Category: Health Policy News

Health Policy News – May 2020

The much-anticipated final Payment Notice and Letter to Issuers in the Federally-facilitated Marketplaces was released early this month, with states’ concerns about the impact of COVID-19 evident in many of the finalized policy changes. The first post this month details the Centers for Medicare and Medicaid Services’ (CMS) final changes and includes an updated fact ...

The Federal Administration Continues to Release Guidance and Waivers in Response to the COVID-19 Pandemic

Health Policy News continues tracking federal-level action aimed at addressing the broad impact of the COVID-19 pandemic with a focus on actions to support states and providers in their efforts to respond to the pandemic and its impact. As in our March and April articles, this post aggregates the latest updates from the federal level, ...

Health Policy News – April 2020

Last month, Health Policy News brought you breaking news about the legislation and guidance aimed at providing greater flexibility to states and providers as they struggle to meet health and service demands during this global pandemic; requirements relative to COVID-19-related health coverage; and examples of action at the state level to address local need. As ...

Health Policy News – March 2020 Special Edition

  Introduction Health Policy News had planned content for the month of March, but given the unprecedented times we are all living through, we thought it best to dedicate this month’s entire edition to recent federal and state efforts to support consumers, providers, and health insurance carriers in combating COVID-19. Just in the past week, ...

Health Policy News – February 2020

Introduction On January 31, 2020, the Centers for Medicare and Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters (NBPP) and the draft Letter to Issuers in the Federally-facilitated Exchanges, as well as accompanying guidance and timelines. The March 2nd deadline for comment on the proposed policy changes included in the annual ...

Health Policy News – January 2020

Introduction Happy 2020 Health Policy News readers! We hope you all had an enjoyable and relaxing holiday season. As we continue to await the proposed Marketplace guidance for 2021, we wanted to take this opportunity to share recent health policy developments from the federal and state levels. In breaking news, our first article includes our ...

UPDATED: Centers for Medicare and Medicaid Services releases Long-Awaited Block Grant Guidance

2/7/2020 Update: Click here for a detailed analysis of the Healthy Adult Opportunity (HAO) guidance (SMDL 20-001) from PCG’s Health Policy News subject matter experts. The Centers for Medicare and Medicaid Services (CMS) released its long-awaited guidance promoting block grant waivers – being referred to as the Healthy Adult Opportunity (HAO) – yesterday. As expected, under guidance, in exchange for funding limited to an ...

Chronic Care Alternative for Marketplace Enrollees: State Complex Care Plan

Over the past four years, thirteen states have received approval to implement State Innovation Waivers (renamed “State Relief and Empowerment Waivers” by CMS in October 2018) under the authority of Section 1332 of the Affordable Care Act. Twelve of those states (all except Hawaii) leveraged Section 1332 to implement reinsurance programs aimed at reducing premiums. ...

California’s Innovative Approach to Address Rising Pharmaceutical Costs

Addressing rising prescription drug costs has been a top priority for California Governor Gavin Newsom’s administration. Health Policy News reported early in his term about the Governor’s Executive Order that authorized the state’s Department of Health Care Services to negotiate prescription drug prices for the state’s Medicaid program. Governor Newsom’s efforts continued into 2020 with ...

Public Comment Period on Draft Transparency in Coverage Rule Extended Until January 29th

The draft Transparency in Coverage rule was developed by the Departments of Treasury, Labor and Health and Human Services (hereinafter “the Departments’) and published on November 27, 2019.  This rule was developed in response to the President’s Executive Order on Improving Price and Quality Transparency. The proposed rule applies to group plans and health insurance ...