Tag: CMS

Health Policy News – May 2019

Introduction This month, we are launching a new series of articles about alternative approaches to healthcare delivery—with a focus in this edition on approaches targeting social determinants of health, specifically nutrition, via health coverage. Stay tuned for an upcoming white paper that will include a review of Accountable Care models in a number of states, ...

Eat Your Veggies!

How do we increase the promotion of produce prescriptions in the never-ending quest to implement and integrate social determinants of health? As of 2010, diet has surpassed smoking as the leading cause of death for Americans—which translates to hundreds of billions of dollars being spent to combat diseases stemming from poor health and diet. Data ...

Health Policy News – April 2019

Introduction In this month’s edition of Health Policy News, we delve into two of last month’s breaking Federal litigation updates: the decisions issued in cases regarding the Association Health Plan Final Rule and the use and operationalization of Medicaid work requirements. As both decisions reverse course on recent health policy developments, we analyze their likely ...

CMS Releases the Final 2020 Exchange Guidance

The Centers for Medicare & Medicaid Services (CMS) released final annual Exchange guidance for 2020 on April 18, 2019, via the Final Notice of Benefit and Payment Parameters for 2020 (NBPP) and the 2020 Letter to Issuers in the Federally-facilitated Exchanges (Letter) as well as ancillary guidance. CMS’s stated goals for this year’s guidance are: ...

Work Requirement Waiver Approvals Vacated in Kentucky and Arkansas

On March 27, 2019,  Judge James Boasberg of the United States District Court for the District of Columbia issued rulings on back-to-back cases addressing work requirement eligibility criteria included in Section 1115 waiver applications submitted by the states of Arkansas and Kentucky. Judge Boasberg again ruled against the implementation of a Medicaid work requirement in Kentucky, while ...

Health Policy News – February 2019

Introduction While 2019 started slowly under the Federal shutdown, its pace of action has significantly quickened. We bring you a range of health policy updates in this edition of Health Policy News. With the comment period closed for the annual Exchange guidance, states await final guidance for 2020 related to the certification and oversight of ...

Health Policy News Hosts Webinar on Annual Exchange Guidance

On February 7, 2019, the Health Policy News team hosted a webinar highlighting the proposed changes outlined in the Centers for Medicare and Medicaid Services’ (CMS) long-awaited annual Exchange guidance (proposed Notice of Benefit and Payment Parameters for 2020 and the 2020 Draft Letter to Issuers in the Federally-facilitated Exchanges) released on January 17, 2019. ...

Health Policy News – January 2019

 Introduction As readers are likely aware, the Centers for Medicare and Medicaid Services’ (CMS) long-awaited annual Exchange guidance was released on January 17, 2019, and, as in past years, PCG subject matter experts have prepared a summary of notable changes to assist states in parsing through this voluminous guidance. In addition to the summary, PCG ...

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 ...

2018 Retrospective & Looking Forward to 2019

This past year brought increased flexibility for states related to both public health care programs and commercial health plans, with the Federal administration announcing numerous policies to give states more control over the design / regulation of the coverage offered to consumers. We saw first-of-their-kind waivers approved at the Federal level, including community engagement / ...