As employers who sponsor group health plans well know, health care reform prevents plans from imposing waiting periods in excess of 90 days for employees who are otherwise eligible to enroll in a plan. The latest guidance relating to the waiting-period rules addresses the boundaries of “reasonable and bona …
HHS POISED FOR ROUND TWO OF ORPHAN DRUG FIGHT
June 16, 2014 Leave a Comment
HHS isn’t ready to throw in the towel in the fight over expansion of the 340B program under the Affordable Care Act (ACA). On Thursday HHS said in a court filing that it will appeal last month’s federal court ruling that struck down a regulation issued by the Health Resources & Services …
Pay-or-Play: Think Globally
June 9, 2014 Leave a Comment
With the effective date of the “pay-or-play” employer mandate just over the horizon, employers who sponsor group health plans are well aware of the layers of complexity presented by the mandate. One of the layers that employers should be sure to unpack: how do the rules affect expatriate (expat) and …
Finally…CMMI announces first dozen HCIA Round 2 Awards
May 22, 2014 Leave a Comment
After much delay, the Center for Medicare & Medicaid Innovation (CMMI) today announced a dozen awards under its Health Care Innovation Award (HCIA) Round two competition. The $1 billion funding competition sought proposals focused on reducing Medicare and Medicaid expenditures and proposing new payment models. …
Oh Baby: Medicare Wants to Focus on Early Elective Deliveries
May 21, 2014 Leave a Comment
Deep within the proposed FY 2015 Inpatient Prospective Payment System (IPPS) rule released a few weeks back is an interesting proposed new measure to the Medicare hospital Value-Based Purchasing (VBP) program - elective deliveries prior to 39 weeks gestation. When most people think of Medicare, delivering …
First of Two HHS Secretary Confirmation Hearings Set
April 28, 2014 Leave a Comment
The Senate Health, Education, Labor and Pensions Committee will kick off the vetting of HHS Secretary-designee Sylvia Matthews Burwell with a confirmation hearing on May 8th. Burwell, currently the head of the Office of Management and Budget (OMB), will also have to go before the Senate Finance Committee in the …