Category: CMS Guidance

Health Policy News Hosts Round Table Discussion of Public Option Programs

On October 9th, Health Policy News held the second event in our 2018 Fall Webinar Series. This webinar featured a round table discussion on the history of public options, and the various design and programmatic options available to states crafting such programs. The HPN team was joined by a buy-in expert from the PCG Health ...

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 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 ...