Health-Exchange-Alert

The House Energy & Commerce Committee’s surprise billing fix would save $21.9 billion over the course of 10 years, according to the Congressional Budget Office.

Fifty-nine percent of Medicaid beneficiaries under the age of 21 received a well-child screening in fiscal 2017 -- a decrease of five percentage points from fiscal 2010 and well short of CMS’ target ratio of 80%, according to a new report from the Government Accountability Office.

HHS’ Office of Civil Rights (OCR) is looking into using its authority under HIPAA to tackle concerns over surprise billing and discussed the idea with a group of insurance industry stakeholders on Tuesday, according to a source who attended the meeting.

A group of high-profile economists, the association representing state insurance commissioners, the U.S. Chamber of Commerce, key issuer lobbies and other stakeholders have submitted amicus briefs to the Supreme Court supporting health insurance companies who demand the government pay them the total $12 billion or so owed under the Affordable Care Act’s risk corridor program.

Lawmakers and administration officials are slowly backing away from the White House’s promise to roll out a large-scale Affordable Care Act replacement plan and are instead saying the president is focusing on smaller-scale items such as drug pricing and surprise billing, and will take another look at protecting coverage for preexisting conditions if the courts overturn the health law.

A Kaiser Family Foundation analysis of insurance data submitted to CMS finds that health insurance companies will likely distribute about $1.3 billion in rebates due to the Affordable Care Act’s medical loss ratio for the 2018 plan year, which is the largest amount since 2012.

The California legislature passed an amended version of controversial legislation that aims to remove any financial incentives for dialysis firms to donate to chartable premium assistance programs by limiting reimbursement for patients receiving financial help, and stakeholders on both sides of the issue are now taking their case to Democratic Gov. Gavin Newsom.

Democratic advocates and lawmakers on Tuesday (Sept. 10) blasted the Trump administration’s health policy agenda after the U.S. Census found nearly 2 million people more were uninsured in 2018 than in 2017, and they warned that the Department of Justice’s stance against Obamacare in the Texas lawsuit could further destroy the health care system.

The National Governors Association is encouraging governors to craft policies to tackle surprise medical bills and is also pushing Congress to pass a federal fix to help the over 150 million Americans who receive employer-sponsored coverage, which is regulated under the Employee Retirement Income Security Act (ERISA) and not subject to current state surprise billing laws.