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Health-Exchange-Alert

September 06, 2019 | Daily News

UnitedHealth Group on Thursday pointed to out-of-network physicians who work in emergency departments as a key reason for the increase in surprise billing, releasing a brief that says those providers increase health care prices for consumer by $6 billion a year.  

September 05, 2019 | Daily News

Emergency physicians took to Capitol Hill two days before lawmakers return from August recess to lobby for the addition of independent dispute resolution to the Senate’s final surprise billing legislation.

September 05, 2019 | Daily News

Two states took major steps in their transition to a state-based marketplace on Wednesday: Nevada kicked off its “soft-launch” for existing consumers, and Gov. Tom Wolf (D) announced board appointees and a new executive director for the Pennsylvania Health Insurance Exchange Authority.

September 05, 2019 | Daily News

Legislation requiring that all California health plans cover pediatric hearing aids unanimously passed the state senate appropriations committee last week and will soon head to the senate floor.

September 04, 2019 | Daily News

Stakeholders in Texas are urging the state legislature to add guardrails to its new arbitration approach to end surprise medical bills.

September 04, 2019 | Daily News

The federal government will collect more than $15.52 billion from most health insurers in 2020 if Congress does not extend the existing suspension of the Affordable Care Act’s health insurance tax, IRS says in a guidance memo out Tuesday.

September 03, 2019 | Daily News

The federal government’s refusal to pay billions of dollars under the Affordable Care Act’s risk corridor program is a bait and switch of staggering proportions that will undermine the government’s ability to function as a trusted business partner if a lower court decision is not reversed, several issuers who participated in the health insurance exchanges and allege they are owed millions by the government tell the Supreme Court in opening briefs filed Friday (Aug. 30)

August 30, 2019 | Daily News

Maine Democratic Gov. Janet Mills told CMS Thursday (Aug. 29) that it intends to transition to a state-based exchange, although it plans to continue to rely on Healthcare.gov’s enrollment technology and consumer call center for 2021 before potentially moving to a fully state-operated exchange for the 2022 plan year.

August 30, 2019 | Daily News

CMS awarded $10 million in navigator grants to 34 different organizations in federally facilitated exchange states, the agency announced on Friday (August 30).

August 30, 2019 | Daily News

Insurers, employers and consumer groups who favor the Senate health committee's approach to end surprise billing through a benchmark pay rate are fighting a recent slew of advertisements from dark money groups that are trying to defeat the committee’s proposal.

August 29, 2019 | Daily News

Nevada Attorney General Aaron Ford has officially appealed Texas U.S. District Judge Reed O’Connor’s decision that bars HHS from enforcing the Affordable Care Act’s contraceptive coverage mandate on any person or employer with religious objections.

August 29, 2019 | Daily News

Advocates for Medicaid expansion in Nebraska filed a lawsuit Wednesday (Aug. 28) seeking to force state officials to implement voter-approved Medicaid expansion nearly a year earlier than the Republican governor’s planned October 2020 launch date.

August 29, 2019 | Daily News

More health insurers are stepping into the health insurance exchange markets in 2020, helping to fill out areas that had seen lackluster participation in earlier years due to market volatility.

August 29, 2019 | Daily News

California's rate-setting model has reduced the number of surprise bills consumers face, according to a study from the RAND Corporation, but it has also shifted bargaining power toward insurers and has led to physician group consolidation.

August 28, 2019 | Daily News

The Trump administration’s so-called public charge rule will deter many immigrant families from enrolling their children in Medicaid, potentially undermining decades of work to expand children’s coverage, the Georgetown University Center for Children and Families argues in a new report.

August 28, 2019 | Daily News

Republicans are pointing to the premium decreases in states with reinsurance programs established through the Affordable Care Act’s 1332 waivers as proof that working around the law’s mandates will lower prices, particularly for those ineligible for tax credits, while Democrats, who created the waivers, say efforts to boost the ACA must also help the lower income population.

August 27, 2019 | Daily News

The government is putting up new barriers to drug copay coupons, and pharmacy benefit managers say the new rules will help control drug spending.

August 26, 2019 | Daily News

California has seen a significant increase in the number of in-network doctors since implementing its surprise billing legislation in 2016, according to a new study funded by America’s Health Insurance Plans.

August 26, 2019 | Daily News

Large employers are increasingly open to the government negotiating prices of high-cost drugs, a notable change from previous years that reflects ongoing concern over skyrocketing costs, according to a new survey by the National Business Group on Health (NBGH).

August 26, 2019 | Daily News

CMS on Friday (Aug. 23) instructed state Medicaid agencies on how to take full advantage of federal rules that allow them to recoup money from the U.S. sponsors of legal immigrants if those immigrants use Medicaid benefits, including potentially suing the sponsors if they don’t pay up.

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