Category: State Activity

Health Policy News Summer 2018

As in past years, Health Policy News is publishing one summer edition, featuring a new report entitled “Revisiting the Public Option- Medicaid Buy-Ins” with a legislative tracking overview of recent movement on public health insurance programs at both the State and Federal level. We will be hosting a webinar to present the report, with an ...

States Are Increasingly Turning to Uniform Prior Authorization Forms

Background Prior authorization is a common tool for utilization management and controlling health care costs. While the approach to the process is similar across payers, each insurance carrier and public program has its own forms – with variations on questions asked, how they are asked, and the order in which they are asked – and ...

Balance billing – a new report on recent efforts by state

PCG subject matter experts recently completed a survey report entitled “Balance Billing: Report of Recent Efforts to Protect Consumers.” The practice of balance billing is historically commonplace, but increased scrutiny on rising out of pocket health care costs is driving efforts to provide greater transparency into the practice. For those states contemplating crafting consumer balance ...

The latest news from D.C.

Following the failure in the Senate to pass various legislative proposals – the Better Care Reconciliation Act (the Senate version of repeal and replace), the straight repeal option, or the “skinny repeal” bill – last week, Senate leadership has continued to say that they are moving on to other agenda items for now. However, there still seem to be daily updates ...

Section 1332 State Innovation Waiver – Recent developments and the newly-released checklist

In follow-up to its letter to Governors regarding the Section 1332 Waiver opportunity, the Centers for Medicare and Medicaid Services (CMS) and the Department of Treasury released a Section 1332 checklist on May 16 designed to help states pursue ACA State Innovation Waivers. Section 1332 of the ACA allows states to waive specific ACA provisions ...

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). ...

PCG creates summary of the House-passed health care bill

The American Health Care Act (“the bill”) passed the House of Representatives on May 4, 2017. As outlined in greater detail in the PCG summary, the bill does not repeal the Affordable Care Act (ACA) in full, but rather proposes changes primarily focused on the ACA’s insurance affordability, Medicaid expansion, coverage requirements and revenue provisions. ...