Report Shows ACA Impact on Affordability, Competition, and Choice

 

The U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation (ASPE) released a report on June 18, 2014 showing the impact of the Affordable Care Act (ACA) on health insurance premium affordability, competition, and consumer choice for individuals who obtained coverage through federally-facilitated and State Partnership Exchanges/Marketplaces in 36 states during the 2013-2014 open enrollment period. On affordability, the report shows that individuals who selected qualified health plans (QHPs) through the Exchanges and received advance premium tax credits (APTCs) owed a net premium liability 76 percent less than the full premium. They owed on average $82 per month to the QHP, after subtracting $264 in APTCs from the $346 per month average full premium, and 46 percent of individuals owed $50 or less after the APTCs. [More]

 

DHHS Office Issues 10-Year Framework for Achieving Interoperable Health IT

 

On June 5, 2014, the US Department of Health and Human Services (DHHS) Office of the National Coordinator for Health Information Technology (ONC) released a multi-year plan for achieving an interoperable information technology (IT) infrastructure. [More]

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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]

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Reports Show Emerging ACA Impact on Medicaid Enrollments, Hospital Charges, and Payer Mix

 

The Centers for Medicare and Medicaid Services (CMS) released on June 4, 2014 a report showing that the 26 jurisdictions (25 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by April 2014 saw on average a 15.3 percent increase in Medicaid/CHIP enrollments for April 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. States which had not implemented Medicaid expansion by April 2014 saw on average a 3.3 percent increase as compared to their 2013 baselines. Total reported Medicaid/CHIP enrollments nation-wide as of April 2014 reached 65,016,775, an increase of 6,050,059 (10.3 percent) as compared to 2013 baselines. [More]

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President's Council Offers Health Systems Engineering Recommendations

 

The President's Council of Advisors on Science and Technology submitted a compelling report to President Obama on May 29, 2014 entitled, "Better Health Care and Lower Costs: Accelerating Improvement Through Systems Engineering." The report acknowledges demonstration programs and payment reforms in the Affordable Care Act but calls for an accelerated transition to payment models that create appropriate incentives to drive increases in the value of patient care, rather than volume of services. [More]

 

CMMI Begins Round Two for SIM Grants

 

The Centers for Medicare and Medicaid Innovation (CMMI) released a funding opportunity announcement (FOA) on May 22, 2014 for grant awards under round two of the State Innovation Models (SIM) program. The FOA outlines opportunities for states to obtain model design awards for January 1, 2015 - December 31, 2015 as well as model testing awards for January 1, 2015 - December 31, 2018. CMMI expects that it will approve up to 15 model design awards, limited to $3 million per state, and up to 12 model testing awards, ranging from $20 million to $100 million per state. [More]

 

CMS Broadens Medicare Payment Policies for Certain Skilled Care Treatments

 

In accordance with a 2013 Settlement Agreement in the case of Jimmo v. Sebelius, (see Fact Sheet here), the Centers for Medicare & Medicaid Services (CMS) recently issued revised portions of the relevant program manuals used by Medicare contractors. [More]

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HHS Addresses Medicare DME Program Integrity

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), proposed rules in the May 28, 2014 Federal Register which would require prior authorization of certain durable medical equipment (DME), prosthetics, orthotics, and medical supplies that CMS considers frequently subject to unnecessary utilization. [More]

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HHS Updates Exchange and Insurance Market Standards for 2015 and Beyond

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), issued draft final rules on May 16, 2014 to update and clarify a wide range of health insurance rules under the Affordable Care Act (ACA). The final rules take into account public comments submitted by April 21, 2014 on proposed rules published in the Federal Register on March 21, 2014. The final rules address standards for health insurance issuers, including but not limited to issuers offering qualified health plans (QHPs) through Exchanges and the Small Business Health Options Program (SHOP); requirements on health care quality, medical loss ratios (MLRs), and rebates to consumers from issuers that do not meet MLRs; and requirements under the ACA reinsurance, risk corridor, and risk adjustment programs. [More]

 

HHS Proposes More Flexibility in Electronic Health Records Rules

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued draft proposed rules on May 20, 2014 to offer greater flexibility under requirements governing Medicare and Medicaid incentive payments to promote the meaningful use of electronic health records. [More]