March 10, 2014
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(1) The announcement by the Obama administration on March 5 that health insurers and state regulators have the option of extending individual and small-group policies that do not meet Affordable Care Act (ACA) coverage requirements for an additional two years will likely not be as big of a deal for insurers as was the first time the cancelled plans were given a reprieve .... (more)
(2) A bill on the two-midnight rule was introduced in the U.S. Senate on March 6 by Sens. Robert Menendez (D-NJ) and Deb Fisher (R-NE) .... (more)
(3) Democratic senators have proposed the creation of a new, lower-cost metal tier category for policies sold through public insurance exchanges .... (more)
(4) The White House is requesting $629 million from Congress for CMS activities and administrative expenses supporting insurance exchange operations in fiscal year 2015. The figure is part of the Obama administration’s $77.1 billion request to fund all HHS operations, according to a White House budget blueprint released March 4. In the document, CMS said it will collect roughly $1.2 billion in user fees from issuers in the federal exchange, as well as reinsurance and risk adjustment administrative collections, for a total of $1.8 billion. Other ACA-related items include a $400 million request in funding for the Office of Inspector General (OIG), an increase of $105 million over fiscal year 2014 levels. The increase would let OIG expand its CMS program integrity and investigative efforts focused on civil fraud, oversight of grants, and the operation of Affordable Care Act programs, according to the budget. (Reprinted from AIS’s Health Reform Week's e-News Alert)
(5) CMS is practicing common sense by allowing people who could not get federal subsidies when trying to purchase health insurance on technologically troubled exchanges the opportunity to retroactively obtain them .... (more)
(6) Diagnostic Imaging Group (DIG) agreed to pay $15.5 million to settle allegations that it submitted claims to Medicare and Medicaid for tests that were not performed or were not medically necessary .... (more)
(7) Covered California on Feb. 28 said that about 14,500 residents will need to resubmit their online applications due to a software malfunction .... (more)
(8) The Arkansas House of Representatives on March 4 voted 76-24 to appropriate federal funding to continue the state’s closely watched Medicaid expansion program under the Affordable Care Act (ACA), according to a March 4 article by Arkansas News. The state Senate passed the $915 million appropriations bill last month by a 27 to 8 vote. Arkansas Gov. Mike Beebe (D) said he would sign the bill. The House had failed in four previous attempts to pass a continuation of the so-called “private option” Medicaid expansion plan, the article said. Opponents questioned whether the state would be able to afford its eventual 10% share of the program’s cost, according to the article. Under the ACA, states may voluntarily expand Medicaid to individuals earning up to 138% of the federal poverty level. The feds pay for 100% of the expansion population until 2016, at which time funding starts to gradually taper off to 90%. Many GOP-controlled states have rejected the expansion. Arkansas gained national attention for its model that uses federal Medicaid dollars to subsidize people who purchase private health insurance. Roughly 94,000 people have enrolled in private plans through the program, and another 11,000 who applied have been enrolled in traditional Medicaid, according to the Arkansas Department of Human Services, the Arkansas News reported. (Reprinted from AIS’s Health Reform Week's e-News Alert)
(9) The Obama administration on March 5 released a set of final rules and policy changes to the Affordable Care Act (ACA) .... (more)
(10) Olmsted Medical Center in Rochester, Minn., said that on Feb. 3 it “became aware of unlawful and unauthorized electronic access to information stored on OMC’s employee database." .... (more)
(11) The Nevada Health Services Coalition (NHSC) last month filed a federal complaint with HHS’s Office for Civil Rights (OCR) against Dignity Health .... (more)
(12) OCR has posted its model Notice of Privacy Practices in Spanish .... (more)
(13) According to the HHS Office of Inspector General (OIG), Humana Inc. agreed to pay $1,814,000 for allegedly violating the Civil Monetary Penalties Law by submitting prescription drug event (PDE) claims .... (more)
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