The same day the administration announced it would let consumers renew non-ACA compliant plans for another two years, CMS quietly backed off a controversial plan to limit an issuer's ability to participate in the federally facilitated health insurance exchanges if it raises rates for qualified health plans (QHPS) sold through the exchange significantly more than for its non-QHP products offered outside the exchanges.
CMS has extended from March 13 to April 10 the deadline for comments on changing the way outpatient specialist practitioners are paid for both chronically ill beneficiaries and for one-time patients, building on the Bundled Payments for Care Improvement model for episodes of care in inpatient hospital stays.
CMS is considering instituting restrictions on Medicare Advantage plans that move to narrow provider networks in the middle of a plan year -- a move that some beneficiary advocates back but others question because they say narrow networks are necessary to curb costs.
House Ways & Means Republicans pounced on a letter from the Medicare Payment Advisory Commission in opposition to CMS' proposal to open preferred-pharmacy networks to nonpreferred pharmacies, using MedPAC's concerns to bolster their case that the Part D proposed rule should be scrapped.
Most employers in the small group insurance market likely won't move any time soon to ACA-compliant plans now that HHS is giving insurers the option to renew non-compliant policies for another two years, a health policy expert with Avalere Health tells Inside Health Policy.
HHS since fiscal year 2010 has spent roughly $304 million of the $1 billion Health Insurance Reform Implementation Fund that was established by the health law to help cover administrative expenses related to the ACA's implementation, according to new exchange spending details that were required by the omnibus appropriations legislation passed earlier this year.
Outgoing CMS insurance chief Gary Cohen told a gathering of insurance executives Thursday (March 6) that the agency is not collecting data that would quantify how many previously uninsured individuals are joining the health insurance exchanges -- coming the same day a new McKinsey & Company survey found that people who have been insured are signing up for exchange plans at much higher levels than those who had been without coverage.
Outgoing Center for Consumer Information and Insurance Oversight (CCIIO) Director Gary Cohen told reporters Thursday (March 6) that he had always intended for his stint at CMS to be temporary and that his decision to leave at the end of the current open enrollment period is not related to the widely panned roll out of healthcare.gov.
The fiscal 2015 proposed HHS budget gives Project BioShield a funding bump, but levels for other medical countermeasure initiatives within FDA and Biomedical Advanced Research and Development Authority remain flat.
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Breaking SGR News
In a blow to doctors, House GOP leadership plans to pay for Medicare physician-reform by repealing the ACA's individual mandate, according to Democratic Whip Steny Hoyer (MD).