News & Analysis as of

Public Health Insurance Marketplace

Manatt, Phelps & Phillips, LLP

CMS Proposed 2026 Notice of Benefit and Payment Parameters Rule Focuses on Marketplace Oversight

On October 4, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters (NBPP) for plan year 2026. This proposal begins the annual rulemaking cycle for the Marketplaces...more

Manatt, Phelps & Phillips, LLP

States Challenge CMS Rule Making DACA Recipients Eligible for Marketplace Subsidies

On August 8, a coalition of 15 state attorneys general sued CMS in the North Dakota federal court seeking to overturn a May 2024 CMS final rule making Deferred Action for Childhood Arrivals (DACA) recipients eligible for...more

McDermott Will & Emery

The Impact of the ACA 1557 Final Regulations on Gender-Affirming Care

Section 1557 of the Affordable Care Act (ACA) prohibits discrimination on the basis of race, color, national origin, sex, age or disability, or any combination thereof, in a health program or activity, any part of which is...more

Foley & Lardner LLP

CMS Changes Medicare Advantage and Part D Plans’ Agent/Broker/TPMO Compensation Landscape

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In its November 2023 Proposed Rule and in its recently issued Final Rule that will be published in the Federal Register later this month, the Centers for Medicare & Medicaid Services (CMS) addressed concerns related to agent...more

Manatt, Phelps & Phillips, LLP

Emerging Opportunities for State-Based Marketplaces (SBMs)

The Affordable Care Act (ACA) Marketplaces have nearly tripled their enrollment in their first decade of operation, from eight million people in 2014 to 21.4 million in 2024. At the national level, the ACA has helped cut the...more

McDermott+

McDermottPlus Check-Up: March 15, 2024

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THIS WEEK’S DOSE President Releases FY 2025 Budget: The budget requests $130.7 billion in discretionary spending for the US Department of Health and Human Services (HHS) for fiscal year (FY) 2025. House Ways & Means Committee...more

Sheppard Mullin Richter & Hampton LLP

CMS Promotes Health Equity through Marketplace Standards and More in New Proposed Rule

On November 24, 2023, the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule to modify certain Patient Protection and Affordable Care Act (“ACA”)...more

Manatt, Phelps & Phillips, LLP

[Webinar] The Role of State-Based Marketplaces in Advancing Health Equity - December 14th, 3:00 pm - 4:00 pm ET

Join Manatt for the Fourth of Our Imperatives Deep-Dive Sessions on the Topics You Voted Most Important to You. There are currently a record-breaking 12.2 million Americans enrolled in coverage through health care...more

McDermott Will & Emery

Weekly IRS Roundup October 3 – October 7, 2022

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Presented below is our summary of significant Internal Revenue Service (IRS) guidance and relevant tax matters for the week of October 3, 2022 – October 7, 2022...more

Manatt, Phelps & Phillips, LLP

Innovative 1332 Waivers Proceed in Colorado and Washington

The Biden administration gave its stamp of approval last week to Colorado’s novel waiver under Section 1332 of the Affordable Care Act (ACA) to require premium reductions in a public option program, a first-of-its-kind plan...more

King & Spalding

CMS Outlines Strategy to Advance Health Equity

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Pursuant to Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, federal agencies and departments, including HHS, have recently released their plans to advance...more

Jackson Lewis P.C.

Ohio’s Surprise Billing Law – Impact on Health Plans

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Ohio’s Surprise Billing Law, R.C. § 3902.51, became effective January 12, 2022, but its impact on health plans is still evolving. The law strives to prevent patients from receiving and paying surprise medical bills,...more

Manatt, Phelps & Phillips, LLP

Treasury Releases Proposal to Address ‘Family Glitch’ as Biden Administration Touts Coverage Gains

On April 5, President Biden held an event at the White House celebrating coverage gains since the enactment of the Affordable Care Act (ACA). Joined by Vice President Harris and former President Obama, President Biden...more

Nossaman LLP

Understanding the HHS 2023 Proposed Rule

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The Department of Health and Human Services (HHS) released its Notice of Benefit and Payment Parameters for the 2023 Proposed Rule on Wednesday, January 5th 2022. ...more

Manatt, Phelps & Phillips, LLP

[Webinar] Levers of Change: Remapping the Health Care Landscape - March 9th, 1:00 pm - 2:00 pm ET

President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more

Manatt, Phelps & Phillips, LLP

What’s Ahead for Federal Health Policy in 2022

As the Biden administration begins its second year in office, the administration remains focused on its core health policy agenda—advancing coverage, access and equity....more

Manatt, Phelps & Phillips, LLP

The Manatt State Cost Containment Update - February 2022: Additional Resources

Office of Health Strategy (OHS) Roadmap for Strengthening and Sustaining Primary Care, Connecticut Office of Health Strategy (OHS). Draft of as November 2021. In collaboration with the state Department of Social Services...more

Manatt, Phelps & Phillips, LLP

A Potential Public Option Path for Oregon

In July 2021, Governor Kate Brown signed into law HB 2010, which charges the Oregon Health Authority (OHA), in collaboration with the Department of Consumer and Business Services (DCBS), with developing a potential path for a...more

Manatt, Phelps & Phillips, LLP

Oregon Health Authority Public Option Implementation Report

Oregon is committed to closing the remaining gap in health insurance coverage and doing so in a way that helps the State meet its goal of eliminating health inequities. According to the Oregon Health Insurance Survey,...more

King & Spalding

HHS Proposes Repeal of Two Trump Administration Rules on Guidance, Enforcement, and Adjudication Procedures

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On October 20, 2021, HHS published in the Federal Register a proposal to repeal two final rules issued during the Trump administration. The final rules up for repeal are the “Department of Health and Human Services Good...more

Manatt, Phelps & Phillips, LLP

The State of Play: A Midyear Update on the Public Option at the Federal and State Levels

In a new “Expert Perspective” prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health provides a midyear update on the public option at the federal and state levels. ...more

Manatt, Phelps & Phillips, LLP

Accessing Out-of-Network Subspecialty Cancer Care in Marketplace Plans

In a new report prepared in partnership with the Leukemia & Lymphoma Society (LLS), summarized below, Manatt Health reviews policy challenges that may hamper patients’ ability to navigate and obtain proper treatment for their...more

Manatt, Phelps & Phillips, LLP

Accessing Out-of-Network Subspecialty Cancer Care in Marketplace Plans - Key Findings From a Scan of Four States

Blood cancer takes a demanding physical, mental and emotional toll on the 1.3 million patients living with this disease in the U.S. Many blood cancer patients also face the daunting task of managing their own care—obtaining...more

Williams Mullen

DOL Issues Model Notices and FAQs for COBRA Subsidy

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As described in our previous alert, the American Rescue Plan Act of 2021 (the ARPA), provides a full subsidy for COBRA premiums for certain qualified beneficiaries entitled to COBRA continuation coverage from April 1, 2021,...more

King & Spalding

President Biden Orders Special Enrollment Period for Federal Marketplaces and Review of Policies “Inconsistent” with ACA and...

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On January 28, 2021, President Biden signed the “Executive Order on Strengthening Medicaid and the Affordable Care Act” which, among other things, ordered a special enrollment period (SEP) for the federal Health Insurance...more

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