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Obama Administration Delays Implementation of Star Ratings, Transparency Requirements for Marketplace Health Plans

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…In other Friday afternoon developments, the administration made clear in its final proposal for the collection of health plan data that it continues to slow-walk implementation of the ACA transparency provisions. These provisions require non-grandfathered health plans both inside and outside the marketplaces to disclose detailed claims and other data to help policymakers, regulators and the public better understand how…

Major New Rule Seeks to Modernize & Improve Quality of Medicaid Managed Care

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By Kelly Whitener, Georgetown University Center for Children and Families (CCF) Earlier this week, CMS released the much-anticipated final rule on Medicaid and CHIP managed care. The rule marks the first update to Medicaid managed care rules in over a decade, and it comes at a time when more and more Medicaid beneficiaries are covered under managed care arrangements. Three-quarters…

NAIC Roundup: Catching Up on the Spring Meeting and Looking Ahead

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…have requested. Using Big Data in Insurance: Debating the Benefits and Risks And finally, on that Big Data hearing that packed a big convention hall so early on a Sunday morning, the Market Regulation and Consumer Affairs (D) Committee Big Data Working Group heard testimony from representatives of insurers and consumers on the use of Big Data in all lines…

One Way Insurers Could Improve Marketplace Risk Pools? Stop Cannibalizing Their Own Business

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…will no longer pay broker commissions for off-season enrollment into ACA-compliant plans, some of those very same companies appear to be happy to pay commissions for the sale of the underwritten short-term policies. By doing so, however, they are siphoning healthy risks away from ACA-compliant coverage, undermining the marketplace risk pools, and – to the extent they’re operating in both…

New Florida Law Protects Residents from Surprise Medical Bills

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…amounts prior to invoking the dispute resolution process. If the dispute resolution process is initiated, the law requires the dispute resolution organization to be transparent and publish the evidence or data the organization used to make its findings. Publicity over unexpected medical bills and consumer complaints can land the issue of surprise bills squarely on the political agenda, as it…

HHS Study Shows Benefits of Shopping and Subsidies, but Costs Still a Concern

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…their coverage even after the ACA’s market reforms. According to 2014 survey data, one third (33 percent) of those with Marketplace coverage reported having trouble paying for their premiums, compared with 17 percent of those with employer-sponsored coverage. Kaiser’s survey data suggests that this difficulty in affording coverage stems from the interaction of premium costs with other expenses, some directly…

CHIR Expert Testifies Before U.S. House Education & Workforce Committee about Innovations in Health Care

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On Thursday, April 14, CHIR’s own Sabrina Corlette joined a panel of witnesses before the Subcommittee on Health, Education, Labor and Pensions of the Education & Workforce Committee to discuss “Innovations in Health Care: Exploring Free-Market Solutions for a Healthy Workforce.” Other panelists included Tresia Franklin, an executive with Hallmark Cards, Amy McDonough of Fitbit, Inc., and John Zern, a…

Obama Administration Moves Forward with New Continuity of Care Protections—How Will They Affect Existing State Laws?

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…compared to the federal proposal. Now that the administration has finalized its continuity of care protections, the trio of researchers issued their final post for the series on continuity of care protections for the Commonwealth Fund. In this piece, they explain the new federal continuity of care requirements and provide an analysis of the rule’s impact, along with a 50-state…

Post ACA, 3 Communities Respond to a Shifting Health Care Landscape for Newly Insured

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…care services and attain financial security? To find out, CHIR researchers, with funding from the Robert Wood Johnson Foundation, visited three diverse communities – Tampa, Florida; Columbus, Ohio; and Richmond, Virginia – and met with various community stakeholders who interact directly with consumers, including navigators and assisters, brokers, free clinics and community health center staff, hospital representatives and health insurance…

Telemedicine: Another Tool in the Toolkit to Meet Network Adequacy Standards?

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…slower to embrace this alternative care method. And few, if any, are using it as a tool to help meet state or federal network adequacy standards. Although the newly updated network adequacy model law adopted by the National Association of Insurance Commissioners recognizes telemedicine as an alternative health care delivery option, no state to date has enacted it. To find…

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