…the next week. Connecticut: The state’s Health Insurance Exchange Advisory Committee recommended to the exchange board that it designate the state’s largest commercial HMO plan, the ConnectiCare HMO plan, as the state’s benchmark. The Committee presented its recommendation to the exchange board which adopted a proposed policy on the essential health benefits and has requested comments on the policy until…
…these forms are the culmination of hundreds of hours of effort as part of a statutory working group tasked with developing the templates for these forms. Put together by the National Association of Insurance Commissioners (NAIC), the working group represented state insurance regulators, consumers, insurance companies, health care providers and insurance brokers. We spent over a year working through the…
…set of “Affordability Standards” for insurers, under which their requests for premium rate increases will be assessed. These standards include efforts to improve the delivery of primary care, adopting a chronic care model of medical home, standardizing electronic medical records, and working towards comprehensive payment reform. The Rhode Island Commissioner has used his rate review authority to reduce rate increases…
…develop arrhythmias, may need a pacemaker, and can develop liver disease, among other complications. Because the oldest person with this condition is only in his 30s, no one really knows what the life-expectancy is, but we do know care over their lifetime will be costly. With the Affordable Care Act comes new hope for Joshua and his parents. Beginning January…
Late last month, HHS published proposed rules for the market reforms and essential health benefits (EHB) and cost-sharing provisions of the Affordable Care Act. As stakeholders scramble to submit their comments by the deadline on December 26, there are a few areas in each rule worth highlighting. The market reform rule lays out a framework for the ACA provisions governing…
…26-34. Coverage was up across the board for young adults, but men seem to have gained more than women, with coverage up 8.2%, compared to 4.9% for women. This is in part due to Medicaid, but also because women are more likely to be full-time students in this age cohort. Unmarried adults were more likely to get coverage than married…
…exchange participation. While OPM indicates that, exceptions aside, multi-state plans will need to comply with any exchange certification rules, it’s hard to reconcile deemed certification with exchange efforts to use selective contracting or competitive bidding strategies. In states that want to limit the number of qualified health plans on the market, multi-state plans will have an inherent competitive advantage. Whether…
…compared with average risk adults. Drawing from interviews with state regulators, consumer assistance programs, medical directors of major insurance companies, medical providers, billing experts, and patients, we found variation in how cost-sharing is applied and how providers code procedures in all three scenarios. We also found that state regulators were looking to the federal government for guidance on how to…
…to process those feelings of neglect, never fear. The National Association of Insurance Commissioners (NAIC) is stepping forward to fill the void – at least partially. Later today their “Regulatory Framework Task Force” is meeting to continue its process of developing model state laws to implement the ACA’s health insurance reforms, including the new prohibitions on health status discrimination and…
…tight deadlines in implementing the ACA, some NAIC observers—including CHIR’s own Sabrina Corlette on the Community Catalyst blog—noted that the NAIC’s committees, working groups, and task forces “largely chose to kick the can down the road.” For example, the original agenda of the Market Regulation and Consumer Affairs (D) Committee included an item to “Discuss ACA Enforcement and State Coordination,”…
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