Tagged with ACA Affordable Care Act

New Hampshire Senate Passes Medicaid Telehealth Bill

The New Hampshire Senate has passed a bill expanding Medicaid coverage for telehealth services. The bill, if finalized, would allow a patient to receive primary care in addition to specialty care via telehealth and enables Medicaid to cover far more connected care services than previously.

Federal Judge Rules ACA is Unconstitutional

A federal judge in Texas has ruled that the entire Affordable Care Act (ACA) is unconstitutional on the grounds that its mandate requiring people to buy health insurance is unconstitutional and the rest of the law cannot stand without it.

Illinois Legislature Overrides Veto of Short-Term Health Plan Limit

State legislators in Illinois have voted to override the Governor’s veto of a bill intended to place restrictions on short-term health insurance plans sold in in the state, which are exempt from offering certain protections required under the Affordable Care Act (ACA).

CY 2019 OPPS and ASC Payment System Final Rule Released

CMS has released its Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule for the next calendar year. According to the agency, the policies adopted in the CY 2019 final rule will help lay the foundation for a patient-driven healthcare system and will also strengthen the Medicare program by providing more choices and lower cost options.

Virginia – House Passes Medicaid Expansion

The Virginia House of Delegates recently passed a state budget that includes funding for Medicaid expansion and stricter work requirements. If finalized, the state budget legislation would expand Medicaid eligibility to about 400,000 low-income adults.

Humana Claim Processing Edits

Humana has released several claims processing edits, including updates to Outpatient Prospective Payment System (OPPS), Modifiers 96 and 97, HCPCS Drugs & Biologicals, and other policies.

Final 2019 Notice of Benefit and Payment Parameters Released

CMS and the Department of Health and Human Services (HHS), on April 9, issued the Notice of Benefits and Payment Parameters (NBPP) final rule for plan year 2019, updating policies and standards applying to qualified health plans (QHPs) offered on Affordable Care Act (ACA) Exchanges.

New Hampshire House and Senate Approve Medicaid Expansion Bill

The New Hampshire House Health and Human Services Committee and Senate have passed legislation to reauthorize the state’s Medicaid expansion program for an additional five years, as well as add work requirements, and will also transition beneficiaries from the individual insurance exchange into a managed care model.

Department of Health and Human Services Announces Future Changes to Provider Reimbursements

The Department of Health and Human Services (HHS) has announced its plans to overhaul the way the federal government reimburses providers. The Department states, in an effort to improve technology and transparency, it will make changes to interoperability, price transparency, and care delivery through Medicare and Medicaid, and remove regulations that hinder private innovation.

States Consider Individual Mandates in Place of Federal Individual Mandate

Nine states and the District of Columbia have announced they are considering laws that would require residents to purchase health insurance. Connecticut, Rhode Island, New Jersey, and Vermont, are amongst the states considering the state mandates to replace the recently repealed federal individual mandate.

New CBO Estimate shows ACA Mandate Repeal Cuts CHIP Funding Costs

The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) recently announced that the repeal of the Affordable Care Act’s (ACA) individual mandate will significantly cut the cost to fund the Children’s Health Insurance Program (CHIP) for five more years.

OH – State Review Panel Releases Medicaid Funds

The Ohio Controlling Board voted unanimously to continue funding for the state’s Medicaid Program, releasing $264 million in state funding needed to qualify for $638 million in federal matching funds.

House Votes to Continue CHIP Funding

The U.S. House of Representatives voted 242-174 to reauthorize federal funding to maintain low-cost health insurance to 8.9 million children and 370,000 pregnant women under the Children’s Health Insurance Program (CHIP). The Healthy Kids Act extends CHIP’s federal funding for five years and federally qualified health centers for two years.

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