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As Ground Ambulance Committee Begins Its Work, New Report on Balance Billing by Ground Ambulance Providers Highlights a Gap in the No Surprises Act

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On December 9, the Centers for Medicare and Medicaid Services (CMS) announced the membership of the Advisory Committee on Ground Ambulance and Patient Billing (GAPB). This committee was created by the No Surprises Act (NSA), legislation that instituted landmark federal protections against unexpected bills when patients receive unanticipated out-of-network care. While the NSA applies to services provided by physicians, hospitals,…

Proposed 2024 Payment Rule, Part 1: Insurance Market Reforms And Consumer Assistance

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…Inpatient Hospitals Other ECP Providers (defined to include Substance Use Disorder Treatment Centers, Community Mental Health Centers, Rural Health Clinics, Black Lung Clinics, Hemophilia Treatment Centers, Sexually Transmitted Disease Clinics, and Tuberculosis Clinics). In the 2024 NBPP, HHS is proposing two modifications to its ECP standards. First, it would create two new and distinct ECP categories: Mental Health Facilities and…

Navigator Guide FAQs of the Week: Coverage of Reproductive Health Care

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…area of law that is constantly evolving. Contact the National Women’s Law Center here if your employer or insurer says contraception is not covered or you experience cost-sharing that is not allowed under the law. Also, check with your state insurance department to see if there are other ways to access free or low-cost contraception if your employer plan does…

November Research Roundup: What We’re Reading

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…highlight the Accountable Health Communities model, which established financial incentives for social needs screenings and promoted integration of clinical and community services. Health data exchange networks and integrated technology platforms can also help connect patients to community resources. For instance, the state of North Carolina pioneered a shared platform called NCCARE360 to connect patients with local services. Evaluation of VBP…

Supporting Continuity of Coverage from Medicaid into the Marketplace: Post-PHE Considerations for States

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…Robert Wood Johnson Foundation’s State Health & Value Strategies program, the Urban Institute’s Jason Levitis and CHIR’s Sabrina Corlette delve into specific actions states can take to minimize gaps in coverage for consumers who become ineligible for Medicaid. You can read the full post here. *Jason Levitis is a Senior Fellow with the Health Policy Center at the Urban Institute….

Navigator Guide FAQs of the Week: Small Businesses

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…state, you will be able to find a SHOP-registered agent or broker to assist you with choosing the right plan or you can enroll directly with an insurance company. Under some state-based SHOP marketplaces, you may be able to select and enroll in a health plan. 45 C.F.R. § 155.700 et. seq.; CMS, The Future of the SHOP: CMS Intends…

The Erosion of Employer-Sponsored Health Insurance and Potential Policy Responses

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…options include prohibiting anti-competitive contracting practices as well as promoting market entry and competition.The Biden administration has begun taking a closer look at enhancing antitrust enforcement, and bipartisan legislation in Congress would limit the anti-competitive practices of monopolistic provider systems. Improving Price Transparency. CBO finds that improving the transparency of the prices employers pay for health care goods and services,…

Congressional Proposals for a Federal Public Health Insurance Option

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…goals is the creation of a public health insurance option, a publicly funded, government-run insurance plan that directly competes with private health insurance coverage to drive down premiums and underlying health care costs. Democrats in Congress have put forward several proposals to create a public health insurance option over the past decade. In a new post for the Commonwealth Fund’s…

Navigator Guide FAQs of the Week: Family Glitch Fix

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…and/or cost-sharing subsidies, you can get a rough estimate of how much you’ll save on marketplace plan premiums by visiting HealthCare.gov and completing the brief cost estimator form. You can find out the exact amount you would pay by completing the marketplace application and picking a plan. Keep in mind that if you decide to decline employer-sponsored coverage for your…

October Research Roundup: What We’re Reading

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…care. As the Commonwealth Fund authors note, making the current, more generous marketplace subsidies permanent; banning non-ACA-compliant products like short-term plans; and creating new public insurance options would help expand access to comprehensive and affordable coverage to protect Americans’ health and financial wellbeing. Jared Ortaliza, Krutika Amin, and Cynthia Cox, As ACA Marketplace Enrollment Reaches Record High, Fewer Are Buying…

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.