Health Policy News Summer 2018

As in past years, Health Policy News is publishing one summer edition, featuring a new report entitled “Revisiting the Public Option- Medicaid Buy-Ins” with a legislative tracking overview of recent movement on public health insurance programs at both the State and Federal level. We will be hosting a webinar to present the report, with an opportunity for Q&A – stay tuned for an invite to this event.

This edition also includes a summary of the Department of Labor final rule on Association Health Plans, as well as a project spotlight on creating uniform prior authorization forms.

Lastly, Health Policy News will be at the upcoming National Conference of State Legislators (LA July 29th-August 2nd) and National Academy of State Health Policy conference (August 15th-18th). Be sure to visit our booth as we would be happy to discuss the report as well as any other health policy questions you may have.

Hope you all have a wonderful summer and we look forward to an exciting fall.

Revisiting the Public Option

At the same time that health policy changes – large and small – continue at the Federal level, State efforts to strengthen health insurance markets and reduce premium cost increases for consumers while ensuring access to high quality, affordable health care persist. One recent development in a number of states, as well as at the Federal level, is the exploration of a public health insurance option. We will continue to follow this topic, and share the results of any impact studies produced by or for states exploring establishing a Medicaid buy-in program. In the meantime, we hope this report provides a foundation of the concepts and considerations related to public options as states start setting legislative priorities over the coming months. To read the full report, click here.

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DOL Issues Final Association Health Plan Rule

On June 19, 2018, the Department of Labor (DOL) issued a final rule on Association Health Plans (AHPs), which culminated a nine-month effort by the Federal administration to expand access to such plans. The regulations establish additional and more flexible criteria under which an association of small employers may be treated as an employer itself for the purposes of offering group health insurance plans. The administration’s stated goal is to expand access to health insurance coverage by allowing small employers access to coverage under the large group market. To read the full fact sheet on the final rule, click here.

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States Are Increasingly Turning to Uniform Prior Authorization Forms

Prior authorization is a common tool for utilization management and controlling health care costs. While the approach to the process is similar across payers, each insurance carrier and public program has its own forms – with variations on questions asked, how they are asked, and the order in which they are asked – and processes for submitting and processing those forms. PCG subject matter experts have worked with states on creating uniform prior authorization forms and share insights into how states can reduce administrative burden and improve patient experience. To read more, and see an overview of how states across the country have begun to tackle this process, click here.

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  1. […] On October 9th, Health Policy News held the second event in our 2018 Fall Webinar Series. This webinar featured a round table discussion on the history of public options, and the various design and programmatic options available to states crafting such programs. The HPN team was joined by a buy-in expert from the PCG Health team, Ms. Lisa Lee, formerly Kentucky Medicaid Commissioner and CHIP Director. Ms. Lee brought decades of on-the-ground expertise to the round table discussion, and offered key insights and lessons learned to attendees. The webinar summarized and updated information included in HPN report released this past summer entitled “Revisiting the Public Option- Medicaid Buy-Ins”. […]


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