Tagged with ACA Affordable Care Act

VT – ACO Pilot Project Announced

Vermont has entered into a one year agreement with OneCare to launch an ACO pilot program serving 30,000 Medicaid beneficiaries.

Humana to Exit ACA Exchanges by 2018

Humana has announced its plans to cease sales of individual health insurance plans through the ACA’s exchanges by 2018, potentially leaving more than 150,000 customers without a carrier.

CMS Issues Non-ACA Compliant Plans Extension

CMS issued an insurance standards bulletin granting another extension to non-ACA-compliant health plans to allow insurers and consumers to extend for an additional year.

CMS Releases Medicaid Spending Report

According to the recently released annual report from CMS, in fiscal year 2016 states and federal government grew 4.3% to $575.9 billion and federal Medicaid spending grew 4.5% to $363.4 billion for the program to cover low income and disabled people. The report states Medicaid spending has increased in recent years and is expected to continue to rise, potentially reaching levels that could “displace spending on other important programs.”

OIG Final Rule Expands Exclusion Authorities

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has issued a final rule expanding the authority to exclude individuals and entities from federal health care programs.

PA – New Global Capitation Model for Rural Hospitals

CMS has announced a new global capitation model for rural hospitals in Pennsylvania. Under the new model participating critical access hospitals and acute care hospitals will receive all-payer global budgets for a fixed amount of money that is set in advance and funded by all participating insurers, to cover inpatient and outpatient services.

UnitedHealth Group to Buy Outpatient Surgery Chain for $2.3 Billion

UnitedHealth Group has announced plans for its health services unit, Optum, to acquire Surgical Care Affiliates (SCA). Under the acquisition, Optum would add to its footprint SCA 205 surgical facilities, which SCA operates in partnership with thousands of surgeons in 33 states.

ACA Repeal Efforts Begin, while Sign-Ups Continue to Rise

As senate and legislative efforts to repeal the Affordable Care Act (ACA) pick-up, the American Medical Association sent a letter to congressional leaders called on lawmakers to outline plans to replace the ACA before they repeal the law. Despite these efforts, it was recently announced that 8.8 million U.S. residents have signed up for health plans through the federal exchange.

ME – Citizens Respond to State’s Denial of Medicaid Expansion

The only northeastern state not to choose Medicaid expansion under the Affordable Care Act (ACA), Maine will be one of five of the original 23 ACA-created co-ops that will continue into 2017. In response and in hopes of in hopes of extending coverage to 70,000 residents, residents are petitioning to put a proposal to expand the ME Medicaid program before the Legislature.