Category: Private Insurance

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, ...

Payment Notice and Letter to Issuers in the Federally-facilitated Marketplaces Finalized for the 2021 Plan Year  

With filing deadlines quickly approaching, the Centers for Medicare and Medicaid Services (CMS) released final versions of the Notice of Benefit and Payment Parameters (NBPP) for 2021 and the 2021 Letter to Issuers in the Federally-facilitated Exchanges (Letter) on May 7, 2020. At the same time, CMS released accompanying guidance: Key Dates for Calendar Year ...

Updates on the State-Level Responses to COVID-19

As the U.S. continues battling the COVID-19 pandemic, individual states have enacted policy mandates and taken action to ensure patients have access to medication, healthcare, and COVID-19 testing and treatment—while minimizing barriers to these resources and/or the pre-approval needed to access them. With social distancing and the stay-at-home order still in effect, a nationwide focus ...

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 Responses to COVID-19

In this unprecedented time, much attention has been paid to Congressional response to the clinical and economic needs resulting from the COVID-19 pandemic. At the same time, Congress, the Centers for Medicare and Medicaid Services (CMS) and other federal agencies have actively put forth legislation and guidance aimed at providing greater flexibility to states and ...

Comments on 2021 Proposed Payment Notice and Draft Letter to Issuers in the FFM Due March 2nd

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 (hereafter “the Letter”)[1] as well as accompanying guidance and timelines.[2] CMS is accepting comments on these items through 5pm on March 2, 2020. ...

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 ...

Bipartisan Federal Surprise Billing Legislation Likely to Pass

Although it has been discussed and debated at the federal level for years, viable bi-partisan surprise billing legislation had not been proposed until recently, in the form of the No Surprises Act (“the Act”). It seems likely that the current federal legislation will pass soon, which would be a first step towards a nationwide approach ...

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 ...

Federal Departments Finalize Rule to Expand Access to Short Term Health Plans that are not ACA-Compliant

On August 1, 2018, the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (together, “the Departments”) jointly promulgated a final rule on Short-Term Limited-Duration Insurance (“final rule”). The final rule further amends the proposed rule released in February and seeks to carry out the directions given in ...