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.

Tennessee Releases Its Block Grant Plan

This month, Tennessee continued its pursuit of a Medicaid block grant, unveiling its draft Medicaid waiver amendment application on September 17th. Underpinning Tennessee’s months-long exploration of this model is the current federal administration’s interest in supporting these types of proposals—with implementation guidance expected to be released, but still under review, by the Office of Management ...

Legislation aimed at Health Care Costs Advances in Congress

Unlike many topics under discussion in Congress this year, the issue of health care costs is a priority across party lines. With bills pending in both the U.S. House of Representatives and U.S. Senate, and a recent executive order issued on the topic, we have broken down the details on the latest cost control developments ...

The House Passes Legislation Aimed at Preserving the Affordable Care Act

Notable among the bills passed by the U.S. House of Representatives in recent months are two bills aimed at shoring up the Affordable Care Act (ACA). Below, we explore the content of both bills—though it is worth noting that neither bill has been, nor is expected to be, taken up by the Senate. H.R. 987 ...

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 ...

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 ...