Health Reform | AIS Health

California Urges HHS to Reduce Carrier Flexibility Related to Essential Benefits

From AIS's Health Reform Week - States, which were handed the responsibility by HHS in December for setting up “essential health benefits” packages (HRW 12/19/11, p. 1), now are firing back at the agency. California is taking the lead in urging HHS to revise its Dec. 16 guidance on a national minimum benefit standard, citing “significant concerns” with carrier flexibility, among other provisions. Facing HHS’s Jan. 31 deadline for comments, the California Health Benefit Exchange’s board met Jan. Read more

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Insurers, Employers Fear Impact if Only Individual Mandate Is Killed

From AIS's Health Reform Week - As the nation waits for the Supreme Court to decide by early summer the constitutionality of the health reform law, some sectors of the health care and employer community seem to be more concerned about the possibility that only parts of the law are declared unconstitutional than they are of the whole statute being struck down. For health insurers, for instance, the biggest fear seems to be that the high court… Read more

State Flexibility on EHBs Could Encourage Exchange Development

From Inside Health Insurance Exchanges - Recent clarity about how essential health benefits (EHBs) are likely to be defined could provide a small push to procrastinating states when it comes to building an insurance exchange. Rather than develop a national EHB standard, which was largely expected, a 13-page “bulletin” issued by CMS’s Center for Consumer Information and Insurance Oversight on Dec. Read more

On the Health Reform Bookshelf

Financial Impact of Medical Loss Ratio Regulations

Pre-Existing Condition Exclusions

Impact of Health Reform on Benefit Design

Health Reform Blog

What’s in a Name?

By Jennifer Lubell - February 15, 2012

If folks in the health care industry continue on their hesitant path to use the term “Accountable Care Organization” in describing the latest agreement or venture to coordinate patient care, I may just have to change the name of my monthly newsletter. So long, ACO Business News. Hello…Clinical...

Final Exchange Regulations Are Expected This Month

By Steve Davis - February 10, 2012

In the February issue of Inside Health Insurance Exchanges, I interview Joel Ario, who headed HHS’s Office of Health Insurance Exchanges until last September. Last month, he joined Manatt Health Solutions — a division of the law firm Manatt, Phelps & Phillips, LLP — as a managing director. This...

ACO Models Are Eyeing the Pediatric Population

By Jennifer Lubell - January 30, 2012

We’ve all read about the quest to cover Medicare populations in accountable care, but as of late, I’ve been seeing more news items about kids being the focus of ACO-type models. Several efforts are under way in the private sector and at the state level to apply this concept to pediatric care. The...

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