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Policy and Regulation News

GOP Leaders Unveil Proposed ACA Repeal, Replacement Plans

February 20, 2017 - GOP leaders have unveiled their latest proposal to repeal and replace the Affordable Care Act with new health insurance regulations. The outline includes cutting federal Medicaid expansion, moving more Medicaid control to the states, and restructuring how Americans pay for their health insurance.   “Republicans want to put states in charge of their Medicaid programs and give them...


Articles

CMS Proposes New Rule to Stabilize Health Insurance Exchanges

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CMS recently announced a proposed rule designed to help stabilize health insurance exchanges by promoting more coverage options and improving the risk pool for insurers. The proposed rule comes just one day after Humana publicized its decision...

Payers with Larger Market Share Have More Negotiating Power

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Payers that dominate the local market are able to negotiate lower physician office visit prices than their smaller peers, found investigators from Harvard Medical School. Health insurance companies with 15 percent or more of the market share...

Medicaid Expansion Boosts Coverage, Quality at Health Centers

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Federally funded health centers in states that underwent Medicaid expansion through the Affordable Care Act faced higher levels of insured patients and improved care quality compared to their peers in non-expansion states, a recent Health Affairs...

Proposed ACA Replacement Moves Coverage Choices to the States

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Several Republican lawmakers have introduced the “Patient Freedom Act” as a proposed replacement of the Affordable Care Act, emphasizing state authority and local decision-making in the health insurance market. Senators Bill Cassidy,...

Congress Votes to Nominate Tom Price as HHS Secretary

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On February 1, House Representative Tom Price, R-Ga., was officially nominated as the Secretary for the Department of Health & Human Services (HHS), according to the US News & World Report. The Senate Finance Committee moved forward with...

74% of PCPs Prefer Affordable Care Act Changes Over Repeal

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Only about 15 percent of primary care providers favored a complete repeal of the Affordable Care Act, a recent New England Journal of Medicine study stated. While some of the 426 primary care providers surveyed between December 2016 and January...

84% of Physicians Unsure of Quality Payment Program Conditions

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As many as 84 percent of polled independent physicians and medical staff are unaware of how to meet the requirements of MACRA’s Quality Payment Program, according to a survey from Kareo. The majority of surveyed physicians, however,...

20% of Surveyed Physicians Familiar with MACRA Regulations

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No more than 20.6 percent of primary care physicians and 19.5 percent of specialists are “very or somewhat familiar” with MACRA regulations, according to a survey completed in 2016 by Merritt Hawkins for The Physicians Foundation....

Top 3 Health Insurance Industry Headlines of December 2016

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Now that the final month of the year is wrapping up and everyone is planning their New Year’s celebrations, a review of the most popular headlines for the health insurance industry may be beneficial as we head into 2017. Patients Need More...

6.4 Million Enrollees Sign Up on Affordable Care Act Exchanges

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As of December 21, a total of 6.4 million consumers have enrolled in health plans through the Affordable Care Act exchanges on HealthCare.gov, reported the Centers for Medicare & Medicaid Services (CMS) in a fact sheet. The number of enrollees...

ACA Health Insurance Exchanges Bring Challenges for 2017

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The Affordable Care Act (ACA) health insurance exchanges will have some key differences next year. Health insurance companies have faced various obstacles when selling health plans through the exchanges. These challenges include a higher risk...

Senate, House of Representatives Pass 21st Century Cures Act

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This week, Congress passed the 21st Century Cures Act. President Obama signed the legislation into law on Tuesday, December 13. The 21st Century Cures Act passed with bipartisan support 94-5 in the Senate and 392-26 in the House of Representatives....

Premier Offers Healthcare Policy Improvements for ACOs, Payers

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Earlier this year, the provider alliance organization Premier Inc. announced in a company press release a number of recommendations meant to improve the framework of healthcare policy. The key points meant to improve the creation of healthcare...

How the 21st Century Cures Act will Impact Healthcare Payers

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Last week, the House of Representatives passed the 21st Century Cures Act by 392-26 votes. The 21st Century Cures Act affects the health insurance market through a provision that establishes small business health reimbursement arrangements (HRAs),...

Affordable Care Act Replacement Seeks Automatic Enrollment

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Since the Presidential election of Donald J. Trump, a number of differing viewpoints came out emphasizing how the Patient Protection and Affordable Care Act will be impacted. For the last several years, the Republican Party has attempted to repeal...

How to Fix Obama’s Affordable Care Act Without a Repeal

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Now that a new President and a Republican-controlled Congress has been elected, what does the future for healthcare reform and the Affordable Care Act (ACA) look like? What will happen to the Affordable Care Act cannot be answered simply since...

AMA Pledges to Prevent Loss of Americans’ Healthcare Coverage

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The American Medical Association (AMA) released a statement yesterday reaffirming its commitment to ensuring that every American who currently has healthcare coverage will continue to have insurance and access to medical care. In particular,...

House Speaker Paul Ryan Proposes a Privatized Medicare System

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House Speaker Paul Ryan announced in an interview with Fox News Channel several days after the presidential election that the Republican-controlled Congress and White House will look to create a privatized Medicare system and cut funding from...

How MACRA Requirements Impact Accountable Care Organizations

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MACRA legislation impacts a number of healthcare providers and entities including accountable care organizations (ACOs). Only a few Medicare accountable care organizations will actually be able to participate in Advanced Alternative Payment Models...

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