Last week, HHS set November 16 as the deadline for states to submit their insurance exchange plans, CMS granted CO-OP loans to Michigan and Nevada, and the Massachusetts Senate passed a bill to create a new state agency responsible for reining in in long-term health care costs.
AT THE AGENCIES
HHS established November 16, 2012 as the deadline by when state governments must submit proposals for how they intend to operate their exchanges starting on January 1, 2014. The announcement included specific legal and operational guidelines that states must follow to receive federal approval of their proposals. The Obama administration will permit states to divide the responsibilities of managing the new exchanges with the federal government.
CMS finalized two regulations that eliminated rules deemed to adversely affect Medicare participants. One regulation will protect the billing privileges of physicians from unjust revocations and the second will increase the flexibility for hospital governing boards.
On Friday (5/18), Michigan and Nevada became the latest states to receive Consumer Operated and Oriented Plan (CO-OP) loans from the CMS. The total award dollar amount for these grants is now higher than $982 million. CO-OPs, which will be offered through the health insurance exchanges and other plans starting in 2014, are supposed to provide small businesses and individuals more affordable health insurance options. CMS awarded Michigan Consumer's Healthcare CO-OP $71.5 million and Nevada's Hospitality Health CO-OP $65.9 million.
HHS announced that six states – Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington – will receive more than $181 million to assist with the implementation of health insurance exchanges. These states join 28 other states and the District of Columbia in receiving grants from HHS for the establishment of exchanges. States may apply for exchange grants through the end of 2014, and HHS plans to make grant money available beyond then, too, to make sure the exchanges are fully established.
ON THE HILL
Republican leaders in the U.S. House are developing several strategies in preparation for the Supreme Court’s forthcoming decision. If the law is fully upheld, leaders are expected to fight legislatively for removal of components like the individual mandate. If it is partially or fully overturned, they are expected to seek the maintenance of components such as allowing children to remain on parents’ health care plans until age 26, and forcing insurance companies to provide coverage for those with pre-existing conditions. The parties are also preparing for a fight over how to handle the new taxes put in place by the law should the law’s key components be dismantled.
IN THE STATES
In response to rising Medicaid costs in Colorado, Gov. Hickenlooper is expected to sign a bill that will create a Medicaid payment reform and innovation pilot program that will pilot-test fee-for-service alternatives and regional care collaborative organizations.
On Wednesday (5/16), the Missouri House approved legislation that would allow health care workers, medical centers and others to refuse to provide contraception or carry out procedures that violate their religious or ethical beliefs. The measure will now return to the Senate where state senators can accept the House's proposal or request to negotiate.
The Massachusetts Senate nearly unanimously passed a bill to rein in long-term health care costs. The bill included a proposal to create a new state agency responsible for monitoring heath care expenditures
The New York Senate unanimously passed a bill that will create a new state agency called the Justice Center for the Protection of People With Special Needs, which will have prosecutorial powers concurrent with local DAs to bring cases against abusers of those with special needs.
THIRD PARTIES
A new Health Affairs study shows that if the Affordable Care Act had been in place from 2001 through 2008, those in the individual insurance market would have saved around $280 per year on out-of-pocket costs. The report also says that ACA would reduce the risk of incurring extremely high out-of-pocket costs.
The government has been providing doctors incentives to “e-prescribe,” and recent data reveal more than 1/3 of the nation’s prescriptions are now electronic. Starting this year, some doctors who do not use electronic prescriptions even a little bit may see cuts in their Medicare reimbursements.
THIS WEEK
On Wednesday (5/23) at 10:00 a.m. in 215 Dirksen, the Senate Finance Committee will hold a hearing titled "Progress in health care Delivery: Innovations from the Field."
To view our compilation of recent health care reform implementation news, click here.