The election results mean that the Affordable Care Act is here to stay. There may be compromises and tweaks to the reform as it was originally laid out, but it’s clear that much of the law will remain. As deadlines approach, states, insurers, providers, hospitals and employers are drilling down on what they need to do to implement and comply with the law of the land, the Affordable Care Act.
AT THE AGENCIES
CMS approved Washington state to test a managed fee-for-service model for dual eligibles. This voluntary program, called HealthPathWashington, will begin in April 2013 and target 30,000 of the state’s dual eligible patients.
CMS released a final rule implementing a provision of the ACA. The rule will increase Medicaid payments for primary care physicians in family medicine, general internal medicine and pediatric medicine to match Medicare rates over the next two years starting in January.
IN THE STATES
Arizona Gov. Jan Brewer selected a benchmark health insurance plan for her state under the ACA's essential health benefit requirements. The benchmark plan chosen has comprehensive benefits for behavioral care, including serious mental illness. It does not include elective abortion.
In Montana, Referendum 122 passed. Referendum 122 prohibits the state or federal government “from mandating the purchase of health insurance” and prohibits the imposition of “penalties for decisions related to the purchase of health insurance coverage.”
IN THE COURTS
After a district court dismissed the lawsuit and the appellate court said the plaintiffs did not have standing, Liberty University asked the Supreme Court to invalidate the appellate court's ruling. On Wednesday (10/31), the Obama administration said it would not oppose Liberty University's challenge to the Affordable Care Act. Liberty University had challenged the individual mandate on the grounds that it violated the First Amendment ban on the government's establishing or impeding the free exercise of religion by forcing objecting purchasers to buy insurance that could subsidize abortion.
Federal District Court Judge Robert H. Cleland of the Eastern District of Michigan issued an opinion on Wednesday (10/31), granting a preliminary injunction halting enforcement of the HHS mandate against plaintiff Weingartz Supply Company and its owner and president, Daniel Weingart, who objected to the mandate’s requirement that he provide employees with health insurance covering certain contraception.
The American Hospital Association and four health systems filed a lawsuit on Thursday (11/1) suing CMS for allegedly refusing to pay for “hundreds of millions of dollars for necessary care” in Medicare claims.
To view our compilation of recent health care reform implementation news, click here.