Jan 15, 2018 | Legislation/ Budgets/ Macro, Payers
The Department of Labor proposed new rules that would expand the definition of Association Health Plans, potentially making these a more viable option for employers to access health insurance. We believe this will have only modest implications for the composition of the insured, neither upending the current marketplace nor offering a significant solution to rising health care costs. Click to read more.
Jan 11, 2018 | Medicare Advantage
On December 27, 2017, CMS released its Medicare Advantage (MA) Advance Notice plan for year 2019, which included proposed changes to the risk adjustment model. The changes are relatively modest and generally favorable to the industry. The proposed regulations would account for the number of beneficiary conditions, which would boost MA risk scores by an estimated 1.1%. It would also add behavioral health conditions to the risk model and would continue the slow transition toward the use of encounter data for risk scores. Click to read more.
Jan 9, 2018 | Medicaid Managed Care
At its December meeting, the Medicaid and CHIP Payment and Access Commission approved two recommendations to simplify administration of Medicaid managed care authorities. One would allow longer approval periods for certain managed care waivers, and the other would allow state home and community based services programs to include managed care provisions without the need for multiple waivers.Click to read more.
Jan 8, 2018 | Legislation/ Budgets/ Macro, Medicaid
Congress has passed a continuing resolution that funds discretionary spending through January 19, 2018. The CR also funds the Children’s Health Insurance Program (CHIP) through March. Numerous “expiring provisions” remain in contention, as do issues like the device tax.Click to read more.
