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The Courts

July 20, 2018 | Daily News

Two key health insurance industry lobbies on Thursday urged a court in New Mexico to immediately reconsider its demand that CMS vacate the risk adjustment program, arguing the program's suspension could lead not only to higher premiums and potential market exits, but also could upend other related processes, such as the medical loss ratio calculations that are due at the end of the month.

July 20, 2018 | Daily News

CMS opened a new public comment period Thursday (July 19) on Kentucky’s proposal to add work requirements and other new coverage restrictions to its Medicaid program -- a step the agency hopes will allay the concerns of a federal judge who blocked the proposal from taking effect last month.

July 19, 2018 | Daily News

Senate Democrats are urging their GOP colleagues to back a resolution calling for the Senate to intervene and defend the Affordable Care Act's preexisting conditions protections in the lawsuit brought by 20 GOP-led states challenging the constitutionality of the ACA, but Republicans, who have consistently said they support the consumer protections, have yet to agree to the resolution.

July 19, 2018 | Daily News

The final version of the Trump administration’s long-awaited, controversial rule expanding short-term plans landed at the White House Office of Management and Budget for review on Wednesday (July 18) and could be released shortly.

July 18, 2018 | Daily News

A federal court in California on Wednesday dismissed a case brought by 18 Democratic attorneys general challenging the Trump administration's decision last year to end the ACA's cost-sharing reduction payments to insurers, but the court leaves the door open for the attorneys general to refile their case if HHS moves to block the silver-loading workaround that has made up for the lack of CSRs.

July 17, 2018 | Daily News

House Ways & Means Chairman Kevin Brady (R-TX) said Tuesday (July 17) that he has been talking with HHS Secretary Alex Azar about possible ways to resume risk adjustment payments, but he has not yet decided by what means, and that he plans to bring a package of Affordable Care Act-related bills to the floor next week.

July 17, 2018 | Daily News

The group of 18 Democratic attorneys general who filed suit after the administration ended cost-sharing reduction (CSR) payments last October are now asking the federal court in Northern California to put the case, California v. Trump, on hold so long as a silver-loading work-around continues.

July 17, 2018 |

A federal appeals court dismissed hospitals’ lawsuit over cuts to Medicare reimbursement for 340B drugs, again saying the hospitals sued before they had been hurt by the policy.

July 17, 2018 | Daily News

A federal appeals court dismissed hospitals’ lawsuit over cuts to Medicare reimbursement for 340B drugs, again saying the hospitals sued before they had been hurt by the policy.

July 16, 2018 | Daily News

Judge Reed O'Connor is asking all parties in Texas v. United States to respond by July 30 with any reasons to oppose the Department of Justice's request that the federal district court offer a summary judgment finding that the individual mandate is unconstitutional and must be thrown out along with protections for consumers with pre-existing conditions.

July 16, 2018 | Daily News

The ranking Democrats of the Senate and House committees of jurisdiction over health care on Monday (July 16) demanded the Trump administration immediately reverse its decision to halt the Affordable Care Act's risk adjustment program, and sought more information on the timing and justification for the decision, including whether the White House was involved.

July 13, 2018 | Daily News

CMS Thursday released additional, largely technical, guidance to issuers in light of the New Mexico court's order to vacate the risk adjustment program, reiterating the 2017 payments and collections will be halted, but also noting the agency will still collect user fees from issuers for the plan year since they are not reliant on the budget-neutral methodology rejected by the court.

July 13, 2018 | Daily News

Senate health committee Chair Lamar Alexander (R-TN) said he hopes a federal court in New Mexico will decide soon whether CMS can resume the ACA's risk adjustment program to avert further premium hikes.

July 13, 2018 | Daily News

A lawyer familiar with Supreme Court nominee Brett Kavanaugh and his jurisprudence said the judge, should he be appointed to the high court, would avoid deferring automatically to FDA or other federal regulatory agencies on cases involving matters where Congress has not given clear instructions.

July 13, 2018 | Daily News

A lawyer familiar with Supreme Court nominee Brett Kavanaugh and his jurisprudence said the judge, should he be appointed to the high court, would avoid deferring automatically to FDA or other federal regulatory agencies on cases involving matters where Congress has not given clear instructions.

July 10, 2018 | Daily News

Democratic lawmakers and pro-ACA supporters immediately rallied to oppose President Donald Trump's nominee to the Supreme Court, Judge Brett Kavanaugh, due to concerns over his potential views on patients with preexisting conditions and women's health care, while conservatives had already voiced concerns that the federal DC appeals court judge might be too moderate on some health policy issues.

July 10, 2018 | Daily News

CMS on Monday (July 9) issued its summary report of the estimated $10.4 billion in risk adjustment transfers for issuers that participated in the individual and small group markets in the 2017 plan year, while also reiterating it will not make payments or collections due to an ongoing case in New Mexico.

July 10, 2018 | Daily News

Democratic lawmakers and pro-ACA supporters immediately rallied to oppose President Donald Trump's nominee to the Supreme Court, Judge Brett Kavanaugh, due to concerns over his potential views on patients with preexisting conditions and women's health care, while conservatives had already voiced concerns that the federal DC appeals court judge might be too moderate on some health policy issues.

July 10, 2018 | Daily News

The insurance industry was caught off-guard by CMS' decision to hold off making any 2017 risk adjustment payments, and is calling on the Trump administration to issue an interim final rule that would smooth out legal concerns, or take another action, to avert the higher 2019 premium increases expected due to the uncertainty.

July 06, 2018 | Daily News

Hawaii Governor David Ige (D) signed legislation ensuring certain Affordable Care Act benefits are preserved under Hawaii law in the event the federal government repeals all or parts of the law, including the requirements that health insurers cover people with preexisting conditions, not discriminate based on gender and ensure adult children up to 26 years old can stay on their parents’ health plans.

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