Category: CMS Guidance

Health Policy News February 2018

In this month’s edition of Health Policy News, we highlight legislative, regulatory, and administrative developments at the federal level. Just last week, on February 20, 2018, several federal departments jointly released a proposed rule seeking to expand access to Short-Term Limited-Duration Insurance (STLDI) plans. Also, on February 9, 2018, the President signed H.R. 1892, the ...

Health Policy News January 2018

As we enter this new year, and our third year publishing and distributing Health Policy News, we want to thank you all for continuing to support Health Policy News as a source for in-depth policy and regulatory analysis. The first few weeks of 2018 have been busy — with federal guidance released on association health plans as well as ...

Health Policy News December 2017

As 2017 comes to a close, we take a look back at health policy developments from the last 12 months in this edition of Health Policy News, beginning with a close-up on health care provisions in the tax bill being negotiated in Congress as of publication. The remainder of this edition will reflect upon major ...

Health Policy News November 2017

Along with the changing weather, this time of year brings some typical health policy events, which are the focus of this month’s edition of Health Policy News. We start with our in-depth analysis of the Proposed Notice of Benefit and Payment Parameters (NBPP) for 2019, which the Centers for Medicare & Medicaid Services (CMS) released ...

CMS releases several major policy changes and expanded roles for states in its Proposed NBPP for 2019

At the end of October, the Centers for Medicare & Medicaid Services (CMS) released its annual Proposed Notice of Benefit and Payment Parameters (NBPP) for 2019 (along with accompanying guidance, including a Draft 2019 Actuarial Value Calculator). As in past years, the NBPP for 2019 addresses a breadth of issues related to health plan regulation, Exchange operations (including ...

CHIP funding crisis remains unresolved

Congressional authorization of Federal funds for CHIP expired on September 30, 2017.  Nine million children depend on this program.  States are now operating CHIP on carryover and redistribution payments from prior years.  CMS estimates that at least one state will exhaust such funding in this month.  Most states could exhaust such funding by March 2018. ...

CBO estimates that AHCA would severely increase the number of uninsured persons

On May 24, 2017, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released estimates on the impact of the proposed H.R. 1628, the American Health Care Act of 2017 (AHCA), as passed by the U.S. House of Representatives on May 4, 2017.  AHCA would partly repeal the Affordable Care Act (ACA). ...

New ACA-Related announcements from the Federal Administration

The administration is taking more limited steps to influence implementation of the law, including two upcoming changes to enrollment through Marketplaces announcements last month. On May 15, the Centers for Medicare and Medicaid Services (CMS) announced that it will be proposing a rule to have enrollment into Federally-facilitated Small Business Marketplace (known as Small Business Health Options ...

CMS releases final Market Stabilization Rule

On April 13, 2017, the Centers for Medicare and Medicaid Services (CMS) released the final Patient Protection and Affordable Care Act; Market Stabilization Rule. The final rule is aimed at stabilizing the individual and small group markets by tightening enrollment standards and providing increased flexibility related to standards for Qualified Health Plans (QHPs), as outlined in detail ...

Transitional health plans to continue through 2018

In November of 2013, the Centers for Medicare & Medicaid Services (CMS) introduced the concept of “grandmothered plans,” coverage in place prior to 2014 that would have been prohibited as of 2014 as a result of changes under the Affordable Care Act (ACA). CMS issued guidance permitting those plans to be renewed for existing policyholders ...