All posts by Lisa Kaplan Howe

Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News. Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.

Recent Developments in State Health Policy

This month, we’re sharing important developments in two state health policy efforts we covered previously: state efforts to advance a public option (with major developments coming out of the state of Washington) and Tennessee’s pursuit of a Medicaid Block Grant. Read on for more information about how recently-passed legislation in these states has advanced major ...

New Guidance on Association Health Plans

The standards for Association Health Plans (AHPs) continue to be in flux at the Federal level following the Federal District Court ruling at the end of March that invalidated major portions of last summer’s final Federal rule on AHPs. Since the final rule was already in effect for fully insured AHPs and existing self-insured AHPs, ...

Court Ruling Invalidates Major Provisions of the New Association Health Plan Regulations

On March 28, 2019, Judge John D. Bates of the Federal District Court for the District of Columbia issued a ruling invalidating major provisions of last summer’s final rule on Association Health Plans (AHPs). The regulations—which were released by the U.S. Department of Labor (DOL) on June 19, 2018—established additional and more flexible criteria under ...

Newly-Elected Governors Set Their Sights on Healthcare Reforms

The new year brought changes to state leadership across the nation, with 19 governors newly entering the corner office—seven of whom took over from an administration on the other end of the political spectrum. This refresh has brought a surge of new ideas and energy in the realm of state health policy. Below, we highlight

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 ...

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 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 ...

A Preliminary Decision in the Newest Lawsuit Challenging the Affordable Care Act

On December 14th, a decision was published in the Texas v. U.S. case that challenged the validity of the Affordable Care Act (ACA). The case – which was brought by 20 states (“plaintiff states”) and later joined by two individual plaintiffs – contends that the “zeroing out” of the shared responsibility penalty through the 2017 ...

CMS Proposes Changes to the Regulations Governing Medicaid and CHIP Managed Care

On November 14, 2018, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule making changes to the Medicaid and Children’s Health Insurance Program (CHIP) Managed Care regulations. CMS had notified states in March 2017 that it was doing a thorough review of Medicaid and CHIP Managed Care regulations, which were last overhauled ...

States Respond to Recent Federal Regulations

States across the country have spent the past few months reviewing and considering two significant rules promulgated at the Federal level over the summer: the final rule on Association Health Plans (AHPs) issued by the Department of Labor in June, and the final rule on Short Term Limited Duration Insurance (STLDI) issued by the Departments ...