CBO revises U.S. health care budget estimates

On March 24, 2016, the Congressional Budget Office (CBO) released a report entitled, “Federal Subsidies for Health Insurance Coverage for People under Age 65: 2016 to 2026.” The CBO report shows that the net costs of all Federal subsidies, taxes, and penalties related to health insurance coverage, for persons under age 65, will be $660 billion in 2016 (3.6 percent of the U.S. gross domestic product). [More]

Massachusetts enacts law to combat opioid abuse

On March 14, 2016, Governor Charlie Baker signed legislation which incorporates key recommendations to combat the opioid abuse epidemic that is now claiming nearly four lives per day in the Commonwealth. The legislation requires doctors to check a prescription monitoring program database before writing a prescription for a Schedule 2 or Schedule 3 narcotic, limits opioid prescriptions to a seven day supply in many instances... [More]

Supreme Court set to hear oral argument on cases challenging ACA’s contraceptive mandate

On March 23, 2016, the U.S. Supreme Court was scheduled to hear oral argument on a set of seven cases challenging the mandate contained in the Affordable Care Act (ACA) that employers provide contraceptive services to their female employees. Two years before, in the case of Hobby Lobby v. Burwell, the Court decided (following a five to four vote) that the Federal government could not impose the mandate upon religiously objecting owners of closely held businesses. [More]

HHS releases report on growth in national health care spending

On March 22, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE) released a report showing that overall health care spending per person in the United States grew at a 4.3 percent rate in 2014. HHS indicates that the increase was largely the result of coverage expansions under the Affordable Care Act (ACA) and pent-up needs for care among previously uninsured and underinsured persons. [More]

HHS releases report on results of ACA’s third open enrollment period

On March 11, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE) released a report detailing the Affordable Care Act’s (ACA) third open enrollment period numbers. From November 1, 2015 through February 1, 2016, 12,681,874 people enrolled in qualified health plans (QHPs) offered through Federally-facilitated Exchanges (FFEs) and State-based Exchanges (SBEs): 7,794,848 (61 percent) were re-enrollees and 4,887,026 (39 percent) new enrollees. The report shows that, FFEs accounted for the majority (76 percent) of all enrollees; about 68 percent of all enrollees selected “silver” level coverage (medium cost-sharing); and 83 percent qualified for advance premium tax credits (APTCs). [More]

Supreme Court issues decision on major health care case

States across the country have been nervously awaiting the Supreme Court ruling in Gobeille vs Liberty Mutual Insurance Company given its direct impact on state All-Payer Claims Databases (APCDs). That wait ended on March 1st and, with the decision known, states now have another piece of the puzzle to guide their next steps; however, the full impact on APCDs is yet to be seen. [More]

HHS finalizes ACA benefit and payment parameters for 2017

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) finalized its “Notice of Benefit and Payment Parameters” for 2017 in the March 8, 2016 Federal Register. As in prior years, this annual rules notice adjusts a wide range of policy, operational, and information technology requirements applicable to health insurance coverage obtained through Exchanges under the Affordable Care Act (ACA). [More]

Supreme Court declines review of “Origination Clause” challenge to ACA mandates

On February 29, the U.S. Supreme Court declined to review the Fifth Circuit Court of Appeals’ decision that a physician and his employer lacked standing to challenge the individual and employer mandates of the Affordable Care Act (ACA) under the Origination Clause of the U.S. Constitution. Hotze v. Burwell, No. 15-622, cert. denied (U.S. Feb. 29, 2016). [More]

CMS expands funding for health information technology

On February 29, 2016, the Centers for Medicare and Medicaid Services (CMS) released a bulletin expanding the availability of 90 percent Federal financial participation (FFP) on state Medicaid administrative expenditures to promote the adoption and meaningful use of electronic health records (EHRs). With this funding increase, CMS seeks to address the need for improved patient care coordination and care transitions across a wide range of services (e.g., acute, chronic, behavioral health, long term care, etc.), using system-wide health information exchange (HIE) technology solutions. [More]

CMS expands funding for services provided to Native Americans

On February 26, 2016, the Centers for Medicare and Medicaid Services (CMS) released a bulletin expanding the availability of 100 percent Federal financial participation (FFP) on state Medicaid expenditures for services received through Indian Health Service (IHS) facilities. The CMS bulletin states that 100 percent FFP will be available for IHS facility services as well as services authorized under written care coordination agreements between IHS facilities and non-IHS providers enrolled in Medicaid. [More]