U.S. Court of Appeals Finds Written Authorization Form Required by FL Medical Negligence Law Does Not Violate HIPAA

 

On October 10, 2014, a three-judge panel of the 11th U.S. Court of Appeals vacated a decision of a lower federal court and held that a Florida statute requiring a plaintiff to execute a written authorization form for release of protected health information prior to filing a negligence claim in Florida state court does not violate HIPAA. (GLEN MURPHY v. DULAY, No. 13-14637). [More]

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UCLA Publishes Study on Hospital Service Utilization in Demonstration Program

 

The UCLA Center for Health Policy Research published a landmark study on October 17, 2014 entitled, “Increased Service Use Following Medicaid Expansion Is Mostly Temporary: Evidence from California’s Low-Income Health Program.” UCLA analyzed hospital emergency room (ER) use, hospital inpatient admissions, and other hospital outpatient department (OPD) service utilization for individuals who were enrolled in 2011-2013 in the Low-Income Health Program (LIHP) under California’s innovative “Bridge to Reform” Medicaid demonstration waiver. UCLA sorted 182,443 LIHP enrollees in eight counties into four distinct groups based on expected “pent-up demand” in each group (the 69,095 in the highest group had the least access to county funded indigent care before enrolling in LIHP), controlled for other differences such as demographic variables using regression models, and tracked service utilization from the July 1 – September 30, 2011 quarter through the April 1 – June 30, 2013 quarter. [More]

 

HHS Report Updates ACA Impact on Medicaid Enrollments

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), released on October 17, 2014 a report showing that 26 jurisdictions (25 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by August 2014 saw on average a 22.09 percent increase in Medicaid/CHIP enrollments for August 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. [More]

 

California Exchange Offers Insights on 2014 Open Enrollment Period

 

Covered California, the nation’s largest state-based health insurance Exchange, released a comprehensive report on October 14, 2014 entitled, “Covered California Open Enrollment 2013 – 2014: Lessons Learned.” The report shows that many 2014 enrollees needed education about health insurance terminology, enrollment, and coverage through qualified health plans (QHPs); many persons contacting the Exchange in 2014 viewed cost as an enrollment barrier even after advance premium tax credits (APTCs) and cost-sharing reductions (CSRs); training, outreach and enrollment efforts were indispensable to address specific interests and needs of diverse communities; and the volume of consumer interactions on-line, on the phone, by mail and in person challenged many systems and service channels, including insurance agents, enrollment counselors, service center representatives, and county eligibility workers. [More]

 

CMS Releases Pioneer ACO Performance Data

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) released data on October 8, 2014 showing the quality of care and financial performance of accountable care organizations (ACOs) over the first two years of its Medicare Pioneer ACO program. For year two, the program achieved $96 million in net aggregate Medicare savings along with substantial improvements in 28 out of 33 quality of care metrics across four major quality of care domains. [More]

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U.S. Supreme Court Agrees to Review Ninth Circuit Court of Appeals Decision Allowing Providers to Challenge Medicaid Reimbursement Rates

 

On October 2, 2014, the U.S. Supreme Court agreed to consider whether the Supremacy Clause of the U.S. Constitution grants Medicaid providers a private right of action to challenge a state’s reimbursement rates. The Supremacy Clause of the U.S. Constitution provides that when a federal law and a state law deal with the same subject matter, the federal law will prevail. [More]

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OK Federal District Court Judge Issues Adverse Decision in ACA Tax Credit Controversy

 

On September 30, 2014, Judge Ronald White of the U.S. District Court for the Eastern District of Oklahoma ruled that language in the Affordable Care Act (ACA) rendered invalid an IRS regulation that authorizes tax credits in federal exchanges as well as state exchanges. [More]

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HHS-OIG Issues First Report on Exchange Data Security

 

The U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG) issued on September 22, 2014 the first in what will be a series of reports on information security controls in federal and state-based health insurance Exchanges under the Affordable Care Act (ACA). The OIG reviews are based on HHS regulations on administrative, technical, and physical safeguards to safeguard the confidentiality, integrity, and availability of personally identifiable information (PII) obtained and used by Exchanges. The OIG reviews also apply standards developed by the National Institute of Standards and Technology (NIST) which HHS has adopted in instructions to Exchanges about steps necessary to protect PII. [More]

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GAO Confirms That Most of the Largest Health Insurers Are Participating in Most Exchanges

 

The Government Accountability Office (GAO) issued a report on September 29, 2014 which offers a remarkable comparative overview of the individual and small-group health insurance markets in each state. Most but not all of the largest issuers of health coverage in 2012 in those markets participated in health insurance Exchanges under the Affordable Care Act (ACA) in 2014. [More]

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Congress Passes Preventing Sex Trafficking and Strengthening Families Legislation

 

The Senate has passed H.R. 4980, a compilation of many versions and iterations of legislation that was introduced in the House and the Senate. The current version was passed by the House of Representatives on July 23, 2014 by unanimous voice vote, but failed to pass the Senate on the following day. In late night negotiations on September 18, the Senate was able to pass the measure by unanimous support. [More]