California ACA Exchange announces limited negotiated rate increase for 2016 plans

 

On July 28, 2015, several national and many local media outlets reported coverage of an announcement by California officials that the state’s health insurance exchange negotiated a 4 percent average rate increase for its 2016 Affordable Care Act (ACA) plans. [More]

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Categories:Health and Human Services

 

HHS outlines multi-pronged strategy to help individuals with substance use disorders

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued a letter to state Medicaid directors on July 27, 2015 encouraging states to pursue demonstration waivers to improve services for individuals with substance use disorders (SUDs). These may include waivers of the longstanding “institution for mental diseases” (IMD) exclusion and other federal Medicaid rules. [More]

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Categories:Health and Human Services

 

Children and families legislative updates

 

Since the beginning of the 114th Congress, many bills have been drafted, a few have been introduced on either the House or Senate floor, and to date, no legislation has been actually passed. The legislation listed below reflect several themes of growing concern but none that have reached the level of attention for a hearing to be held. Continuous monitoring of these bills will be reported. [More]

 

HHS Proposes New Medicare/Medicaid Standards for Long Term Care Facilities

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register on July 16, 2015 which would update Medicare/Medicaid certification requirements for long term care facilities (LTCFs). The proposed rule offers the most comprehensive update in these requirements since 1991. [More]

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Categories:Health and Human Services

 

HHS Proposes Updates in Medicare Part B Payments

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register on July 15, 2015 which would update Medicare Part B payment policies, including the Medicare physician fee schedule, for calendar year 2016. The proposed rule also outlines initial steps toward implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which replaced Medicare’s Sustainable Growth Rate (SGR) formula, enacted in 1997, with a ground-breaking Merit-based Incentive Payment System (MIPS), to be launched in 2019. [More]

 

HHS and USDA Issue Additional Guidance on Eligibility Integration

 

The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) issued a joint letter on July 20, 2015 to directors of state health and human services, state Medicaid and Children’s Health Insurance Programs, and health insurance Exchanges, about a limited exception to OMB A-87 cost allocation requirements for integrated eligibility systems serving multiple programs. [More]

 

GAO Report Cites Medicaid Challenges

 

The U.S. Government Accountability Office issued a report to a health care subcommittee in the U.S. House of Representatives on July 8, 2015, entitled, “Medicaid: Overview of Key Issues Facing the Program.” Medicaid serves over 70 million persons and program costs now exceed $508 billion ($304 billion federal, $204 billion state funds in fiscal 2014). The GAO report addresses access to care, transparency and oversight, program integrity, and federal financing issues under the program. [More]

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HHS Proposes Medicare Home Health Value-Based Purchasing Program

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register on July 10, 2015 which would update Medicare payment methods and rates under the home health prospective payment system, update home health quality reporting requirements, and launch the home health value-based purchasing (HH VBP) model beginning in January 2016. [More]

 

U.S. Supreme Court to hear case next term concerning control of health care data

 

On Monday, June 29, 2015, the U. S. Supreme Court agreed to hear a case, Gobelle v. Liberty Mutual Insurance Company, in the Court’s next term, as to whether a self-funded insurer should have to turn over certain health related information to the state of Vermont.  [More]

 

Kaiser report estimates 4.4 percent increase in Exchange premiums for 2016

 

The Henry J. Kaiser Family Foundation (Kaiser) has released a June 2015 report entitled, “Analysis of 2016 Premium Changes and Insurer Participation in the Affordable Care Act’s (ACA’s) Health Insurance Marketplaces.”  Kaiser’s report shows that insurer participation in health insurance exchanges (Exchanges) is continuing to grow and that competition among insurers may be helping to contain premiums to about a 4.4 percent increase on average for 2016.  [More]