Update on the Senate’s efforts to Repeal parts of the ACA

After releasing the Better Care Reconciliation Act at the end of last week, leadership in the U.S. Senate announced this week that it will not be voting on the bill before the July 4th Congressional recess as planned. Instead efforts are underway to overhaul the bill, with a vote is expected sometime after the recess. Senate Majority Leader Mitch McConnell has said that he intends to submit a new version of the bill to be scored by the Congressional Budget Office today. [More]

Proposed Benefit and Payment Parameters 2018 Released

This year, the Centers for Medicare and Medicaid Services (CMS) released its annual proposed Notice of Benefit and Payment Parameters earlier than in prior years in order to provide more market certainty. The draft regulations, which were released last week and published in the federal register on September 6, outline changes to operations and rules for health insurance Marketplaces and the commercial health insurance market generally for 2018. [More]

Final Medicaid managed care rules issued

Nearly a year after releasing its proposed overhaul of the regulations governing Medicaid and Children’s Health Insurance Program (CHIP) managed care, the Centers for Medicaid and Medicare Services (CMS) issued the final version of the regulations last week. In addition to their sweeping impact, these rules are particularly meaningful as the first major changes to the Medicaid and CHIP managed care rules since 2002. [More]

Supreme Court issues decision on major health care case

States across the country have been nervously awaiting the Supreme Court ruling in Gobeille vs Liberty Mutual Insurance Company given its direct impact on state All-Payer Claims Databases (APCDs). That wait ended on March 1st and, with the decision known, states now have another piece of the puzzle to guide their next steps; however, the full impact on APCDs is yet to be seen. [More]

HHS finalizes ACA benefit and payment parameters for 2017

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) finalized its “Notice of Benefit and Payment Parameters” for 2017 in the March 8, 2016 Federal Register. As in prior years, this annual rules notice adjusts a wide range of policy, operational, and information technology requirements applicable to health insurance coverage obtained through Exchanges under the Affordable Care Act (ACA). [More]

Draft 2017 letter to issuers in the Federally-facilitated marketplaces

On December 23, 2015, the Center for Consumer Information and Insurance Oversight (CCIIO) and the Centers for Medicare & Medicaid Services (CMS) released the draft 2017 Letter to Issuers in the Federally-facilitated Marketplaces to provide issuers seeking to offer qualified health plans in the Federally-facilitated Marketplaces or the Federally-facilitated Small Business Health Options Programs with operational and technical guidance to help them successfully participate in those Marketplaces. [More]

Supreme Court hears oral arguments on major health care case

Members of PCG Health’s Health Innovation Policy Information Technology (HIPIT) center of excellence have been keeping a close eye on Gobeille vs Liberty Mutual Insurance Company. Gobeille has the potential to seriously undermine state All-Payer Claims Databases (APCD) that many of PCG’s state clients rely on for data collection. These systems allow states to gather data that is necessary to analyze health care services and impact rising health care costs. [More]