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Policy and Regulation News

PA Seeks Increased Payer Coverage of Emergency Air Ambulances

April 25, 2017 - Emergency air ambulances save lives, but they can also leave patients in a mountain of debt.  Pennsylvania Insurance Commissioner Teresa Miller would like payers to shoulder more of the costs of these critical services, and has accordingly voiced her support for proposed federal legislation that would increase transparency and regulate coverage of emergency air transportation. The proposed...


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Senator Calls for Scrutiny of Health Payers, Medicare Fraud

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Senator Chuck Grassley (R-Iowa) is asking federal officials to investigate charges that Medicare Advantage plans were overcharged by health payers. In a letter to CMS Acting Administrator Seema Verma, Grassely cited an improper...

Affordable Care Act Cuts Uninsured Rate by 6.4% Since 2013

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From 2013 to the end of 2016, the percentage of individuals without health insurance dropped across the nation, according to a recent Gallup-Healthways study. The national percentage of those without health insurance went from 17.3 percent in...

Payer Groups Urge Congress to Keep ACA Cost Sharing Reductions

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In a recent letter to the President and leading members of Congress, insurance payer groups and the nation’s largest provider organizations detailed their case to retain the cost sharing reductions (CSR) provision in the ACA.  Payers...

NY Senate Considers Proposal for Single Payer Healthcare

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Since the future of the Affordable Care Act (ACA) remains unclear, and GOP plans to repeal and replace have stalled, states are taking the lead in finding solutions to the rising costs of health care.  New York has joined California as the...

CMS Issues ACA Health Insurance Exchange Stabilization Rule

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CMS  issued the final version of the 2018 Market Stabilization rule for the Affordable Care Act (ACA) health insurance exchange.   The rule focuses on stabilizing the individual and small group health insurance markets while lowering...

Healthcare Payers Seek Passage of Bill to Lower Drug Costs

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The recently introduced the Fair Access for Safe and Timely (FAST) Generics Act seeks to reduce the timeline of bringing generic prescriptions to market and enjoys the support of healthcare payers. The philosophy behind the bipartisan bill is...

OK Legislature Keeps Interstate Health Insurance Bill Viable

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A bill that would allow interstate health insurance options for Oklahoma residents is still on the table following a House committee vote. Senate Bill 478, or the Health Care Choice Act, would authorize Oklahoma’s Insurance Commissioner...

Proposed MA State Budget Targets Medicaid Program Funding

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The Massachusetts House of Ways and Means Committee approved a state budget for fiscal year (FY) 2018 that funds MassHealth, the state’s Medicaid program, through new tax revenues. The committee budget follows the one proposed by Governor...

House GOP Renewing Interest in American Health Care Act

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House Republicans are attempting to keep the American Health Care Act (AHCA) viable by adding a new amendment to the bill prior to Congress taking its spring recess. GOP lawmakers submitted an amendment to the House of Ways and Means Committee...

House Committee Passes Bill with Healthcare Merger Implications

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The House Judiciary Committee has voted 16-10 in favor of a bill that would revise and standardize part of the process of reviewing mergers for potential antitrust violations.   The Standard Merger and Acquisition Reviews Through Equal Rules...

AHA Condemns CMS Rule for Medicaid Third-Party DSH Payments

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The American Hospital Association expressed “deep disappointment” about a CMS final rule that will only include uncompensated care costs for covered Medicaid services in the calculation of hospital-specific DSH limits.   The...

California Legislature to Review Single-Payer Healthcare Bill

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California lawmakers have introduced  a single-payer healthcare bill that would provide all Californians comprehensive coverage with minimal out-of-pocket costs. The State Senate will review SB 562, or “The Healthy California Act,”...

Kansas Lawmakers Vote for Medicaid Expansion Under the ACA

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UPDATE: Kansas Governor Sam Brownback has vetoed the legislation, calling Medicaid expansion "irresponsible and unsustainable." Kansas state lawmakers in the House and Senate have voted to approve Medicaid expansion under the Affordable...

GAO Report: VA Benefits Appeals Process in Need of Reform

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The Government Accountability Office (GAO) has identified notable inefficiencies in the VA benefits appeals process which have resulted in an average processing wait time of three years.   In its report on the issue, GAO also makes several...

House Votes to Boost Health Insurance Options for Businesses

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The House of Representatives has voted 236-175 to move the Small Business Health Fairness Act of 2017 to the Senate in an effort to increase health insurance options for small businesses. The Act is designed to promote the growth of Association...

House GOP Leaders Pull American Health Care Act Before Vote

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Before it could reach the House of Representatives for a vote, Republican party leaders pulled the American Health Care Act (AHCA). Because lawmakers could not agree on the structure or substance of the conservative healthcare framework, the...

House Reps Add Amendments to the American Health Care Act

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House Republicans recently added 21 pages of  updates and changes to the American Health Care Act (AHCA) to push forward the potential Affordable Care Act (ACA) repeal and replace bill. Many of the legislation’s changes would make...

HHS Launches Webpage Detailing ACA Repeal Actions

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HHS created a new online resource that highlights the regulatory and administrative actions the federal department has taken for an Affordable Care Act (ACA) repeal. HHS believes that these actions are necessary to relieve burdens of the...

2017 ACA Open Enrollment Data Shows 12.2M Marketplace Signups

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During the 2017 ACA Open Enrollment Period (OEP), more than 12.2 million healthcare consumers purchased or renewed insurance through Healthcare.gov or their local state exchanges, said CMS in a new data brief.   Marketplace consumers either...

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