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
In December 2022, Oregon became the first state since New York (2015) and Minnesota (2016) to put forth a plan to seek federal approval for implementation of a basic health program (BHP) under Section 1331 of the Affordable...more
Editor’s Note: In the article below, Manatt Health discusses the key policies in the “Mental Health Parity Improvements Act,” the latest draft legislation from the Senate Finance Committee’s bipartisan mental health...more
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
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
2/16/2022
/ Alternative Payment Models (APM) ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Beneficiaries ,
Physicians ,
Public Health Emergency ,
Public Health Insurance Marketplace ,
Surprise Medical Bills ,
Telehealth ,
Webinars
Editor’s Note: The American Medical Association (AMA) and Manatt Health released a national roadmap in September 2019 to guide policymakers in taking action to help end the nation’s opioid epidemic. Based largely on in-depth...more
How Can Mental Health and Substance Use Disorder (SUD) Parity Laws Help Battle the Overdose Epidemic? Learn the Answers—and Catch Up on the Most Recent State and Federal Developments—at a New Webinar from the AMA and...more
1/14/2021
/ Best Practices ,
Department of Insurance ,
Enforcement ,
Health Care Providers ,
Health Insurance ,
Insurance Commissioners ,
Insurance Industry ,
Medicaid ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NAIC ,
NQTLs ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Regulatory Oversight ,
Self-Insured Health Plans ,
State Insurance Administrations ,
Substance Abuse ,
Webinars
Section 9 of Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of...more
Technological innovation has always been at the center of the Affordable Care Act (ACA) Marketplaces and has never been more important than it is now. Changes brought on by the coronavirus pandemic have clearly illustrated a...more
Federal and state actions related to commercial health insurance are already underway—and healthcare stakeholders and state regulators will have to manage a rising tide of emerging developments and new regulations in the...more
Editor’s Note: In a new toolkit prepared for the Robert Wood Johnson Foundation, summarized below, Manatt Health helps insurance regulators understand the wide range of transparency and competition strategies available to...more
3/5/2020
/ Anti-Competitive ,
Antitrust Provisions ,
Benefit Plan Sponsors ,
Competition ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Department of Insurance ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Horizontal Mergers ,
Hospital Mergers ,
Medicaid ,
Medicare ,
Transparency ,
Vertical Mergers
State interest in healthcare cost containment has grown dramatically since Massachusetts enacted the nation’s first cost benchmarking program in 2012. At that time, most states were focused on coverage expansion through the...more
On November 4, Georgia released two draft waiver applications for public comment—a Section 1332 State Relief and Empowerment Waiver (“1332 waiver”) to restructure the state’s individual insurance market and a Section 1115...more
Editor’s Note: Manatt Health and the American Medical Association (AMA) have partnered to create the “National Roadmap on State-Level Efforts to End the Opioid Epidemic: Leading-Edge Practices and Next Steps.” The roadmap is...more
The American Medical Association (AMA) and Manatt Health recently undertook an in-depth analysis of the response to the opioid epidemic by 4 states: Colorado, Mississippi, North Carolina, and Pennsylvania. The analysis...more
North Carolina has fought the opioid epidemic with an array of public- and private-sector initiatives. In 2017, Governor Roy Cooper released the state’s Opioid Action Plan developed in collaboration with community partners....more
In late March, the Centers for Medicare & Medicaid Services (CMS) released its Marketplace open enrollment report showing that 11.4 million people selected Affordable Care Act (ACA) Marketplace plans in 2019—a 4% decline in...more
Colorado has addressed the opioid epidemic with an array of public and private initiatives. In 2013, Governor Hickenlooper launched a yearlong process to develop the Colorado Plan to Reduce Prescription Drug Abuse—one of the...more
Pennsylvania has been hit hard by the opioid epidemic, with prescription opioid-related overdoses growing in the early 2000s—and, more recently, high volumes of heroin and fentanyl coursing through the Commonwealth, given its...more
As Election Day approaches, the outcomes of many federal and state races remain unclear, with the future of health reform hanging in the balance. In this newsletter, we examine how the election—including 36 gubernatorial...more
The Genesis of the Opioid Crisis -
The deaths caused by opioids in 2016 exceeded the total deaths in any single year from car accidents, gun violence and even HIV/AIDS at the height of that epidemic. Multiple factors have...more
1332 Waivers Under Review at CMS -
The Trump administration has approved one 1332 waiver to date, but four more are pending, including a sweeping Iowa waiver. Here is where things stand today...more
CMS Issues Self-Referral Disclosure Protocol for Stark Law Violations -
On March 28, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a new voluntary self-referral disclosure protocol (SRDP) for disclosing...more
4/25/2017
/ Affordable Care Act ,
Anti-Steering Rules ,
Antitrust Provisions ,
Centers for Medicare & Medicaid Services (CMS) ,
Deceptive Intent ,
Department of Justice (DOJ) ,
Drug Pricing ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmacist ,
Self-Referral ,
Stark Law ,
Telehealth ,
Trump Administration
Editor's Note: In a dramatic conclusion to the heated debate surrounding the American Health Care Act (AHCA), the bill was withdrawn after it became clear that House leadership did not have enough votes to pass it. There is...more
4/25/2017
/ Administrative Authority ,
Affordable Care Act ,
Discrimination ,
Executive Orders ,
Gender Identity ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmaceutical Industry ,
Pregnancy Discrimination ,
Section 1557 ,
Trump Administration
The Future of Essential Health Benefits -
Editor's Note: The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and...more
3/24/2017
/ Affordable Care Act ,
Antitrust Immunity ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Essential Health Benefits ,
False Claims Act (FCA) ,
Health Insurance ,
Healthcare Reform ,
Insurer Liability ,
Medicaid ,
Premiums ,
Repeal ,
Trump Administration