…most common languages in the facility’s geographic region, which HHS interprets to be the 15 most common languages spoken in the state. Recognizing, however, that common languages can vary significantly (i.e., the 15 most common languages spoken in a state may not be the most common languages of those served in a specific facility), providers and facilities have flexibility to…
…(D.C.), Maine, Oregon, Vermont, and Washington. Where’s the Crystal Ball? Rate Review Deadlines Require Long Lead Time Federal and state law requires insurers in the individual market to set the next year’s premium rates many months before they go into effect. The federal government (through the Center for Consumer Information and Insurance Oversight, or CCIIO) sets deadlines for the submission…
…use has greatly expanded. One state that took action found a 3,000 percent increase in telemedicine claims compared with the prior year. In a new issue brief for the Commonwealth Fund, CHIR experts reviewed state statutes existing prior to the pandemic in all 50 states and DC, and state actions taken in response to the pandemic. We found state actions…
…and insurers from using the public option plan as a bargaining chip by conditioning participation in other commercial networks on participation in the public option plan. How this prohibition will work in practice, or be enforced, is unclear. State-funded Premium Assistance After the 2019 bill required a study to assess the impact of state-funded premium and cost-sharing assistance, the newly…
We founded CHIR – the Center on Health Insurance Reforms – in 2010, the year the Affordable Care Act (ACA) was signed into law. Our mission was, and is, to improve people’s “access to affordable and adequate health insurance by providing balanced, evidence-based research, analysis and strategic advice.” In our lifetimes, no federal policy has gone farther to expand coverage…
Rising health care costs are squeezing workers’ wages, hindering business competitiveness and straining government budgets. The agencies that purchase health benefits for state and local employees are often the largest employer purchaser in their states, giving them relatively greater influence to tackle the sources of rising health care costs. A new report from Georgetown University’s Center on Health Insurance Reforms…
…consistent with value-based insurance design principles and be approved by the state’s Health Care Cost Containment Committee. Required coverage to include essential health benefits under the Affordable Care Act as well as comply with Connecticut’s state benefit mandates. Allowed the state employee plan to charge the union or the small/nonprofit employer a per member, per month administrative fee. Required the…
…Database, researchers investigated whether hospital-physician integration is associated with medically unnecessary referrals for magnetic resonance imaging (MRI) for selected clinical conditions in patients. What it Finds Researchers compared the patient MRI referral rates of a study cohort of physicians who had recently transitioned to hospital employment during the study period to those of a comparison group who were not employed…
…Colorado’s legislation provides greater incentives for them to do so. If Colorado insurers can’t find a sufficient number of providers to participate, the bill first authorizes them to seek nonbinding arbitration to determine rates. If that does not work, then the insurance commissioner must hold a public hearing. Based on the evidence presented at that hearing, the commissioner may then…
…premium affordability could call for different policy approaches and may expand the uses to which a waiver might be put. Going forward, states may find greater value in waivers that support programs addressing health care system costs or that reduce the burdens of high enrollee cost sharing. To read more, you can access the full analysis at The Commonwealth Fund….
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.
