CMS Issues Final Rule for ACA Marketplace Standards in 2016

In the February 27, 2015 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a final rule establishing new consumer standards as well as requirements for issuers in the Affordable Care Act (ACA) marketplaces for 2016. (80 Fed. Reg. 10750).

Pursuant to current requirements, health insurance issuers seeking a rate hike of 10% or more in the individual or small group market must publicly disclose and justify the increases. [More]

Who’s to Blame for Child Abuse and Neglect Resulting in Child Death?

The media attention that a child death obtains is different for every situation. When it is accidental, the local media may report on it, but it is often not highlighted for days. The death of child who is known to a state child welfare agency typically brings the state agency under tremendous scrutiny for failing the child in some way – agency leadership gets fired, workers get fired or suspended, and in some cases, workers are prosecuted for contributing to the death of a child or for malicious neglect. Recently, a state agency administrator of child protection was quoted as saying, “Parents are to blame for the injuries or death of their children.” [More]

DHHS Secretary Appoints First CEO

U.S. Department of Health and Human Services (DHHS) Secretary Sylvia Secretary Burwell has selected Kevin J. Counihan, who oversaw the successful launch of Connecticut’s health insurance exchange, to be the first CEO of The New York Times has stated that Secretary Burwell made the selection “as part of an effort to improve management of the federal marketplace and to avoid the technological failures that paralyzed its website,, last fall.” [More]

DHHS Providing $100 Million in Collaborative Effort with States to Reform Medicaid Systems

On July 14, 2014, US Department of Health and Human Services (DHHS) Secretary Sylvia M. Burwell announced a new innovative collaboration with states to improve care for Medicaid beneficiaries by accelerating efforts to reform health care systems.

The new initiative, entitled the Medicaid Innovation Accelerator Program, follows recommendations by the National Governors Association (NGA) that The Centers for Medicare & Medicaid Services (CMS) identify opportunities for care improvement and address high-priority areas, such as mental health and emergency department utilization.

DHHS Announces Additional Funds to Expand Community Health Center Services

On June 3, 2014, the US Department of Health and Human Services (DHHS) announced an additional $300 million from the Affordable Care Act (ACA) for existing Health Center Program grantees under Section 330 of the Public Health Service Act. The funds are earmarked to help community health centers expand service hours, hire more medical providers, and add oral health, behavioral health, pharmacy, and vision services. [More]

DHHS Offers Hardship Exemption from Tax Penalty to Certain Individuals

On May 2, 2014, the U.S. Department of Health and Human Services (DHHS) issued new guidance, entitled “Special Enrollment Periods and Hardship Exemptions for Persons Meeting Certain Criteria.” Under section 5000A of the Internal Revenue Code, beginning January 2014, nonexempt individuals who do not have minimum essential (health care) coverage (MEC) or who are not otherwise exempt are required to make a shared responsibility payment with their federal income tax returns. Section 5000A(e)(5) of the Code authorizes the Secretary of DHHS to determine hardship exemptions. [More]