Tag: Medicare

Health Policy News – September 2019

Introduction Since publishing our summer edition, the Health Policy News team has attended various conferences. We were thrilled to see many subscribers in person at the National Conference of State Legislatures Legislative Summit, as well as the National Academy of State Health Policy annual conference. In this edition, we share our insights (and relevant fact ...

CMS Issues New Regulations to Enhance Program Integrity

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), published a final rule in the September 10, 2019 Federal Register to implement program integrity enhancements to the provider enrollment process under Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).  The CMS rule will be effective November 4, ...

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 ...

Hearings Begin on “Medicare for All” Legislation

On June 12, 2019, the U.S. House of Representatives’ Ways and Means Committee conducted its initial hearings on H.R. 1384, the Medicare for All Act of 2019. Introduced by U.S. Representative Pramila Jayapal (D-WA) in February, H.R. 1384 would: Provide health coverage for all U.S. residents. Authorize automatic enrollment upon birth or establishment of U.S. ...

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 ...

2019 Brings Progress on Prescription Drug Cost Control Efforts at State and Federal Level

As states and the federal government grapple with how best to address the issue of rising prescription drug costs, various models have emerged at the federal level that are similar to efforts underway at the State level. The Administration has called upon states to create innovative approaches to state Medicaid programs, particularly by examining value-based ...

Health Policy News December Edition

Introduction As in years past, the primary focus of the December edition is highlighting some of the important topics we wrote about in 2018, while also foreshadowing policy trends that we believe will be of particular importance to states in 2019. Before many of you take a break to spend time with family and friends, ...

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 ...

CMS finalizes rules on episode payment models

On January 3, 2017, the Centers for Medicare and Medicaid Services (CMS) published final rules on new Medicare episode payment models (EPMs) to be implemented on July 1, 2017. The EPMs are designed to encourage participating hospitals to devise strategies to improve discharge planning, adherence to treatment and medication regimens, and coordination among all providers ...

CMS announces the release of $22 Million in Health Insurance Enforcement and Consumer Protections grant funding

On June 15, 2016, the Centers for Medicare and Medicaid (CMS) announced the release of $22 million in grant funding for State planning and implementing of the health insurance market reform provisions of the Affordable Care Act (ACA). The grants are aimed at helping States ensure their laws, regulations and procedures are in line with ...