HHS Proposes Changes in Coding Rules

The U.S. Department of Health and Human Services (HHS) proposed rules on April 17 that would require nationwide use of standardized health plan identifier codes by all health plans, helping providers to improve the efficiency of automated billing operations and coordination of benefits. Estimates of potential savings in administrative costs range up to $4.6 billion over ten years. [More]

HHS Finalizes Rules on Health Insurance Exchanges

The U.S. Department of Health and Human Services (HHS) issued on March 12 a draft copy of final rules on state health insurance exchanges under the Affordable Care Act (ACA). The final rules are scheduled to be published officially in the Federal Register on March 27, to be effective 60 days later. HHS may consider additional comments for up to 45 days after publication on nine “interim final” provisions within the rules. [More]

Obama’s FY 2013 Budget for Human Services

The Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies held a hearing this week with U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius to discuss the President’s budget recommendations for her agency in FY 2013. The President’s 2013 Budget for HHS includes a reduction in discretionary funding for ongoing activities and extensive legislative proposals saving. [More]

Federal Judge Orders NH Dept of HHS to Follow Federal Procedures for Setting Medicaid Rates

In a 31-page order issued on March 2, 2012, Federal District Court Judge Steven McAuliffe ordered the New Hampshire Medicaid agency to follow federal Medicaid procedures when setting reimbursement rates. The judge held that the state failed to notify the public or hold required hearings on proposed rate cuts. Per the opinion, the state has 15 days to give notice of the cuts. [More]

HHS Releases New Rules on Health Information Technology

The Centers for Medicare and Medicaid Services (CMS) released proposed rules on February 23 specifying “stage 2” criteria that eligible professionals, general hospitals, and critical access hospitals must meet by 2014 to continue to qualify for Medicare and Medicaid payment incentives for the adoption and meaningful use of electronic health record (EHR) systems under the American Recovery and Reinvestment Act of 2009 (ARRA). [More]

HHS and Treasury Issue Final Rules on Waivers for States

The U.S. Departments of Health and Human Services (HHS) and the Treasury released final rules on February 22 on waivers of federal requirements that are available to states to design and implement a wide array of innovative health care programs. HHS released final rules pursuant to section 10201(i) of the Affordable Care Act (ACA) on Medicaid and Children's Health Insurance Program (CHIP) demonstration waivers. Those rules define a state public notice process, application procedures, a federal public notice and approval process, monitoring and compliance procedures, evaluation requirements, and reporting requirements on Medicaid/CHIP waivers. [More]

HHS Awards $229 Million for Health Insurance Exchanges

The U.S. Department of Health and Human Services (HHS) announced on February 22 that it is awarding another $229 million in health insurance Exchange establishment grants to 10 states (Arkansas, Colorado, Kentucky, Massachusetts, Minnesota, Nevada, New Jersey, New York, Pennsylvania, and Tennessee) under section 1311 of the Affordable Care Act (ACA). To date, HHS has awarded $610 million in Exchange establishment grants to 33 states and the District of Columbia. [More]

HHS, Labor, and Treasury Require Uniform Health Coverage Information

The U.S. Departments of Health and Human Services, Labor, and the Treasury published a final rule in the Federal Register on February 14 requiring group health plans and health insurance issuers offering individual or group coverage to provide uniform summaries of benefits and coverage (SBCs). The final rule implements section 2715 of the Public Health Service Act as amended by the Affordable Care Act (ACA). It requires that plans give purchasers the opportunity to obtain summaries in succinct formats for each insurance product, with clear descriptions of the services covered, cost-sharing (deductibles, co-insurance, and co-payments), a uniform glossary of terms, and exceptions, reductions, or limitations applicable to services in the plan. [More]

ACF Issues Interim Final Rule for Tribal Child Welfare

On January 6, the Administration for Children and Families (ACF) published an interim final rule in the Federal Register to implement statutory provisions related to the Tribal title IV-E program. The rule is effective February 12, 2012 and addresses multiple provisions related to the Fostering Connections Act (P.L. 110-351) that provided tribal agencies with the option of applying to the secretary of the Department of Health and Human Services (HHS) to operate a Title IV-E program. The legislation provided for planning grants for tribal agencies to use for the purposes of developing infrastructure programmatically and fiscally that would ensure that the tribes were able to operate a Title IV-E program that was consistent with federal guidance. The Interim Final Rule provides further detail on how tribal agencies must operate going forward. Also on January 6, ACF released an Information Memorandum (ACYF-CB-IM-12-01) which informs states, tribes, and territorial agencies that an interim final rule was released. [More]

States Awarded Bonuses for High CHIP Enrollments

On December 28, 2011, the U.S. Department of Health and Human Services (DHHS) awarded 23 states $296 million in bonus payments for exceeding enrollment targets in the CHIP program. As an example, Maryland is getting $28.3 million because the state "has streamlined the children's health coverage enrollment process...and uses electronic databases to verify family information." [More]