109 Sable Trace Lane
Acworth Ga, 30102-7621


Phone/Fax: 678-574-8421

ACA weekly update July 13, 2015

Week of July 13, 2015

An overwhelming majority of states are getting poor marks from research groups for their health care transparency efforts. The Catalyst for Payment Reform and the Health Care Incentives Improvement Institute issued a report card on state transparency laws that gave 45 states a failing grade.

The 21st Century Cures Act was approved in the House on Friday by a 344-77 margin. The Senate is considering its own version of the bill. The White House has indicated tacit support for many of its components.
Republican leadership of the Senate has indicated its reluctance to pass a bill repealing parts of the Affordable Care Act (ACA) through a budget-crafting parliamentary tool known as reconciliation. The process would allow the body to send legislation rolling back parts of the ACA to the House with just a simple majority vote.
The Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would allow Medicare to reimburse physicians for having advance-planning discussions with their patients. The move so far has been met with limited opposition. Pending final approval, the rule could take effect as early as January.
The Department of Health and Human Services (HHS) is paying more than $840 million to state and municipal health departments to improve emergency preparedness. About $228 million will go toward creating new regional coalitions of health care organizations, while $611 million will serve as additional funding for local health departments.
President Obama announced last week that he plans to nominate the current acting head of CMS,Andy Slavitt, to become the agency's permanent administrator. The President also announced the nomination of Mary Wakefield as Deputy Secretary of Health and Human Service

From Aetna health reform weekly


ACA weekly update July 6, 2015

Week of July 6, 2015

A majority of Americans think the U.S. Supreme Court made the right call when it decided to allow consumer subsidies to continue. A Kaiser Family Foundation poll found that 62 percent of Americans support the Court decision. However, overall favorability ratings for the Affordable Care Act (ACA) have not changed: 43 percent view the law favorably while 40 percent view it unfavorably.

House Majority Leader Kevin McCarthy (R-CA) announced that both the 21st Century Cures Act and the Innovation Act will be heading to the floor this month for a vote by the full House. The Cures Act still lacks $12 billion in budgetary offsets, which could complicate its path forward. The Innovation Act faces heavy opposition from the pharmaceutical industry as a result of its drug patent reforms.
An IRS regulation intended to motivate small business owners to provide health insurance to their employees took effect last week. The rule allows the IRS to fine employers up to $100 per day per employee if caught providing additional pay to employees for medical care rather than directly providing health insurance. Legislation in the Senate and House (S 1697/H.R. 2911)would repeal the rule, but immediate action is unlikely.
Employer groups have renewed their push for repeal of the ACA's "Cadillac" plan excise tax. In a letter to the Senate Finance Committee and House Ways and Means Committee, the National Coalition on Benefits warned that the tax would affect nearly one-quarter of all employer-provided plans and that quality of care would diminish as a result.
The IRS released a notice intended to guide the implementation of the Expatriate Health Coverage Clarification Act of 2014 (EHCCA). The notice essentially says that consumers can rely on previous ACA guidance to define an expatriate health plan. The EHCCA generally exempts individuals receiving coverage under expatriate health plans for a period of time from the requirements of the ACA.
GEORGIA: The Department of Insurance has asked health plans for input on draft regulations that would impose new requirements regarding provider contracts. Specifically, the regulations would eliminate the use of "most-favored nation" clauses as well as "upper limit trigger clauses".

From Aetna health reform weekly


ACA update week of June 29, 2015

Week of June 29, 2015

The U.S. Supreme Court announced its long-anticipated decision last week in the King vs. Burwell case, ruling that consumer subsidies for health care coverage can continue through federally facilitated exchanges under the Affordable Care Act (ACA). The 6-3 decision ensures that their health care benefits will not be disrupted. Many in the health care industry hope legislators will now turn their attention to addressing the numerous ACA implementation issues that remain.
A day later, a different Supreme Court ruling recognized same-sex marriage as protected by the Constitution in all states. Expanding the definition of marriage nationally is expected to impact access to health care benefits for LGBT families. Exactly how the decision will affect issues such as same-sex domestic partner coverage and coverage under the ACA is generating expanding media coverage.

Eleven Democrats joined with House Republicans last week to pass a bill repealing the ACA'sIndependent Payment Advisory Board. The board was created to explore ways to slow rising Medicare costs. President Obama has said he will veto the bill if it passes the Senate. The House is still short of a veto-proof majority, and its prospects in the Senate remain uncertain.
The House Appropriations Committee has advanced a $153 billion spending bill to fund the Departments of Labor, Health and Human Services (HHS), and Education. The bill makes deep cuts to family planning programs while increasing funding to the National Institute of Health (NIH). It also blocks discretionary funding for the ACA.
The full Senate Appropriations Committee considered its own Labor-HHS-Education funding billat a markup session last week. Much like its House counterpart, the Senate bill would boost funding for the NIH and community health centers. The bill would also to prevent appropriations from being used for the ACA's risk corridor payments to health plans.
A bipartisan bill has been introduced in the Senate that would now allow commissions paid to licensed insurance agents and brokers to be included in the calculation of medical loss ratios. The Senate bill has been referred to the Committee on Health, Education, Labor and Pensions for consideration.
The Congressional Budget Office (CBO) has released a report on the 21st Century Cures Act. The bill would appropriate funds to develop drugs and other technologies that prevent and treat disease. The CBO projects that the Act would cost $106.4 billion over the next five years in appropriations provisions.
The House Ways and Means Committee held a hearing last week examining "Rising Health Insurance Premiums Under Obamacare." Three state insurance commissioners and a law professor discussed the factors at play behind increasing premiums, including adverse selection, small employers moving their employees into the individual market, medical trend and increases in prescription drug costs.

From Aetna health reform weekly