HHS

CMS Supports Modernizing Enrollment on State-Based Exchanges

by Kelsey Waddill

CMS is offering $20 million in grants to states in order to update their state-based exchanges in light of the spike in Affordable Care Act marketplace enrollment. “Our State-based Marketplaces...

Experts Consider Impacts of SCOTUS Affordable Care Act Decision

by Kelsey Waddill

Since the Supreme Court dismissed California v Texas on June 17, payers and healthcare leaders have vocalized their support for the decision, their readiness to continue building on the Affordable Care...

HHS Expands Interpretation of Sex Discrimination in Section 1557

by Kelsey Waddill

Updated 5/11/2021: This article has been updated to include a statement from David Brown, legal director at TLDEF. HHS has announced that it will enforce its interpretation of the Affordable...

HHS: ACA Premiums Drop 25% for New Enrollees on HealthCare.gov

by Kelsey Waddill

HHS announced that the federal health insurance market, HealthCare.gov, has gained nearly 940,000 new enrollees as a result of the Affordable Care Act premium tax credits and the special enrollment...

CMS Finalizes Second 2022 Payment Notice with Cost-Sharing Limits

by Kelsey Waddill

The second 2022 Notice of Benefit and Payment Parameters final rule (“2022 payment notice”) finalized changes that made cost-sharing limits $400 lower than what CMS had proposed in...

HHS, 23 Orgs Boost ACA Enrollment Outreach in Black Communities

by Kelsey Waddill

The US Department of Health and Human Services (HHS) is redoubling its Affordable Care Act enrollment outreach efforts in order to increase awareness in the Black community about coverage options...

5 States With Highest SEP Enrollment Rejected Medicaid Expansion

by Kelsey Waddill

CMS has released special enrollment period enrollment levels data, which has seen more than 500,000 new enrollees and will last another four months. “Access to quality, affordable health care is...

HHS Will Spend $50M on Outreach for Special Enrollment Period

by Kelsey Waddill

The US Department of Health and Human Services (HHS) and CMS announced that the Biden Administration would spend $50 million to advertise the special enrollment period. “We’re...

Biden Administration Extends Federal Special Enrollment Period

by Kelsey Waddill

The Biden administration has extended the federal special enrollment period on the Affordable Care Act marketplace until August 15, US Department of Health and Human Services...

NC Medicaid Program Audit Reveals Improper Medicaid Payments

by Kelsey Waddill

An audit of North Carolina’s Department of Health and Human Services (DHHS) revealed that the department failed to properly conduct Medicaid provider credentials verifications and other key...

DOJ Supports the Affordable Care Act in Supreme Court Case

by Kelsey Waddill

The Department of Justice has backed down from its opposition to the Affordable Care Act, a letter from the Department of Justice to the Supreme Court announced. “Following the change in...

Downstream Impacts of Recent Surprise Billing Law Remain Uncertain

by Kelsey Waddill

The impacts related to the No Surprises Act—which Congress included in the Consolidated Appropriations Act in order to address surprise billing—remain unclear, a Kaiser Family Foundation...

Medicaid Expansion Helped Detect Undiagnosed HIV Infections

by Hannah Nelson

Medicaid expansion under the Affordable Care Act (ACA) led to increases in the identification of undiagnosed HIV infections and the use of HIV prevention services, according to new research out of the...

Surprise Billing Law Covers Contract Disputes, Price Transparency

by Kelsey Waddill

Congress has passed a new law that seeks to eliminate surprise billing, particularly surprise bills that result from contract disputes, inaccurate provider directories, and air ambulatory...

How 3 Major Payers Extended Temporary COVID-19 Benefits into 2021

by Kelsey Waddill

Update 1/12/2021: This article has been updated to reflect that the public health emergency was extended to January 21, 2021. In a previous version, some sentences said that the public health...

CMS Finalizes ACA Risk Adjustment, Error Rate Calculation Changes

by Kelsey Waddill

CMS has issued a final rule to regulate the Affordable Care Act risk adjustment data validation program. The risk adjustment data validation program, run by HHS, certifies the integrity of data that...

What the New Rebate Rule Means for Medicare Part D Plans, MCOs

by Kelsey Waddill

The Department of Health and Human Services has released its finalized rebate rule which changes safe harbors around prescription drug pricing, impacting Medicare Part D plans and certain Medicaid...

5 Challenges, 5 Policy Solutions for the Medicare Enrollment Process

by Kelsey Waddill

Beneficiaries suffer from chronic confusion over Medicare enrollment but policymakers can take action to streamline the process and improve beneficiary experience, Better Medicare Alliance asserted in...

Overview of Federal Policy Around Pre-Existing Conditions Coverage

by Kelsey Waddill

Update 11/5/2020: This article has been corrected to state that the Supreme Court will hear the oral arguments regarding the Affordable Care Act’s constitutionality on November 10, 2020. A...

What Happens When Medicaid COVID-19 Flexibilities, Funding Expire?

by Kelsey Waddill

Temporary Medicaid coronavirus flexibilities and funding may be about to expire and CMS needs to be clearer about transition guidelines in order to help states be prepared, Kaiser Family Foundation...