Washington state's decision this week to initially have its SHOP exchange operate in only a few counties instead of statewide has led to questions about whether the federal government will let the health law's small business tax credits be available outside the small business exchanges next year, an official with the Washington Health Benefit Exchange says.
A top policy official at DaVita, who was “bummed” in February about CMS' terms for participation in the kidney care ACO demonstration, told investors the dialysis chain is now optimistic the agency will change the demo enough for the company to participate, although company officials say CMS has not indicated it will make the changes sought by DaVita.
CMS: Only State-Based Exchanges Eligible For Utah Model In 2014
In a loss for drug plans, CMS is applying to Part D a health law provision dictating what portion of income from premiums plans must spend on clinical services.
In an effort to further contain costs so the program lasts through the end of the year, CMS says provider payment rates in federally-run Pre-Existing Condition Insurance Plans starting June 15 will be set at Medicare rates for most covered medical services.
CMS' proposed formula for calculating cuts to Medicaid disproportionate share payments is designed to incentivize states to target DSH payments to the most needy hospitals, Congress' Medicaid payment and access advisers said, but commission members expressed concerns that lag time between CMS' calculations and any changes to state policy may take away from those incentives.
Revamping the Medicaid 1115 waiver process to focus less on budget-neutrality and more on permanent payment and delivery reform was floated by some congressional Medicaid payment advisers this week, drawing interest from Medicaid officials, as a top CMS official acknowledged the agency already exercises some flexibility in enforcing the budget-neutrality rule.
FDA's recent invocation of the Park doctrine in a warning letter to a dietary supplement firm is likely the first time the agency has cited the responsible corporate officer doctrine in a warning letter, according to several food and drug attorneys, who disagreed about whether the move marks a change in the way FDA will enforce supply chain security.
Pioneer ACOs looking to direct patients to lower-cost post-acute care settings recently received a primer on a study funded by the home-health industry that shows patients often could be discharged to lower-cost settings, according to Allen Dobson, president of the health economics firm Dobson | DaVanzo & Associates, which conducted the research.
Hours before the House GOP voted 229-195 in favor of repealing the health reform law, the White House sent out an email plugging key pieces of the law that are viewed as appealing to the Middle Class and urged recipients to sign into a White House website to become part of a network for future ACA messaging.
Health Reform Insider
At least five additional states are considering running their own small business exchanges while letting the federal government run individual exchanges in the wake of HHS' precedent-setting decision on Friday (May 10) allowing Utah to pursue this approach, sources say. Read The Insider