On February 21, 2012, the Centers for Medicare & Medicaid Services (CMS) announced that seven organizations will receive a total of $639 million in federal low-interest loans to launch new, consumer-governed health insurance plans in eight states. The plans, authorized by the Affordable Care Act (ACA), are scheduled to open for business in 2014 and primarily will serve people under age 65 in the individual and small-group insurance markets. [More]
On February 17, 2012, Congress passed legislation that, in addition to extending the payroll tax cut and unemployment benefits, contained a 10-month extension of a payment freeze that will once again avert a 27% cut to Medicare physician payment. The Act is entitled the "Middle Class Tax Relief and Job Creation Act of 2012" (H.R. 3630). To pay for the averted cut in physician reimbursement, the bill phases down Medicare bad debt reimbursements to hospitals and skilled nursing facilities to 65% beginning in 2013 for providers who currently are being reimbursed at 70%, while phasing in the reduction to 65% over 3 years for those who are reimbursed at 100% of their bad debt. [More]
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]
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]
In a February 13, 2012 press release, the Obama Administration outlined the $3.8 trillion 2013 education budget proposal it sent to Congress on that date. Among other things, the Administration is requesting $69.8 billion in funding for competitive grant programs, $1.7 billion more than Congress awarded for 2012, while proposing no increase in 2012 funding levels for key formula grant programs such as special education, English learners, and disadvantaged students. [More]
The Brookings Institution released a report on February 8 on the implementation of health information exchanges in Indiana, Massachusetts, New York, Tennessee, and California. Drawing upon interviews with stakeholders and health information technology experts in each state as well as case studies and other research, the report sets forth lessons learned from experience with health information exchanges in these states and addresses the development of health insurance benefits Exchanges under the Affordable Care Act (ACA). [More]
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]
President Obama released his proposed budget for FY 2013 on February 13. The proposal would cut federal Medicaid and Medicare expenditures by $360 billion over ten years. The Medicaid/Children’s Health Insurance Plan (CHIP) section of the proposed budget would establish a single “blended” match rate for Medicaid and CHIP, reduce the states’ ability to use provider taxes to generate the state share of Medicaid expenditures, limit Medicaid payments for durable medical equipment (DME) to Medicare rates obtained through Medicare’s DME competitive bidding program, and make further cuts (beyond those in the Affordable Care Act) in Medicaid disproportionate share hospital (DSH) payment adjustments. [More]
In a letter dated Thursday, February 9, 2012, the Centers for Medicare & Medicaid Services (CMS) advised Florida that the state "could not impose $10 monthly premiums on Medicaid beneficiaries." CMS also denied the state's proposal to charge $100 co-pays for any non-emergency ER visits. CMS noted that the proposals violated federal statutory requirements designed to shield poor people from additional costs. CMS pledged in the letter to consider alternative approaches to meet the goal of promoting cost-effective use of hospital emergency department services.
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As part of the Child and Family Services Improvement and Innovations Act of 2011, states are required to amend their Title IV-B state plan to identify appropriate use and monitoring of psychotropic medications, as part of the state’s current oversight of prescription medications. (Social Security Act Sections 422 (b)(15)(A)(ii)and (v). [More]
