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Health-Exchange-Alert

January 25, 2019 | Daily News

CMS recently provided states with four concepts could consider under the revised guidance for the Affordable Care Acts 1332 waivers, but Administrator Seema Verma is making clear that she has a favorite: In an editorial published last week, Verma strongly endorsed the idea of allowing states to create health expense accounts that consumers could use to purchase health coverage, similar to the Health Indiana Plan Medicaid waiver that she helped craft as a consultant.

January 25, 2019 | Daily News

Massachusetts Governor Charlie Baker (R) is requesting state legislation to let its Medicaid program negotiate supplemental rebates for expensive drugs.

January 24, 2019 | Daily News

D.C. federal district court judge John Bates showed interest in the Democratic attorneys general’s complaints challenging the Trump administration’s expansion of association health plans, repeatedly saying during Thursday’s hearing that the administration’s underlying intention in the rule was to modify the Affordable Care Act, not the definition of an employer under ERISA.

January 24, 2019 | Daily News

A bipartisan group of House lawmakers on Thursday (Jan. 24) reintroduced legislation that would fully repeal the 40 percent excise tax on high-cost health plans, commonly known as the “Cadillac tax,” garnering immediate praise from wide-ranging stakeholders that have long worked to strike the provision from the Affordable Care Act.

January 23, 2019 | Daily News

Medicare for All is picking up support among the American public and federal lawmakers are beginning to consider the idea more seriously.

January 23, 2019 | Daily News

CMS’ annual letter describing key policy changes for health and dental plan issuers seeking to participate in the federally facilitated marketplaces in the 2020 plan year largely relies on processes spelled out in previous letters, but it does warn the agency may audit issuers to ensure they’re following rules on cost-sharing for out-of-network services provided in an in-network setting.

January 22, 2019 | Daily News

The proposed 2020 Notice of Benefit and Payment Parameters includes a proposal requiring insurers that offer Affordable Care Act plans covering abortion also to offer at least one other identical plan that does not cover abortion.

January 22, 2019 | Daily News

Federal DC District Judge John Bates is slated to hear oral arguments Thursday (Jan. 24) on the Department of Justice’s motion to dismiss or move to judgment the lawsuit brought by 12 Democratic attorneys general over the Trump administration’s final association health plan (AHP) rule.

January 18, 2019 | Daily News

Arizona is the eighth state to receive permission from the Trump administration to add work requirements to its Medicaid program, and after months of behind-the-scenes negotiations between state officials and CMS lawyers, CMS allowed the state to exempt some Native Americans from the requirements.

January 17, 2019 | Daily News

CMS on Thursday (Jan. 17) released its long-awaited exchange policy regulation, and while it avoided making changes to the silver-loading process, the agency did propose several other policies including allowing mid-year drug formulary changes, creating a new special enrollment period for people newly eligible for subsidies, increasing maximum out-of-pocket spending limits, and reducing the user fee by half of a percentage point.

January 17, 2019 | Daily News

CMS is calling for a legislative solution to reinstate cost sharing reduction payments to insurers and to end the silver-loading workaround by plan year 2021 as a part of the proposed 2020 Notice of Benefit and Payment Parameters.

January 17, 2019 | Daily News

CMS proposed letting exchange plans change formularies mid-year to speed generic drug uptake, the agency announced Thursday (Jan. 17).

January 17, 2019 | Daily News

The Senate on Thursday (Jan. 17) voted against proceeding with a GOP measure to codify the Hyde amendment to permanently ban federal funding for abortions.

January 17, 2019 | Daily News

The 2020 Notice of Benefit and Payment Parameters, the crucial rule that will set the requirements for next year’s Affordable Care Act marketplaces, cleared the review at the White House Office of Management and Budget on Wednesday (Jan. 16) and could be published soon.

January 16, 2019 | Daily News

Energy & Commerce Committee Democrats will soon push short-term fixes to stabilize the Affordable Care Act markets, such as reinstating cost-sharing reductions, establishing a permanent reinsurance program and extending risk corridor payments to insurers, newly appointed Energy & Commerce Oversight Subcommittee Chair Diana DeGette (D-CO) told reporters on Wednesday (Jan. 16).

January 16, 2019 | Daily News

Insurers tell CMS not to finalize the proposal to separately bill consumers the portion of their premium that goes toward abortion coverage, saying the policy would increase costs far beyond the agency’s estimates, would frustrate consumers and risk plan cancellations, and would be impossible to implement on the proposed timeframe.

January 16, 2019 | Daily News

The number of Arkansas Medicaid beneficiaries who lost coverage as a result of the state’s newly enacted work requirements grew to more than 18,000 last month, according to data released by the state Tuesday (Jan. 15).

January 15, 2019 | Daily News

Attorney General nominee William Barr in his Tuesday (Jan. 15) confirmation hearing told Sen. Kamala Harris (D-CA) that he is open to reconsidering the Department of Justice’s decision to not fully defend the Affordable Care Act against a constitutional challenge from 20 GOP-led states.

January 15, 2019 | Daily News

Two associations representing health plans tell CMS that with the annual exchange rule stalled at the White House Office of Management and Budget (OMB) due to the government shutdown, the agency should immediately issue informal guidance that the plans need to understand regulatory and operational changes for the 2020 plan year.

January 14, 2019 | Daily News

A Pennsylvania district court judge on Monday (Jan. 14) issued a nationwide injunction blocking the implementation of two Trump administration rules that would loosen the Affordable Care Act’s requirements that employers cover contraceptive services by allowing those employers to claim moral or religious exemptions.

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