This week HHS released a final regulation implementing the medical-loss-ratio provision of the Affordable Care Act, 13 more states received grants to implement insurance exchanges, and HHS rejected Indiana and Louisiana’s requests for temporary exemptions from the medical-loss-ratio requirements.
IN THE COURTS
There was no citation of Virginia's challenge to the Affordable Care Act in documents released by the Supreme Court on Monday (11/28), indicating that the Court put off deciding whether to hear the state’s case.
AT THE AGENCIES
On Wednesday (11/30), the Government Accountability Office released a report that found, had the Medical Loss Ratio requirements of the Affordable Care Act (which require that insurance plans devote a minimum percentage of their budgets to pay for their enrollees' care), been in effect during 2010, 64 percent of insurers would have met the spending rate requirements.
Then, on Friday (12/2) a final regulation was issued to implement a federal medical-loss-ratio standard of the Patient Protection and Affordable Care Act. The rule requires new individual and small group-market insurance plans to spend 80 percent of premium dollars on medical care and health care quality improvement, and 85 percent for large group-market plans. The regulations also detail disclosure requirements for insurers. The final rule rejected most insurer requests for changes to the proposed version of the rule.
On Tuesday (11/29), HHS Sec. Sebelius announced that 13 states will receive grants totaling $220 million to help them set up health insurance exchanges, bringing the number of states to receive such grants to 29. The new grant recipients are Alabama, Arizona, Delaware, Hawaii, Idaho, Iowa, Maine, Michigan, Nebraska, New Mexico, Rhode Island, Tennessee, and Vermont. Among the 13 states receiving grants, six are parties to the lawsuit challenging the Affordable Care Act. Though these states do not support the law, they are preparing now to implement it in case the Supreme Court upholds it.
The CMS Center for Consumer Information and Insurance Oversight awarded technology company CGI Federal a two-year contract to build the federal health insurance exchange.
CMS has developed a guide to help physicians and other eligible professionals navigate the phases of the Medicare electronic health-record incentive payment program.
ON THE HILL
A recent IRS regulation would provide tax credits to anyone in either a state or federal-run health exchange. On Thursday (12/1), Sen. Orrin Hatch (R-Utah) charged that under the text of the Affordable Care Act, tax credits should only be available in state-run exchanges.
IN THE STATES
On Tuesday (11/29), state political and budget leaders released the Fiscal Survey of States, which reports that while overall state budgets are expected to grow slowly over the next few years, Medicaid is expected to consume an increasing share of them.
On Monday (11/28), HHS rejected Indiana and Louisiana’s requests for exemptions from the Affordable Care Act provision that requires insurers selling policies to individuals to dedicate 80 percent of the premiums they collect to medical care.
CMS approved a plan by the Arizona Medicaid program to cut payments to hospitals and other providers by 5 percent. The cuts are expected to save the state $95 million this year.
Last week, Virginia Gov. Bob McDonnell forwarded new findings from the Virginia Health Reform Initiative Advisory Council to the General Assembly, including a recommendation that Virginia establish its own health insurance exchanges, rather than joining a federal exchange. In a letter preceding the report, Gov. McDonnell told the Assembly that the Obama administration was dragging its feet and preventing states from effectively complying with health reform.
Arkansasdecided to drop its plans for a state-run health insurance exchange, and will instead rely on one created by the federal government.
The Affordable Care Act created the Pre-Existing Condition Insurance Plan, a temporary program launched last year to provide health insurance to those who were shunned by health insurers due to chronic conditions until exchanges were formed. California received $761 million to implement this program and thought that would be enough to insure 23,000 people until 2014 when the program would be phased out. California's Pre-Existing Condition Insurance Plan is actually costing the state three times more per enrollee than it estimated.
On Thursday (12/1), over 2,400 people, mostly doctors and nurses, signed a letter urging HHS to reject recommendations from the Institute of Medicine for defining essential benefits, which all health plans will soon have to cover.
On Monday (12/5) at 6:30 p.m. at the Hyatt Regency Bethesda, the National Institutes of Health, National Cancer Advisory Board Subcommittee on Global Cancer Research held a meeting.
On Wednesday (12/7), the House Oversight and Government Reform Subcommittee on Government Organization, Efficiency and Financial Management will hold a hearing titled "A Medicaid Fraud Victim Speaks Out: What's Going Wrong and Why?"
On Wednesday (12/7) at 10:00 a.m. at the Omni Shoreham, the HHS Health IT Policy Committee will hold an advisory meeting.
To view our compilation of recent health care reform implementation news, click here.