Dec. 16, 2013
You must be a registered user on AISHealth.com to access the stories below. If you haven't yet registered, please take a minute to register now, and get access to thousands of articles, blogs, Today from Washington postings and more.
(1) HHS Sec. Kathleen Sebelius on Dec. 11 said that she is taking steps to address the “structural and managerial policies that led to the flawed launch of HealthCare.gov.” ... (more)
(2) Since Oct. 1, nearly 1.2 million people have selected a plan or had a Medicaid or CHIP eligibility determination made through the state or federal health insurance exchanges, HHS said on Dec. 11 .... (more)
(3) Maine state Sen. Dawn Hill (D) introduced a bill that would require Anthem Blue Cross Blue Shield to be “transparent” in justifying why its narrow-network product excludes York Hospital and five other hospitals in the state .... (more)
(4) The HHS Office of Inspector General (OIG) has issued a report on the degree to which users of electronic health records have policies addressing the use of the copy-paste function in EHRs and have implemented fraud safeguards .... (more)
(5) HHS on Dec. 12 issued an interim final rule that would move the premium payment deadline for policies purchased on HealthCare.gov and taking effect Jan. 1 up to Dec. 31 from Dec. 23 .... (more)
(6) Horizon Blue Cross Blue Shield of New Jersey on Dec. 6 said a pair of laptops containing members’ personal information, including Social Security numbers and limited clinical information, were stolen from the insurer’s Newark headquarters on the weekend of Nov. 1 .... (more)
(7) Arizona’s Dept. of Insurance on Dec. 6 said health plans that don’t comply with the Affordable Care Act will not be allowed to renew after Jan. 1 .... (more)
(8) Blue Shield of California, WellPoint, Inc. unit Anthem Blue Cross and Health Net Inc. were ordered to “cease and desist” by the California Dept. of Managed Health Care .... (more)
(9) With the consumer-facing www.HealthCare.gov showing significant improvements, HHS is focusing now on what happens after consumers select a plan, according to a Dec. 9 article by Bloomberg News. Data transmission errors on the 834 enrollment forms have been reduced to 1 in 10 since Nov. 30, CMS said on Dec. 6, according to the article. Still, the agency is urging people to call their insurer if they haven’t received a confirmation letter within about a week of signing up. CMS doesn’t have “precise numbers” on how many of the 834 forms, which contain basic information about an enrollee, have been sent to insurers or how many of them contain errors, CMS spokesperson Julie Bataille said Dec. 6. The data that insurers are receiving is improving, although the process remains “a work in progress,” said Aetna Inc. spokesperson Cynthia Michener, according to Bloomberg. When Aetna receives files with missing data, the company contacts CMS to get the information and complete the enrollment, Michener said. But if people call Aetna to confirm their enrollment and it has no information on them, “they may fall into a category of missing records,” she said, according to the article. One bug causing Social Security numbers to be omitted from the enrollment forms has been fixed, Bataille said, adding that this was causing about 80% of the errors. (Reprinted from AIS’s Health Reform Week's e-News Alert)
(10) A coalition of HIV/AIDS organizations contends that some insurers on the exchange are employing tactics that discourage people with HIV from enrolling in their plans, a move that would be illegal. A number of “disturbing trends are emerging regarding coverage of HIV antiretrovirals,” the HIV Health Care Access Working Group (HHCAWG) said in a Dec. 2 letter to HHS Sec. Kathleen Sebelius. The group describes some of these as “egregious cost-sharing designs.” In addition, the group says it continues to see qualified health plans (QHPs) on the exchange that are not covering the HIV antiretrovirals recommended in the HHS Guidelines for the Use of Antiretroviral Agents, including the single tablet regimens that are now recommended as the “preferred” course of treatment. Among others, HHCAWG points to Cigna Corp. placing all of the HIV antiretrovirals on Tier 5 with an up to 40% coinsurance after a deductible of up to $2,750 (reported for Florida and possibly other states), and Aetna Inc. placing the majority of HIV drugs on Tier 3, which requires a 50% coinsurance after a deductible (reported in Florida). The ACA prohibits insurers discriminating against people with pre-existing conditions. The Wall Street Journal on Dec. 10 reported that an HHS spokesperson said the department was “looking into the issue of HIV drug coverage to see if further action is needed." The Journal also reported that a spokesperson for Cigna said it offered a variety of options that allow customers to pick a plan that best meets their needs. A spokesperson for Aetna and its recently acquired unit Coventry Health Care said its plans provide access to HIV care that follow the latest HHS guidelines and evidence-based practices, according to the Journal. (Reprinted from AIS’s Health Reform Week's e-News Alert)
(11) OIG has taken the HHS Office for Civil Rights to task for not meeting all the federal requirements in its oversight and enforcement of the HIPAA security rule .... (more)
Have breaking news or an editorial question? E-mail BJ Taylor, editor of GOVERNMENT NEWS OF THE WEEK, at firstname.lastname@example.org. If you are interested in sponsoring GOVERNMENT NEWS OF THE WEEK please contact Bailey Sterrett at email@example.com.
GOVERNMENT NEWS OF THE WEEK is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this e-mail to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at http://www.magnetmail.net/actions/ atlantic_subscription.cfm, where you can also sign up for AIS's Health Business Daily and Spotlight on Health Insurers.
Copyright © 2013 Atlantic Information Services, Inc. (AIS). All rights reserved. It is not permissible to include all or any portion of this content on any Web site, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to firstname.lastname@example.org.