 15, 2015 that HHS has conditionally approved the establishment of state-based health insurance exchanges (Exchanges) by those states. The conditional approvals for Delaware and Pennsylvania are for state-based individual and small business Exchanges in 2016. The conditional approval for Arkansas is for a state-based small business Exchange in 2016 and an individual Exchange in 2017. [More]


U.S. Supreme Court rejects Maine’s attempt to end Medicaid coverage for young adults


On Monday, June 8, 2015, the U.S. Supreme Court refused to review a decision by the First Circuit Court of Appeals, which upheld a decision by the Centers for Medicare & Medicaid Services (CMS) rejecting a plan by Mary Mayhew, Maine’s top health official, to cease Medicaid coverage for 6000 19- and 20-year-olds. [More]


Hearing Held in Lawsuit by House Against Federal Government’s Implementation of ACA


On Thursday, May 28, 2015, a hearing was held in Federal District Court in Washington, D.C. to determine whether the U.S. House of Representatives has legal standing to sue the federal government with respect to its implementation of the Affordable Care Act (ACA). Media reports indicate that U.S. District Court Judge Rosemary M. Collyer was “skeptical” of the government’s position and seemed unlikely to dismiss the case, House of Representatives v. Burwell. [More]

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RWJF Report Estimates 20 States Could Lose $720 Billion in Federal Health Funds Over Ten Years


The Robert Wood Johnson Foundation (RWJF) issued a report on May 18, 2015 estimating that 5,623,000 persons in 20 states that have declined to implement state-based health insurance Exchanges under the Affordable Care Act (ACA) may become uninsured in 2016 if the U.S. Supreme Court rules that advance premium tax credits (APTCs) and cost-sharing reductions (CSRs) are only available through state-based Exchanges, not federally-facilitated Exchanges. A ruling in King v. Burwell on that question is expected by June 30, 2015. [More]


Medicaid/CHIP Enrollments Exceed 70 Million


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) has released a May 1, 2015 report showing that 29 jurisdictions (28 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by February 2015 saw on average a 26.99 percent increase in Medicaid/CHIP enrollments for February 2015, as compared to their average monthly enrollments in a July – September 2013 baseline period. [More]