Tag Archives: Patient Protection and Affordable Care Act (PPACA)

CMS Monthly Calls on ACA Provider Issues – Medicaid Expansion Call on Sept. 13

CMS has announced that it is hosting monthly conference calls on ACA implementation efforts that impact doctors, nurses, hospitals and other health care providers. These calls will be held on the second Thursday of the month, and will review recent HHS announcements, focus on select topics, and provide an opportunity for public feedback.  The first … Continue Reading

Congressional Hearings

The Senate Health, Education, Labor and Pensions Committee held a field hearing in Connecticut on “Lyme Disease: A Comprehensive Approach to an Evolving Threat.”  On September 11, 2012, the House Ways and Means Oversight Subcommittee is holding a hearing on the Internal Revenue Service’s implementation of various ACA tax provisions. Also on September 11, the … Continue Reading

Jumping Off The ‘Fiscal Cliff’? What Can Happen When Congress Returns?

With all attention now focused on the campaign for control of Congress and the Presidency, it might be easy to forget that the 112th Congress is still in session and returns to work in September. When Congress does return, a number of important decisions affecting health care and energy policy, among other areas, remain to be considered.… Continue Reading

IRS Schedules Nov. 9, 2012 Hearing on ACA Branded Prescription Drug Fee

The Internal Revenue Service (IRS) is holding a November 9, 2012 public hearing on the ACA’s branded prescription drug fee.  The subject of the hearing will be the agency’s August 18, 2011 notice of proposed rulemaking that cross-referenced temporary regulations also issued on August 18.  The IRS must receive outlines of topics to be discussed at the … Continue Reading

HHS Final Rule on Accreditation Entities, Data Collection Requirements for ACA Qualified Health Plans

On June 20, 2012, HHS is publishing a final rule to implement the first phase of a process to recognize accrediting entities that will certify qualified health plans for participation in ACA Affordable Insurance Exchanges. In phase one, HHS is recognizing the National Committee for Quality Assurance and URAC as accrediting entities on an interim … Continue Reading

July Congressional Hearings

Congressional panels have examined a number of health policy issues recently, including: ACA Hearings: The House Ways and Means Committee held a hearing on the implications of the Supreme Court’s ruling that the individual mandate in the ACA is constitutional, particularly as it relates to Congress’ taxing authority.  The House Oversight and Government Reform Committee … Continue Reading

House Appropriations Panel Votes to Defund ACA, AHRQ

On July 18, 2012, the House Appropriations Subcommittee on Labor, Health and Human Services, and Education approved legislation funding federal programs in its jurisdiction. Among other things, the bill would block funding to implement the ACA (except for select provisions) and cut funding for various government entities established by the ACA, including the Center for … Continue Reading

Massachusetts Loosens Drug/Device Manufacturer Gift Ban and Disclosure Law, Allows Certain Drug Coupons and Vouchers

As drug and device manufacturers continue to await final federal rules implementing the Affordable Care Act’s Physician Payment Sunshine Act (“Sunshine Act”) provisions, Massachusetts has relaxed its similar state law banning the provision by manufacturers of gifts to health care practitioners (HCPs) and requiring disclosure of payments and transfers of value to HCPs. The revisions … Continue Reading

Congressional Panels Schedule Hearings on ACA Issues (Tax Policy, Physician/Economic Impact)

On July 10, 2012, the House Ways and Means Committee will hold a hearing on the implications of the Supreme Court’s ruling that the individual mandate in the Affordable Care Act (ACA) is constitutional, particularly as it relates to Congress’ authority to lay and collect new taxes. Also on July 10, the House Oversight and Government … Continue Reading

Supreme Court Upholds ACA Insurance Mandate, Limits Withholding of Medicaid Funds to States

This post was also written by Tillman J. Breckenridge. As has been widely reported, today the U.S. Supreme Court ruled that the Affordable Care Act’s (ACA) individual health insurance mandate does not violate the Constitution because it may be viewed as a permissible tax on individuals who do not obtain health insurance.  The only provision of the … Continue Reading

IRS Proposes ACA Standards for Charitable Hospitals

On June 26, 2012, the Internal Revenue Service (IRS) published proposed regulations implementing ACA requirements for charitable hospitals relating to financial assistance and emergency medical care policies, charges for certain care provided to individuals eligible for financial assistance, and billing and collections. Note that the proposed regulations do not address the ACA’s community health needs … Continue Reading

Insurers to Provide $1.1 Billion in Rebates Under ACA Medical Loss Ratio (MLR) Standard

HHS announced on June 21, 2012 that health insurers will pay a total of $1.1 billion in rebates this summer under the ACA’s MLR provision. Under this provision, insurers were required to spend at least 80% of total premium dollars collected on medical care and quality improvement in 2011 or pay rebates to their customers … Continue Reading

Accreditation Entities for ACA Qualified Health Plans

On June 5, 2012, the Department of Health and Human Services (HHS) published a proposed rule that would implement the first phase of a process to recognize accrediting entities that will certify qualified health plans for participation in ACA Affordable Insurance Exchanges. In phase one, HHS proposes to recognize the National Committee for Quality Assurance … Continue Reading

CMS Accepting New Applications for Advance Payment ACO Model

Through the Advance Payment Accountable Care Organization (ACO) initiative, CMS is testing the extent to which pre-paying a portion of future shared saving could increase participation in CMS’s Medicare Shared Savings Program (MSSP). While CMS previously announced that applications would only be accepted for April 1, 2012 and July 1, 2012 start dates, CMS now … Continue Reading

Congressional Health Policy Hearings

Recent hearings on health policy issues include: Senate Health, Education, Labor and Pensions Committee hearings on HIV/AIDS drug costs, health care delivery reforms, and federal laws to ensure patients’ access to care and privacy. A Senate Finance Committee hearing on “Progress in Health Care Delivery: Innovations from the Field.” A House Judiciary Subcommittee on Intellectual … Continue Reading

ACA Medical Loss Ratio (MLR) Notification Requirements

CMS published a final rule May 16, 2012 that establishes reporting requirements for health insurance issuers in the group and individual markets that meet or exceed the applicable Affordable Care Act (ACA) MLR standard in the 2011 MLR reporting year. The policy builds on a December 7, 2011 final rule with comment period that established notice … Continue Reading

HHS Corrects ACA Affordable Insurance Exchanges Rule, Issues Guidance for States.

The Department of Health and Human Services (HHS) has posted a notice correcting technical and typographical errors in its March 27, 2012 interim final rule implementing the new Affordable Insurance Exchanges under the ACA. The correction notice is effective May 29, 2012. HHS also has released an “Exchange Blueprint” for states to use to demonstrate … Continue Reading

PCORI Announces ACA Comparative Effectiveness Funding

The Patient-Centered Outcomes Research Institute Board (PCORI), which was established by the ACA, has announced that it is seeking applicants for $120 million in funding for comparative effectiveness research projects involving: (1) Assessment of prevention, diagnosis, and treatment options; (2) improving healthcare systems; (3) communication and dissemination; and (4) addressing disparities.… Continue Reading