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. ...

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 ...

Health Policy News – December 2019

Health Policy News is once again dedicating our December edition to reflecting on the past year’s high-profile healthcare topics—providing context, summarizing recent developments, and predicting what activity is in store for these issues in the coming year. HPN editors Lisa Kaplan Howe and Margot Thistle have dedicated this edition to reflect on 2019 and forecast ...

2020 Prediction: Continued Focus on Ensuring Access to Healthcare, Prescription Drugs, and Healthy Food to Combat Diet-Related Illness

Over the past year, Health Policy News readers were drawn to topics that were top of mind for many policymakers, as well as articles that detailed innovative solutions to complex problems like controlling health costs and expanding access to healthcare. As 2019 comes to a close, this piece revisits these popular topics, providing updates on ...

2020 Prediction: More State Waivers and Activity Related to Major Health Policy Litigation and Federal Regulations

Many major health policy developments in 2019 were related to state waivers, major health policy litigation, and federal health insurance regulations, with activity on these issues expected to continue into 2020. One of these developments—this week’s new ruling in the Texas vs United States case challenging the validity of the Affordable Care Act (ACA)—is certain ...

Health Policy News – November 2019

Introduction We hope many of you were able to join us for our second annual Fall Health Policy Webinar, which focused on innovative approaches to state Accountable Care Organization (ACO) Programs. If you were unable to attend (or would simply like to review Health Policy News’ report, tracking tool, and presentation materials), we have provided ...

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