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]

 

Pennsylvania Governor Outlines ACA Contingency Plan

 

Pennsylvania Governor Tom Wolf submitted a letter to U.S. Secretary of Health and Human Services Sylvia Burwell on May 1, 2015 declaring the Commonwealth of Pennsylvania’s intent to implement a State-based individual and SHOP Marketplace using the federal platform for plan year 2016. [More]

 

Florida Sues HHS Over Planned End to Low Income Pool Hospital Funding Program

 

On Tuesday, April 28, 2015, Florida Governor Rick Scott instituted a lawsuit against the U.S. Department of Health and Human Services in an attempt to prevent a threatened end to an optional federal program, providing Florida and eight other states with hospital funds for low income people (LIP). (Rick Scott v. United States Department of Health and Human Services, Case 3:15-cv- 00193-RS-CJK Document 1, filed 4/28/15). [More]

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Categories:Health and Human Services

 

HHS Proposes New Inpatient Hospital Payment Rules

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued proposed rules on April 17, 2015 to update its Medicare reimbursement methods under inpatient prospective payment systems for 3,400 acute care hospitals and 435 long term care hospitals. [More]

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HHS Releases Funding Opportunity Announcement for Navigator Grants

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued a funding opportunity announcement (FOA) on April 15, 2015 related to grants to support health insurance eligibility and enrollment “navigators” in Federally-facilitated and State Partnership Marketplaces/Exchanges under the Affordable Care Act (ACA). [More]

 

HHS Proposes New Rules for Eligibility IT Systems

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published proposed rules in the Federal Register on April 16, 2015 which would authorize 90 percent Medicaid federal financial participation (FFP) for the design, development, installation or enhancement of Medicaid eligibility and enrollment (E&E) systems; and 75 percent Medicaid FFP for the maintenance and operation (M&O) of such systems. The proposed rules would also update requirements for federal prior approval of State Medicaid agencies’ Advance Planning Documents (APDs) for system enhancements, contract solicitation, and contract execution. [More]

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1332 Waivers Will Allow State-Specific Variation to Health Care Reform Efforts

 

State Innovation Waivers authorized under Section 1332 of the Affordable Care Act will allow state-specific variations to health insurance marketplace rules. This PCG report, prepared for the Policy Innovations Committee of the Arkansas Health Insurance Marketplace Board, examines the role that so called ‘1332 Waivers’ could play in shaping future Arkansas health care reforms. [More]

 

HHS Initiates Health Care Payment Learning and Action Network

 

On March 25, 2015, U.S. Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell announced the creation of the Health Care Payment Learning and Action Network, a collaborative public, private initiative emphasizing quality of care and alternative payment models. According to a fact sheet published on that date at CMS.gov, “More than 400 Medicare ACOs participating in the Shared Savings Program and the Pioneer ACO Model have generated a combined $417 million in savings for Medicare.” Under the new Network project, the goals are to move 30 percent of Medicare payments into alternative payment models by the end of 2016 and 50 percent into alternative payment models by the end of 2018. [More]

 

HHS Launches New ACO Model

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), announced on March 10, 2015 that accountable care organizations (ACOs) soon will have an opportunity to participate in Medicare under the “Next Generation ACO” model, another important step under section 3021 of the Affordable Care Act (ACA) toward paying for services based on value to patients rather than volume of services. [More]

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