On February 20, 2018, the Department of the Treasury (Treasury), the Department of Labor (DOL), and the Department of Health and Human Services (HHS) jointly promulgated a proposed rule on Short-Term, Limited-Duration Insurance (STLDI) plans. The proposed regulatory changes seek to carry out the directions given in Executive Order 13813, “Promoting Healthcare Choice and Competition Across the United States,” to expand access to STLDI plans. STLDI plans are excluded from the definition of individual health insurance coverage and, therefore, are not required to meet the coverage and consumer protection requirements of the Affordable Care Act (ACA).

On February 9, 2018, President Trump signed H.R. 1892, the Bipartisan Budget Act of 2018.  The new law reauthorizes federal funding for many health programs, modifies scheduled reductions in Medicaid disproportionate share hospital (DSH) allotments to states, tightens third party liability (TPL) billing requirements, and updates requirements affecting Medicare Advantage plans, accountable care organizations (ACOs), and providers’ adoption of telehealth.

On January 24, 2018, a Federal District Court in Tennessee held that the Centers for Medicare and Medicaid Services (CMS) improperly included a billing threshold requirement in a final rule concerning whether physicians received an enhanced Medicaid rate for primary care services under a provision of the Affordable Care Act (ACA). 

On December 5, 2017, the Government Accountability Office (GAO) issued a a report on Centers for Medicare and Medicaid Services (CMS) fraud prevention efforts, recommending that CMS more closely align its approach with the Fraud Risk Framework put forth by the GAO in 2015. Medicaid and Medicare fraud and abuse prevention has been increasingly in the spotlight...