Insights from the AHIP National Health Policy Conference

Last week, America’s Health Insurance Plans (AHIP) held its annual health policy conference (#AHIPPOLICY) in Washington DC, with top industry leaders, regulators and policy makers convened to provide diverse voices and perspectives on today’s most urgent health care issues. The conference themes were familiar and front of mind topics; tackling the opioid epidemic, rising prescription drug ...

2019 Brings Progress on Prescription Drug Cost Control Efforts at State and Federal Level

As states and the federal government grapple with how best to address the issue of rising prescription drug costs, various models have emerged at the federal level that are similar to efforts underway at the State level. The Administration has called upon states to create innovative approaches to state Medicaid programs, particularly by examining value-based ...

Department of Transportation to Establish Committee to Study Air Ambulance Billing Practices

Concern about out-of-pocket costs associated with air ambulance transport has been growing for some time. Groups such as the National Association of Insurance Commissioners (NAIC) have advocated for state flexibility to regulate the billing practices of the industry. A small but meaningful step forward came last fall with the passage of a legislative requirement that ...

Health Policy News Hosts Webinar on Annual Exchange Guidance

On February 7, 2019, the Health Policy News team hosted a webinar highlighting the proposed changes outlined in the Centers for Medicare and Medicaid Services’ (CMS) long-awaited annual Exchange guidance (proposed Notice of Benefit and Payment Parameters for 2020 and the 2020 Draft Letter to Issuers in the Federally-facilitated Exchanges) released on January 17, 2019. ...

Health Policy News – January 2019

 Introduction As readers are likely aware, the Centers for Medicare and Medicaid Services’ (CMS) long-awaited annual Exchange guidance was released on January 17, 2019, and, as in past years, PCG subject matter experts have prepared a summary of notable changes to assist states in parsing through this voluminous guidance. In addition to the summary, PCG ...

CMS Releases Its Long-Awaited Exchange Guidance for 2020

The Centers for Medicare & Medicaid Services (CMS) released first drafts of its long-awaited annual Exchange guidance on January 17, 2019 – the Proposed Notice of Benefit and Payment Parameters for 2020 (NBPP) and the 2020 Draft Letter to Issuers in the Federally-facilitated Exchanges (Letter) as well as ancillary guidance (the draft Actuarial Calculator and ...

A Reminder from PCG’s Cost Allocation Team to Reference the Correct Federal Guidance in Cost Allocation Plans and Indirect Cost Rates

December marked five years since the Federal Office of Management and Budget (OMB) consolidated eight prior OMB Circulars into a single source of federal guidance, and four years since that guidance went into effect. Yet, despite all the years, our Cost Allocation team still sees federal, state, and other agencies referencing the former OMB Circulars—such ...

Update on Medicaid Buy-In Efforts: Public Impressions and Specific Approaches to Medicaid Buy-in Programs

Many states considering a Medicaid buy-in public option have expressed the hope that it will provide an affordable coverage option for individuals, noting that insurance remains highly costly even for those individuals receiving Federal premium subsidies or employer contributions. States across the country have or will be exploring the feasibility and options available to them ...

A Look at Two States’ Responses to the Association Health Plan Final Rule

Implementation of the new Federal Association Health Plan (AHP) Rule—and new options for associations seeking to offer health insurance coverage—is well underway. The new rule became effective for all fully-insured AHPs seeking to operate under the new rule in September, and will go into effect for existing self-insured AHPs seeking to operate under the new ...

Two Insurance Markets, Similar Stories to Tell

Massachusetts and New Hampshire held public meetings this past fall aimed at providing insights into the factors affecting health care costs in their respective states. The Massachusetts Health Policy Commission (HPC) held its sixth annual Cost Trend Hearing on October 16th and 17th. The New Hampshire Health Insurance Department (NHID) held its annual hearing at ...

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