Editor’s Note: The Affordable Care Act (ACA) brought sweeping changes to the Medicaid program that have had profound implications for family planning coverage, services and providers. In particular, in the 17 states with...more
Maryland becomes the first State to mandate over-the-counter contraceptive coverage; Missouri plans to increase Medicaid asset limitations by 500% by 2021; and HHS' final rule extends protections against sex discrimination to...more
5/18/2016
/ Affordable Care Act ,
Contraceptive Coverage Mandate ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Health Insurance Exchanges ,
Medicaid ,
Opioid ,
Religious Accommodation ,
SCOTUS ,
Sex Discrimination ,
Zubik v Burwell
South Dakota expects additional $18 million in Medicaid expansion savings due to CMS's revised IHS rules; Arizona uses procedural maneuvers to reinstate enrollment in CHIP; and comprehensive Medicaid managed care enrollment...more
CMS's sweeping final rule aligns Medicaid and CHIP managed care with QHP and Medicare Advantage regulations; New York's DSRIP is enabling change in the State's Medicaid delivery system; and Medicaid expansion reduces...more
Oklahoma proposes Medicaid coverage for 175,000 currently uninsured; a report finds State-based Marketplaces boost Medicaid enrollment growth rates; and CMS issues a final rule on mental health parity in Medicaid and CHIP....more
4/6/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Contraceptive Coverage Mandate ,
Employer Mandates ,
Enrollment ,
Medicaid Expansion ,
Mental Health ,
SCOTUS ,
State Health Insurance Exchanges ,
Zubik v Burwell
HHS approves waiver extending Medicaid coverage to Flint residents impacted by the water crisis; SCOTUS rules that states cannot require self-insured health plans to provide claims data; and seven insurers sign on to...more
STATE STAFFING UPDATES:
Nevada: New Insurance Commissioner Appointed -
The Director of Nevada's Department and Industry announced Barbara Richardson as the Commissioner of the Division of Insurance. Richardson...more
3/2/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
GAO ,
Healthcare Reform ,
Healthcare.gov ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Native American Issues ,
OIG ,
State Health Insurance Exchanges
CMS details requirements for Kentucky's transition to HealthCare.gov; a new special enrollment period is established for subsidy-eligible individuals who failed to file their 2014 taxes; and President Obama sends his final...more
Louisiana's Governor pushes ahead on Medicaid expansion, while expansion is blocked by Wyoming's Legislature; Massachusetts plans to submit a 1332 waiver application to preserve its merged markets; and CBO lowers its 2016...more
1/28/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Healthcare Reform ,
Healthcare.gov ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Prescription Drugs ,
State Budgets ,
State Health Insurance Exchanges ,
Tax Credits
HealthCare.gov enrolls 8.2 million; Manatt and RWJF release an open access dataset on Marketplace plans nationwide; Montana names administrator for its Medicaid expansion; and Michigan gets the green light in the nick of time...more
A flurry of support for Medicaid expansion this week…with Virginia hospitals backing a provider assessment, Wyoming's Governor putting forth a budget initiative, and Arkansas announcing plans to extend its waiver. Meanwhile,...more
12/10/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Conflicts of Interest ,
Enrollment ,
Governor Pence ,
Healthcare Costs ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
State Budgets ,
Waivers
CMS concludes no QHPs can be certified as comparable to CHIP coverage; California's Marketplace plans to connect consumers to vision coverage issuers; and states react to CMS's proposed HealthCare.gov user fee....more
HHS proposes significant new network adequacy standards and surprise billing protections for 2017 QHPs; Louisiana's Governor-elect reiterates his intent to expand Medicaid on "Day One"; and California considers pursuing a...more
Best Practices for Using Social Media in Healthcare: Maximizing Impact, Mitigating Risk -
Editor's note: In a generation more likely to seek health information online than see a doctor, social media is playing an...more
11/23/2015
/ Affordable Care Act ,
Ann Taylor ,
Federal Trade Commission (FTC) ,
Form 1095 ,
FTC Endorsement Guidelines ,
HCQIA ,
Health Information Technologies ,
Health Insurance Exchanges ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Hyundai ,
IRS ,
Licensing Boards ,
Marketing ,
NC Board of Dental Examiners v FTC ,
Peer Review ,
Reporting Requirements ,
SCOTUS ,
Social Media ,
State Action Immunity
Kansas legislators supportive of Medicaid expansion are pulled from committee; Montana’s Medicaid expansion is off to a strong start; and New Mexico sees declines in uncompensated care since ACA implementation....more
11/18/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Healthcare.gov ,
Legislative Committees ,
Managed Care Contracts ,
Medicaid Expansion ,
Medicaid Reform ,
Request for Proposals ,
State Health Insurance Exchanges ,
Waivers
With the election of a new Governor, the future of Kentucky’s Marketplace and Medicaid expansion is uncertain; CMS questions Iowa on its Medicaid managed care transition timeline; and the Supreme Court agrees to hear a case...more
11/11/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Co-Op ,
Contraceptive Coverage Mandate ,
Hepatitis C ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Pharmaceutical Industry ,
SCOTUS ,
State Health Insurance Exchanges
Montana receives approval to expand Medicaid beginning 2016; California’s $6.2 billion Medicaid waiver receives pre-approval; and HHS proposes broadening circumstances under which states receive enhanced federal matching...more
11/5/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Co-Op ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare.gov ,
Medi-Cal ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Native American Issues ,
Open Enrollment ,
Proposed Amendments ,
Public Health Insurance Marketplace ,
State Health Insurance Exchanges ,
Waivers
HHS announces average premium price increases of 7.5% across HealthCare.gov; Michigan and Illinois launch the country’s first joint cloud-based, real-time Medicaid information management system; and the Marketplace carrier...more
10/28/2015
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Enrollment ,
GAO ,
Health Insurance ,
Healthcare ,
Healthcare.gov ,
Insurance Industry ,
Medicaid ,
Premiums ,
Prescription Drugs ,
Public Health Insurance Marketplace ,
Tax Credits ,
Waivers
Editor’s note: Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs into the nation’s largest health insurer. Medicaid’s 50th birthday is a fitting time to...more
10/27/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Eligibility ,
Enrollment ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance ,
Healthcare ,
Healthcare Costs ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Tax Credits ,
Value-Based Purchasing ,
Waivers
Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more
10/21/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Co-Op ,
Co-payments ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
DSRIP ,
Enrollment ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
OIG ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
State Health Insurance Exchanges ,
Tax Credits ,
Waivers
Iowa's largest insurer joins the State's Marketplace for coverage year 2017; carrier changes are announced for Marketplaces in Kentucky, Oklahoma and Wyoming; and South Dakota's Governor convenes the Health Care Solutions...more
10/14/2015
/ Affordable Care Act ,
Blue Cross ,
Blue Shield ,
Health Care Providers ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
Healthcare.gov ,
HIV ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Open Enrollment ,
Public Health Insurance Marketplace ,
Qualified Health Plans
Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs to the nation’s largest health insurer. The occasion of Medicaid’s 50th birthday is a fitting time to...more
9/30/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Enrollment ,
Health Insurance ,
Information Technology ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Waivers
New study shows Marketplace premiums parallel the employer market; Montana likely to select a private insurer to administer benefits to its Medicaid expansion population; and Washington’s Exchange customers will begin paying...more
9/30/2015
/ Affordable Care Act ,
Audit Reports ,
Blue Cross ,
Centers for Medicare & Medicaid Services (CMS) ,
Co-Op ,
Cost-Sharing ,
Deductibles ,
Eligibility ,
Employer Group Health Plans ,
Employer Mandates ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Minimum Essential Coverage ,
NYDFS ,
OIG ,
Public Health Insurance Marketplace ,
State Health Insurance Exchanges ,
Verification Requirements
The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more
9/23/2015
/ Affordable Care Act ,
Bundled Payments ,
Burwell v Hobby Lobby ,
Census Bureau ,
Centers for Medicare & Medicaid Services (CMS) ,
Contraceptive Coverage Mandate ,
Department of Health and Human Services (HHS) ,
GAO ,
Governor Bentley ,
Governor McCrory ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Long-Term Care ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Medicaid Reimbursements ,
Medicare ,
OIG ,
Pending Legislation ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
Religious Accommodation ,
SCOTUS ,
State Budgets ,
State Medicaid Programs
The GAO reports an increase in choice of plans both on and off Marketplaces; Hawaii submits the first 1332 waiver application, with a focus on substituting the employer mandate and SHOP provisions with pre-existing State...more
9/16/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Employer Mandates ,
GAO ,
Health Insurance Exchanges ,
Healthcare Reform ,
Healthcare.gov ,
Medicaid ,
Public Health Insurance Marketplace ,
SHOP Program ,
State Health Insurance Exchanges