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Health-Exchange-Alert

October 16, 2019 | Daily News

House Democrats on key committees plan to amend Speaker Nancy Pelosi’s (D-CA) drug pricing bill to restrict drug launch prices, extend price negotiation to more drugs and let seniors who hit catastrophic spending limits early in the year smooth out those payments in installments, according to a summary of amendments distributed by the House Energy & Commerce and Education & Labor committees.

October 16, 2019 | Daily News

House Democratic leadership announced on Wednesday (Oct. 16) that the Ways & Means Committee will mark up the government drug price negotiation plan spearheaded by House Speaker Nancy Pelosi (D-CA) the week of Oct. 21, and that the bill will hit the floor vote the week of Oct. 28 if the committees are ready to report out.

October 16, 2019 | Daily News

Virginia Sens. Tim Kaine (D) and Mark Warner (D) asked the Virginia Insurance Commissioner about the impact short-term plans have had on the state's residents.

October 16, 2019 | Daily News

Health experts at the Urban Institute and Commonwealth Fund analyzed eight health reform proposals ranging from building off the Affordable Care Act to transitioning to a full single-payer system that covers all people in the country in a bid to help policymakers and voters understand the trade-offs of each option.

October 15, 2019 | Daily News

Sens. Elizabeth Warren (MA) and Bernie Sanders (VT) defended Medicare for All during the sixth Democratic primary debate on Tuesday (Oct. 15), arguing that it is the best way to expand coverage to all Americans, despite its costs, while moderate candidates argued for a public option and otherwise building on the Affordable Care Act.

October 15, 2019 | Daily News

As the nation’s largest insurance exchange kicks off its three-and-a-half-month open enrollment period on Tuesday (Oct. 15), Covered California touts its first-in-the-nation policy to offer financial assistance to middle-income residents for the 2020 plan year.

October 15, 2019 | Daily News

California Democratic Gov. Gavin Newsom signed controversial legislation designed to eliminate the financial incentives for dialysis firms to contribute to charitable premium assistance programs by limiting reimbursement for certain patients that receive such assistance, and a kidney charity has already said it will stop operating in the state Jan. 1 due to the law.

October 11, 2019 | Daily News

CMS will begin to automatically enroll consumers into 2020 marketplace plans on Oct 15, ahead of the Nov. 1 start of open enrollment, according to a recent webinar.

October 10, 2019 | Daily News

Planned Parenthood Action Fund unveiled 89 endorsements for key House and Senate races as part of a $45 million campaign to combat the Trump administration’s changes to the Title X program and other reproductive health policies in the 2020 election.

October 10, 2019 | Daily News

HHS is on the hook to pay potentially $24 million or so it allegedly netted from debts owed by Colorado’s failed ACA co-op since the department has no authority to override the state’s law governing liquidation priorities, the Federal Court of Claims ruled last week.

October 09, 2019 | Daily News

The Tenth Circuit Court of Appeals could soon deliver a ruling in the ongoing case on whether HHS wrongly assumed that the Affordable Care Act's risk adjustment program had to be budget neutral, and whether state-wide adoption of that policy means that average premiums in the risk adjustment methodology should stand.

October 09, 2019 | Daily News

HHS on Wednesday (Oct. 9) released long-awaited proposals to change the physician-self referral and anti-kickback statute regulations aimed at easing providers’ participation in value-based pay models, including new, permanent exceptions to the Stark Law for value-based pay arrangements within and outside Medicare and a new safe harbor under the anti-kickback statute for certain incentives beneficiaries can access through CMS demonstrations.

October 08, 2019 | Daily News

Days after CMS unveiled a tool to help employers who are thinking about funding a health reimbursement account that workers can use to buy individual coverage (ICHRA), a private company launched a similar, interactive affordability calculator and administrative platform that can facilitate the new coverage option finalized in July.

October 07, 2019 | Daily News

About 27% of adults under the age of 65 have preexisting conditions that could make them uninsurable in the individual or non-group markets, should the courts overturn the Affordable Care Act, according to a recent analysis from the Kaiser Family Foundation.

October 07, 2019 | Daily News

Immigration advocates and health experts immediately blasted the Trump administration’s unexpected move to block entry of legal immigrants who may “financially burden” the country’s health care system, including those who may be eligible for subsidized exchange coverage.

October 07, 2019 | Daily News

Immigration advocates and health experts immediately blasted the Trump administration’s unexpected move to block entry of legal immigrants who may “financially burden” the country’s health care system, including those who may be eligible for subsidized exchange coverage.

October 04, 2019 | Daily News

CMS approved New Jersey’s request to transition from a federally facilitated exchange to a state-based exchange reliant on the federal platform (SBM-FP), and the state plans to devote up to $2 million for ACA navigators and other outreach projects for the 2020 plan year now that it is taking over those functions, New Jersey’s Department of Banking and Insurance announced Thursday.

October 04, 2019 | Daily News

The LIttle Sisters of the Poor is again asking the Supreme Court to take up a longstanding argument over whether the ACA’s contraceptive mandate violates the Religious Freedom Restoration Act and argues that without a decision from the high court litigation on the issue is destined to continue in perpetuity.

October 04, 2019 | Daily News

Top officials at Blue Cross Blue Shield Association, one of the major insurers lobbying on Congress’ surprise billing legislation, indicated they would prefer Congress take no action on the issue rather than implement a policy that uses arbitration.

October 04, 2019 | Daily News

As Congress scrambles to pass a surprise billing fix before the end of the year, insurers are unwilling to consider a compromise on any solution that includes arbitration, senior officials at Blue Cross Blue Shield Association said.

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