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Health-Exchange-Alert

January 08, 2020 | Daily News

The Medicaid And CHIP Payment and Access Commission released a report Monday (Jan. 6) finding that Institutions for Mental Diseases, or IMDs, lack clear federal oversight and face a patchwork of state regulation as many states sidestep the restriction that prevents Medicaid from paying for inpatient services in these large facilities.  

January 08, 2020 | Daily News

The Medicaid And CHIP Payment and Access Commission released a report Monday (Jan. 6) finding that Institutions for Mental Diseases, or IMDs, lack clear federal oversight and face a patchwork of state regulation as many states sidestep the restriction that prevents Medicaid from paying for inpatient services in these large facilities.  

January 07, 2020 | Daily News

In light of President Donald Trump’s Medicare executive order, CMS is seeking advice on how to eliminate Medicare regulations that are more stringent than state laws and limit what services certain non-physician practitioners can offer.

January 07, 2020 | Daily News

Cyber policy pros are urging operators of industrial control systems and other critical infrastructure to be particularly alert to cyber threats following the U.S. attack that killed Iran's top general, amid intense discussions on whether the right cyber policy tools are in place for a potentially unprecedented confrontation in cyberspace.

January 07, 2020 | Daily News

The 10th Circuit Court of Appeals recently reversed a district court ruling that shot down CMS’ risk adjustment methodology for the 2014-2018 plan years.

January 06, 2020 | Daily News

The Supreme Court is already moving quickly on Democrats’ request that it promptly review the constitutionality of the Affordable Care Act: Parties in the case have until Friday (Jan. 10) to respond to calls by the House of Representatives and state Democratic attorneys general for the high court to expeditiously review Texas v. USA.

January 06, 2020 | Daily News

Sens. Susan Collins (R-ME), Doug Jones (D-AL), Martha McSally (R-AZ) and Bob Menendez (D-NJ) Monday (Jan. 6) introduced a bill that would fund a three-year pilot program to increase federal Medicaid funding for whole genome sequencing (WGS) services for children with a suspected genetic disease.

January 03, 2020 | Daily News

Dialysis stakeholders are cheering a California federal judge’s Monday decision blocking the state from implementing a controversial new law that bars patient steering and limits reimbursements for patients who receive charitable help with premiums, and at least one analyst says the move could calm fears that similar legislation might take hold in other states.

January 03, 2020 | Daily News

More than 200 Republican lawmakers on Thursday asked the Supreme Court to reconsider the 1973 Roe v. Wade decision in an amicus brief filed in support of a controversial Louisiana abortion law that the Supreme Court will review March 4.

January 02, 2020 | Daily News

CMS approved a waiver allowing Indiana to use Medicaid to fund inpatient treatment for serious mental illness in late December. The state joins Vermont and the District of Columbia in using Medicaid to fund inpatient treatment in certain large facilities for both serious mental illness and substance use disorder.

January 02, 2020 | Daily News

The industry-lauded repeal of the health insurance tax may lead to Medicare Advantage plans offering more supplemental benefits tied to investment in social determinants of health, according to industry advocacy organizations.

January 02, 2020 | Daily News

Beneficiary advocates are calling on HHS, Congress and the administration to adopt policies to bridge racial disparities in health care, as proposed in a recent report by the Medicare Advantage advocacy organization Better Medicare Alliance in collaboration with other advocates.

December 23, 2019 | Daily News

Health insurers, beneficiary advocates and Democratic lawmakers pilloried the Trump administration for finalizing with some changes a rule requiring separate payments for abortion services, which they argue will result in consumer confusion, higher costs and ultimately diminish coverage.

December 23, 2019 | Daily News

Medicare Advantage plans pushed back against a new HHS Office of Inspector General report that concluded the plans might be receiving inappropriate risk-adjusted payments, saying the report relies on old data and overstates the improper pay rate.

December 20, 2019 | Daily News

Key House and Senate committees are expanding their investigation of private equity’s role in surprise billing practices to physician staffing companies and insurers.

December 19, 2019 | Daily News

The Senate on Thursday (Dec. 19) passed its year-end spending deal 71-23 despite Sen. Bill Cassidy’s (R-LA) last-ditch plea for fiscal conservatives to reject the bill over the high costs of repealing three major Affordable Care Act taxes.

December 19, 2019 | Daily News

CMS is reviewing Nebraska’s proposal to adopt a two-tiered version of Medicaid expansion in which beneficiaries would have to satisfy a work requirement and other criteria in order to qualify for full Medicaid benefits.

December 18, 2019 | Daily News

A federal appeals court created even more uncertainty over the future of the Affordable Care Act when it agreed Wednesday that the law’s individual mandate is unconstitutional but punted back to a lower court to decide which other pieces of the law remain valid -- a highly anticipated ruling that led to more sparring between Democrats and Republicans who view the case through an election lens, opposition from health care stakeholders that benefit from the ACA, and predictions among legal experts on whether the Supreme Court might hijack the case during the election season.

December 18, 2019 | Daily News

California is touting its new, more generous subsidies for middle-income residents as a reason for increased enrollment in its state exchange and encourages other states to enhance assistance in similar programs.

December 18, 2019 | Daily News

If Congress ended surprise medical billing, insurance premiums for people with employer-sponsored plans would drop by as much as 3.4%, or approximately $40 billion annually, a new study from Health Affairs found just days after lawmakers announced they would not vote to end surprise billing until 2020.

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