Tag: ACA

  • Negotiations are now possible, if you can figure out the numbers

    February 28, 2019

    Tags: ,

    A new rule went into effect January 1 requiring hospitals to publish their online price lists for all the medical services they provide.  This was required under the ACA, but now they must be published online in a format that can be downloaded.  The central website for California hospitals for the most common outpatient procedures is www.oshpd.ca.gov/data-and-reports/cost-transparency/hospital-chargemasters/2018-chargemasters

     

  • ACA won’t go away…and the courts are courting further argument

    February 27, 2019

    Tags:

    California’s Attorney General Xavier Becerra is leading the charge of other Attorneys General to appeal a ruling by a conservative Texas federal judge saying that the ACA is unconstitutional.  Even that judge has already said he would reconsider, but for now the rule stands.  The appeal to the US Court of Appeals for the Fifth Circuit is joined by 16 states and the District of Columbia.  “In this particular case we believe the stakes are not only great, but compelling” Becerra, who voted for the ACA when he was a House representative, said.  Ellen Rosenblum from Oregon said “really, this is an absurd interpretation of the law and an overreach of the federal court that will hopefully be stopped at the appellate level”  Of course, others disagree “The court’s decision was about restoring the rule of law and federalism by eliminating an illegal, unconstitutional federal power grab” said a spokesman for the Texas Attorney General.

  • How gruesome is the Newsom model going to be? Or will it be at all…in California

    February 23, 2019

    Tags:

    On his first day in office, the new California governor unveiled a sweeping health plan that would prop up the ACA, expand health care for undocumented immigrants and give the state new powers to negotiation drug prices.  It would fall short of what was indicated in his campaign, however, where he hinted at a Single Payer Health Plan (adored by some, reviled by others).  His plan would reinstate the individual mandate by taxing those who do not have coverage.  While stopping short, Newsom did write to President Trump and congressional leaders asking for permission for California to pursue a government funded health care system.

  • ACA may be here to stay – the judge rules against it, but says it is in place for now

    February 21, 2019

    Tags:

    There has been lots of excitement over the Texas decision ruling the ACA is unconstitutional. Judge Reed O’Connor has now issued a stay of his own opinion, which means the law remains in effect while the inevitable (and already filed) appeals go forward.  Now that the Democrats are in charge of the White House, there will be some other action on this as well, we’re sure.

  • Proposed 2020 Benefit Payment and Parameters Rule | California Benefits Group

    January 30, 2019

    Tags: , ,

    The Centers for Medicare & Medicaid Services (CMS) released a proposed rule for benefit payment and parameters for 2020. CMS also released its draft 2020 actuarial value calculator and draft 2020 actuarial value calculator methodology.

    According to CMS, the proposed rule is intended to reduce fiscal and regulatory burdens associated with the Patient Protection and Affordable Care Act (ACA) across different program areas and to provide stakeholders with greater flexibility.

    Although the proposed rule would primarily affect the individual market and the Exchanges, the proposed rule addresses the following topics that may impact employer-sponsored group health plans:

    • Changes related to prescription drug policy
    • Small Business Health Options Program (SHOP)
    • Prohibition against discrimination
    • Maximum annual limitation on cost sharing for plan year 2020
    • Cost-sharing requirements for generic drugs
    • Cost-sharing requirements and drug manufacturers’ coupons

    CMS usually finalizes its benefit payment and parameters rule in the first quarter of the year following the proposed rule’s release. February 19, 2019 is the due date for public comments on the proposed rule.

    The 2020 open enrollment period will run from November 1, 2019, to December 15, 2019.

     

    by Karen Hsu
    Originally posted on UBABenefits.com

     

  • Negotiations are now possible, if you can figure out the numbers

    February 28, 2019

    Tags: ,

    A new rule went into effect January 1 requiring hospitals to publish their online price lists for all the medical services they provide.  This was required under the ACA, but now they must be published online in a format that can be downloaded.  The central website for California hospitals for the most common outpatient procedures is www.oshpd.ca.gov/data-and-reports/cost-transparency/hospital-chargemasters/2018-chargemasters

     

  • ACA won’t go away…and the courts are courting further argument

    February 27, 2019

    Tags:

    California’s Attorney General Xavier Becerra is leading the charge of other Attorneys General to appeal a ruling by a conservative Texas federal judge saying that the ACA is unconstitutional.  Even that judge has already said he would reconsider, but for now the rule stands.  The appeal to the US Court of Appeals for the Fifth Circuit is joined by 16 states and the District of Columbia.  “In this particular case we believe the stakes are not only great, but compelling” Becerra, who voted for the ACA when he was a House representative, said.  Ellen Rosenblum from Oregon said “really, this is an absurd interpretation of the law and an overreach of the federal court that will hopefully be stopped at the appellate level”  Of course, others disagree “The court’s decision was about restoring the rule of law and federalism by eliminating an illegal, unconstitutional federal power grab” said a spokesman for the Texas Attorney General.

  • How gruesome is the Newsom model going to be? Or will it be at all…in California

    February 23, 2019

    Tags:

    On his first day in office, the new California governor unveiled a sweeping health plan that would prop up the ACA, expand health care for undocumented immigrants and give the state new powers to negotiation drug prices.  It would fall short of what was indicated in his campaign, however, where he hinted at a Single Payer Health Plan (adored by some, reviled by others).  His plan would reinstate the individual mandate by taxing those who do not have coverage.  While stopping short, Newsom did write to President Trump and congressional leaders asking for permission for California to pursue a government funded health care system.

  • ACA may be here to stay – the judge rules against it, but says it is in place for now

    February 21, 2019

    Tags:

    There has been lots of excitement over the Texas decision ruling the ACA is unconstitutional. Judge Reed O’Connor has now issued a stay of his own opinion, which means the law remains in effect while the inevitable (and already filed) appeals go forward.  Now that the Democrats are in charge of the White House, there will be some other action on this as well, we’re sure.

  • Proposed 2020 Benefit Payment and Parameters Rule | California Benefits Group

    January 30, 2019

    Tags: , ,

    The Centers for Medicare & Medicaid Services (CMS) released a proposed rule for benefit payment and parameters for 2020. CMS also released its draft 2020 actuarial value calculator and draft 2020 actuarial value calculator methodology.

    According to CMS, the proposed rule is intended to reduce fiscal and regulatory burdens associated with the Patient Protection and Affordable Care Act (ACA) across different program areas and to provide stakeholders with greater flexibility.

    Although the proposed rule would primarily affect the individual market and the Exchanges, the proposed rule addresses the following topics that may impact employer-sponsored group health plans:

    • Changes related to prescription drug policy
    • Small Business Health Options Program (SHOP)
    • Prohibition against discrimination
    • Maximum annual limitation on cost sharing for plan year 2020
    • Cost-sharing requirements for generic drugs
    • Cost-sharing requirements and drug manufacturers’ coupons

    CMS usually finalizes its benefit payment and parameters rule in the first quarter of the year following the proposed rule’s release. February 19, 2019 is the due date for public comments on the proposed rule.

    The 2020 open enrollment period will run from November 1, 2019, to December 15, 2019.

     

    by Karen Hsu
    Originally posted on UBABenefits.com

     

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