Tavenner answers Senate Finance Committee Questions

Posted on April 25, 2013 | No Public Comments

On April 9th, the Senate Finance Committee held a confirmation hearing for Marilyn Tavenner to be the Administrator of the Centers for Medicare and Medicaid Services (CMS). Committee members submitted additional questions to Tavenner post-hearing on topics ranging from consumer outreach in state insurance Exchanges to pediatric dental services. Health Reform GPS has compiled a list of the Affordable Care Act related questions submitted by the Senate Finance Committee members. The list contains the name of the Senator asking the question, the question number, and the relevant ACA topic addressed.

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CAHI counts number of state-mandated health benefits

Posted on April 25, 2013 | No Public Comments

A study released by the Council for Affordable Health Insurance (CAHI) found that in 2012, there were 2,271 state insurance laws on the books. According to CAHI, Rhode Island had the most state-mandated insurance laws at 69, with Idaho having the fewest at 13. CAHI found that the national number of state insurance mandates has grown over 167% in the last 20 years, and this increase in noted as being a contributor to the rising costs of health care.

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EBSA posts FAQs on summaries of benefits and coverage

Posted on April 25, 2013 | No Public Comments

The US Department of Labor Employee Benefits Security Administration (EBSA) published their 14th set of frequently asked questions regarding the implementation of the Affordable Care Act (ACA). One key topic covered by the FAQs addresses disclosure requirements for individual or group plan summary of benefits coverage (SBC). In regards to disclosure of minimum essential coverage and the attainment of minimum value requirements, the guidance does not make notable changes for the SBC during 2014, the second disclosure year. The FAQs also state that plans unable to alter their SBC for 2014 are permitted to use the authorized year template without penalty if they also provide a cover letter stating whether or not the minimum value requirements are met.

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HHS enhances CLAS standards

Posted on April 24, 2013 | No Public Comments

The US Department of Health and Human Services (HHS) Office of Minority Health released enhanced standards on Culturally and Linguistically Appropriate Services (CLAS) in health care settings. There are many determinants that inhibit the achievement of health equity, and the implementation of CLAS is one mechanism by which disparities can begin to be whittled away. Building upon the original 2000 standards, National Standards for Culturally and Linguistically Appropriate Standards in Health and Health Care: A Blueprint for Advancing and Sustaining CLAS Policy and Practice is designed to provide an organization with the information and tools necessary to mitigate health care disparities and achieve health equity by using CLAS. The enhanced standards aim to improve health equality within health care settings by addressing the categories of (1) governance, leadership, and workforce, (2) communication and language assistance, and (3) engagement, continuous improvement, and accountability.

A synopsis of the enhanced CLAS standards is also available.

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Implementation Brief Navigators and Application Counseling and Assistance

Posted on April 24, 2013 | No Public Comments

The ACA (§§1311(d) and (i)) and implementing regulations (45 C.F.R. §155.210) require that all Exchanges establish Navigator programs to provide fair, accurate and impartial information regarding health insurance coverage across Exchanges and state Medicaid and CHIP programs. Navigators also facilitate selection of QHPs and provide referrals for consumers with questions, complaints, or grievances to other consumer assistance and ombudsman programs. The Navigator program requirement applies regardless of whether the Exchange is operated by a state government or by the federal government (known as a “federally-facilitated Exchange”), either with or without a state Consumer Assistance Partnership…

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MD releases proposed Exchange rate filings

Posted on April 23, 2013 | No Public Comments

The Maryland Insurance Administration released proposed rate filings for plans that will be available in the individual and small group markets at the onset of their health insurance Exchange. After examining the proposed rates and the insurance company’s justification for those rates, consumers have the opportunity to submit a public comment within the 30-day review period.

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CMS to launch payment disclosure website

Posted on April 23, 2013 | No Public Comments

By the end of September 2014, the Centers for Medicare and Medicaid Services (CMS) will launch a new website that publishes payments made to physicians and teaching hospitals by drug and device manufacturers. The website, OPEN PAYMENTS, is a product of the National Physician Payment Transparency Program required by Section 6002 of the Affordable Care Act (ACA). OPEN PAYMENTS will not only collect and aggregate data regarding potential conflicts of interests between manufacturers and providers, but it will also allow providers to access their data prior to public posting and enable them to address any data disputes.

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CMS releases Exchange outreach timeline

Posted on April 22, 2013 | No Public Comments

In response to concerns expressed by the US Senate regarding the slow outreach efforts for the Exchanges, the Centers for Medicare and Medicaid Services (CMS) released the “Consumer Outreach Timeline.” This succinct outline divides the outreach and education efforts into 4 phases: Preparation, Basic Education, Anticipation and Act Now. CMS is currently in the Preparation and Basic Education phases, which includes the continued development of infrastructure and raising awareness amongst consumers and stakeholders.

A narrative version of the timeline has also been released by the Center for Consumer Information and Insurance Oversight.

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New Kaiser analysis predicts rise in health care costs

Posted on April 22, 2013 | No Public Comments

The Henry J. Kaiser Family Foundation (KFF) is out with a new study today that predicts a rise in health care costs. The analysis concludes that by 2019, health care costs will likely grow at a percentage closer to the national historic average, which is above 7%, compared to the 3.9% increase observed in 2009 – 2011. The authors found that the recent lag in health care cost growth was a result of the economic downturn, and pending recovery will likely coincide with increasing health care costs. The study did state that growth may be mitigated by the health care delivery-system reform attributable to the Affordable Care Act (ACA), but the most promising predictor of health care costs remains to be the country’s economic status.

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HHS releases BHP timeline

Posted on April 19, 2013 | No Public Comments

The US Department of Health and Human Services (HHS) provided a timeline for the installation of the Basic Health Program (BHP) to Senator Maria Cantwell (D-WA), a champion of the model. Pursuant to Section 1331 of the Affordable Care Act (ACA), the BHP was intended to serve as a special state insurance option for low-income families and individuals, yet no deadline for HHS to create the BHP was stated in the statute. The timeline details key implementation events from now until January 1, 2015, the time at which the BHP is scheduled to become operational.

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