Category: All Posts

Association Health Plans: Final Rule Fact Sheet

Background: On June 19, 2018, the Department of Labor (DOL) issued a final rule on Association Health Plans (AHPs), which culminated a nine-month effort by the Federal administration to expand access to such plans. The Federal activity began on October 12, 2017 with the President’s signing of Executive Order 13813 “Promoting Healthcare Choice and Competition ...

Looking to the Future of Workers’ Compensation

Several members of the PCG Health team recently attended the Workers Compensation Research Institute’s Annual Issues & Research Conference in Boston. The conference convenes researchers, regulators, and other workers’ compensation professionals from around the country to discuss trends they are seeing within the industry. Below we share a couple of highlights from this year’s conference, ...

Movement on drug cost containment at both the state and federal level

Health Policy News has devoted significant attention to State and Federal efforts to contain drug costs, including recently issuing a report and legislative tracking tool entitled “ Rising Prescription Drug Costs: A report on state and federal efforts to contain costs”. As we head into the summer we offer readers a few short updates on ...

States Pursue Unique Approaches to Permit Non-Compliant Health Plans

While much of the attention over the debate over the Affordable Care Act (ACA) has centered at the Federal level, states continue to act as the laboratories for innovation. Last year Health Policy News featured a series of updates on activity around Section 1332 State Innovation Waivers in the states – with a focus primarily ...

Health Policy News May 2018

In this edition of Health Policy News, we continue our series of updates on state innovation in health policy. In follow-up to last year’s series on 1332 State Innovation Waivers, this year we have focused on other ideas and efforts percolating across the country and aimed at strengthening health insurance markets and expanding access to ...

Health Policy News April 2018

After months of uncertainty and waiting, guidance on various regulatory and policy changes have been issued this month by the federal administration. While we still await final guidance on association health plans and short term limited duration plans, the Centers for Medicare & Medicaid Services (CMS) has released the final Benefit and Payment Parameters, and ...

Mitigating the Loss of the Individual Mandate: State Based Health Insurance Mandates

In December 2017, the federal administration’s tax bill – the Tax Cuts and Jobs Act, phased out the individual mandate requirements, with the penalty for failing to have qualified insurance eliminated starting in 2019. For 2018, the mandate remains, with the penalty set at $695 per adult or 2.5% of household income, whichever is higher.  ...

CMS Proposes Changes to Rules related to Medicaid Access to Care Requirements

On March 23rd, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would exempt states from requirements to analyze and monitor access to care in the Medicaid program under certain circumstances. The proposal seeks to amend 42 CFR 447.203(b), which sets forth the process for states to document whether Medicaid payments ...

CMS Releases Final Exchange Guidance

On April 9, 2018, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited final Exchange guidance for the 2019 plan year – the final Notice of Benefit and Payment Parameters for 2019 (NBPP) and the final Letter to Issuers in the Federally-facilitated Exchanges (Letter). Together, the NBPP and Letter set forth changes to ...

Health Policy News March 2018

This month’s edition focuses on efforts underway across the country to protect consumers from rising prescription drug costs and reduce or cap state drug spending. Health Policy News subject matter experts released a special report and legislative tracking tool outlining state and federal efforts, along with suggestions for states on how to approach this high ...