Medicaid and CCO Update. Presented by Kelly Knivila OSB Health Law Section October 2017
|
|
- Kelley Beasley
- 5 years ago
- Views:
Transcription
1 Medicaid and CCO Update Presented by Kelly Knivila OSB Health Law Section October 2017
2 WHAT WE WILL COVER Federal Medicaid Update Oregon Medicaid Update Some facts, some news, some new laws 2
3 Federal Medicaid Update
4 FEDERAL SOME FACTS Medicaid is joint federal/state program of health insurance for low income Americans Federal share = 50% to 75% Total Medicaid spending = $553B Medicaid = over half of all federal revenue going to states 1 in 5 Americans are covered by Medicaid Largest payer of long-term care services for seniors and people with disabilities 32 states have implemented Medicaid expansion 4
5 FEDERAL SOME NEWS 5
6 FEDERAL SOME NEWS Affordable Care Act Expanded Medicaid to 138% of poverty level (state option) with increased federal match for expansion population (90% in 2020) Better Care Reconciliation Act proposal Phase out additional federal match by 2024 Convert federal Medicaid spending to per capita Limit growth of federal spending using medical CPI Optional state block grant No Medicaid for Planned Parenthood 6
7 FEDERAL SOME NEWS Graham-Cassidy proposal Repeal Medicaid expansion authority and funding by 2020 Convert federal Medicaid spending to per capita Limit growth of federal spending using medical CPI Optional state block grant State option to require work as a condition of Medicaid eligibility (non-elderly, non-disabled) No Medicaid for Planned Parenthood for one year 7
8 FEDERAL SOME NEWS Tom Price, Obamacare Critic, Is Trump s Choice for Health Secretary NYT 11/28/16 Trump Picks Seema Verma To Run Medicare And Medicaid NPR 11/29/16 Seema Verma s Austere Vision for Medicaid The Atlantic 2/17/2017 8
9 FEDERAL SOME NEWS On first day in office, new Medicaid chief urges states to charge premiums, prod recipients to get jobs Washington Post 3/15/17 CMS letter to state governors encourages waivers [E]mpower [low income Americans] with skills and employment Able-bodied work requirements, lifetime limit on benefits Help working-age, non-disabled adults prepare for private coverage by aligning Medicaid with commercial plans Premium payments, ER co-pays, penalties for failing to renew 9
10 FEDERAL SOME NEWS CMS says it will change direction of CMMI, wants providers to have greater flexibility in payment model design HealthcareITNews 9/20/17 Price Resigns From Trump Cabinet Amid Private Jet Investigations NPR 9/29/17 After Tom Price resigns over travel flap, Indiana s Seema Verma on list of possible replacements Des Moines Register 9/30/17 10
11 FEDERAL SOME NEW LAWS Institution for Mental Disease Exclusion MCO Exception went into effect July 2016 Permits states to pay MCOs for treatment in IMDs Up to 15 calendar days/month Not for Substance Use Disorder 11
12 FEDERAL SOME NEW LAWS Mental Health Parity applies to Medicaid plans Mental Health Parity and Addiction Equity Act (MHPAEA) (2008) for group health plans Medicaid Final Rules apply MHPAEA to Medicaid and CHIP programs (2016) 42 CFR et seq. CMS issued guidance toolkit (January 2017) States required to document compliance by October
13 Oregon Medicaid Update
14 OREGON SOME FACTS $8.6B in Medicaid spending FY % = federal share of spending (more for expansion population) 67% of federal funds received by Oregon are Medicaid funds 10% of state general fund spending in Oregon is for Medicaid Medicaid is 50% of long term care spending in Oregon Medicaid expansion ($2.7B in additional federal $) 14
15 OREGON SOME NEWS Oregon Spending Millions On Ineligible Medicaid Recipients, Secretary Of State Warns OPB 5/17/17 Oregon Secretary of State Dennis Richardson slammed for inaccurate Medicaid audit alert USA Today, 5/23/17 Oregon removes nearly 55,000 people from Medicaid after they failed eligibility checks Oregonian, 8/31/17 15
16 OREGON SOME NEWS FamilyCare accuses state of trying to put it out of business Oregonian, 2/2/17 FamilyCare Sues Oregon Health Authority Over Reimbursement Rates Again OPB 2/28/17 State sought to plant negative stories about nonprofit, Portland Tribune 8/8/17 OHA director Lynne Saxton resigns in wake of FamilyCare PR controversy PBJ, 8/8/17 Brown taps DCBS director Allen as OHA s new acting director PBJ 8/16/17 16
17 OREGON SOME NEW LAWS CCO Bill to Convert all CCOs to Non-Profits Dies (HB 2122). Concerns motivating the law: Lack of transparency of finances Profits should be used to improve health Citizen boards not really in charge Keeping control local SB 934 passed By 2023, CCOs must spend 12% of budget on primary care (excluding drugs, vision, dental) Similar requirement for commercial/state plans 17
18 OREGON SOME NEW LAWS HB 2675 passed Mandates that CCO s community advisory council adopt a plan and strategy for integrating physical, behavioral and oral health care services HB 2882 passed Requires CCOs to have a DCO representative on governing board HB 2398 passed Prohibits health care provider from billing or soliciting payment from a Medicaid recipient, except co-pays 18
19 OREGON SOME NEW LAWS SB 419 passed Task force to study feasibility of all-payer hospital rate-setting process (Maryland) HB 2391 passed Health insurance and managed care assessment (aka tax) ($670M) 1.5% tax on Medicaid plans, PEBB, commercial insurers Hospital Provider Tax increases by 0.7% Funds generated used for Medicaid and Oregon Reinsurance Programs 19
20 OREGON SOME NEW LAWS IMD Exclusion Exception New Rule: OAR (10) permits CCO to cover service in IMD consistent with new federal rule Meet requirements for in lieu of services: medically appropriate, cost effective alternative to a covered service Member cannot be required to use Offered CCOs optional contract amendments to permit but no rate increase 20
21 OREGON SOME NEW LAWS Mental Health Parity applies to CCOs in Oregon OHA provided training to CCOs (April 2017) CCOs required to perform mental health parity analysis and submit to OHA (May 2017) Identify MH/SUD benefits Map to 4 benefit classifications (inpatient, outpatient, emergency, prescription drugs) Evaluate quantitative and non-quantitative treatment limits Compare to medical/surgical limits 21
22 OREGON A NEW WAIVER New five year 1115 demonstration wavier ( ) Expedited approval process Maintains core components CCOs providing integrated physical, behavioral and oral health care Payment innovation and sustainable rate of growth Evidence-based benefits (Prioritized List) Continues hospital transformation performance program 22
23 OREGON A NEW WAIVER New Flexibility to Transform the Health System Permits CCOs to be paid financial incentives to offset costs of non-traditional services that improve health Permits new performance incentive payments to PCPs Tribal Uncompensated Care Program transitioned to be a Medicaid benefit Easier enrollment in CCOs for dual eligibles (Medicare/Medicaid) 23
24 Questions? Presented by Kelly Knivila OSB Health Law Section October 2017
Republican Senators Unveil New ACA Repeal and Replace Legislation
September 14, 2017 Republican Senators Unveil New ACA Repeal and Replace Legislation Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI) Sept. 13 unveiled a health
More informationMedicaid Alternative Benefit Plans and Essential Health Benefits 9/10/13
Medicaid Alternative Benefit Plans and Essential Health Benefits 9/10/13 Melissa Harris, Division Director Division of Benefits and Coverage Disabled and Elderly Health Programs Group Background Intended
More informationCMS Final Rule: Mental Health/Substance Use Disorder Parity
CMS Final Rule: Mental Health/Substance Use Disorder Parity Understanding the Impact of the Mental Health Parity and Addiction Equity Act Final Regulations Speakers: Barbara Leadholm, Principal, Don Novo,
More informationMental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) Pete Liggett, Ph.D., Licensed Psychologist Deputy Director, Behavioral Health & Long Term Living Mental Health Parity and Addiction Equity
More informationThe Next Big Challenge. ACA Repeal, MedicaidBlock Grants & Per Capita Caps
The Next Big Challenge ACA Repeal, MedicaidBlock Grants & Per Capita Caps A Joint Project Lisa Pugh, Exec. Director The Arc Wisconsin Lynn Breedlove, Co-Chair WI Long-Term Care Coalition Overview of the
More informationNJ FamilyCare Update Meghan Davey, Director Division of Medical Assistance and Health Services
NJ FamilyCare Update Meghan Davey, Director Division of Medical Assistance and Health Services Division of Mental Health and Addiction Services Provider Quarterly Meeting March 9, 2017 February 2017 Enrollment
More informationOverview of the March 29, 2016 Final Rule on the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care
Overview of the March 29, 2016 Final Rule on the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations, the Children s Health Insurance Program, and
More informationPARITY WORK IN THE STATES. Paritytrack.org
PARITY WORK IN THE STATES WHAT S ON THE AGENDA? Basic overview of parity as a concept Parity laws, both state and federal Parity enforcement & non-compliance with parity laws What are we doing in the states?
More informationImplementing the Alternative Benefit Plan
Implementing the Alternative Benefit Plan Carolyn Ingram, Senior Vice President Shannon McMahon, Director of Coverage and Access State Network Medicaid Small Group Convening April 25, 2013 Agenda Alternative
More informationCOALITION FOR WHOLE HEALTH
COALITION FOR WHOLE HEALTH June 9, 2015 Andy Slavitt, Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, Maryland 21244
More informationIntegrated Care Program and Dual Eligible Transition. Rebecca Thompson Benefits Advocacy Coordinator Progress Center for Independent Living
Integrated Care Program and Dual Eligible Transition Rebecca Thompson Benefits Advocacy Coordinator Progress Center for Independent Living Basics Managed Care Program through the Illinois Department of
More informationACA AHCA BCRA ORRA GCHJ Medicaid. rate 5% each year over a threeyear. period (CYs ), grandfathered federal match for CY 2024 and
Senate Republican leaders are considering a proposal to repeal and replace parts of the Affordable Care Act (ACA) sponsored by Sens. Graham (R-SC), Cassidy (R-LA), Heller (R-NV) and Johnson (R-WI). Below
More informationFinal Regulation on Mental Health Parity in Medicaid: NAMD Summary
Final Regulation on Mental Health Parity in Medicaid: NAMD Summary April 21, 2016 In April 2016, the Centers for Medicare and Medicaid Services (CMS) released a final regulation which implements mental
More informationCMS s 2018 Proposed Medicaid Managed Care Rule: A Summary of Major Provisions
January 2019 Issue Brief CMS s 2018 Proposed Medicaid Managed Care Rule: A Summary of Major Provisions Elizabeth Hinton and MaryBeth Musumeci Executive Summary Managed care is the predominant Medicaid
More informationBehavioral Health Parity and Medicaid
Behavioral Health Parity and Medicaid MaryBeth Musumeci Behavioral health parity refers to requirements for health insurers to cover mental health and substance use disorder services on terms that are
More informationHealth Care Reform Implementation and State Health Policy
The American Occupational Therapy Association, Inc. Health Care Reform Implementation and State Health Policy Chuck Willmarth, CAE Associate Chief Officer, Health Policy and State Affairs ALOTA 2017 Fall
More informationAugust Summary: Senate Better Care Reconciliation Act (BCRA) Incorporating The Graham- Cassidy- Heller Amendment
August 2017 Summary: Senate Better Care Reconciliation Act (BCRA) Incorporating The Graham- Cassidy- Heller Amendment Near the end of July 2017, as the U.S. Senate began voting on various Republican- sponsored
More informationAldridge Financial Consultants January 12, 2013
Aldridge Financial Consultants Mark D. Aldridge, CFP, CFA, ChFC 3021 Bethel Road Suite 100 Columbus, OH 43220 614-824-3080 Fax 614 824-3082 mark.aldridge@raymondjames.com www.markaldridge.com Health-Care
More informationUpdate on the Affordable Care Act. Kevin Shah, MD MBA. Review major elements of the affordable care act
Update on the Affordable Care Act Kevin Shah, MD MBA 1 Goals Review major elements of the affordable care act Review implementation of the Individual Exchange Review the Medicaid expansion Discuss current
More informationAffordable Care Act Repeal and Replacement Legislation
Affordable Care Act Repeal and Replacement Legislation Timeline/ Actions to Date In February 2017, draft legislation aimed at repealing and replacing the Affordable Care Act (ACA), or Obamacare, was informally
More informationSenate s BCRA Includes Major Changes to Medicaid and the ACA
Senate s BCRA Includes Major Changes to Medicaid and the ACA Premium Tax Credits... 1 Cost Sharing Reductions... 3 Insurance Market Reforms... 4 Section 1332 Waivers... 4 State Stability and Innovation
More informationPart I SECTION The first three sections of this initiative focuses on its key objectives, and defines the terminology found throughout Part I.
Part I SECTION 101-103 The first three sections of this initiative focuses on its key objectives, and defines the terminology found throughout Part I. 101 UNIVERSAL COVERAGE PROTECTING HEALTH CARE CHOICES
More informationDepartment of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) 42 CFR Parts 438, 440, 456, and 457 CMS 2333 F
Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) 42 CFR Parts 438, 440, 456, and 457 CMS 2333 F Medicaid and Children s Health Insurance Programs; Mental Health
More informationSummary of the Better Care Reconciliation Act of 2017
June 2017 Updated July 20, 2017 Summary of the Better Care Reconciliation Act of 2017 This summary describes key provisions of H.R. 1628, the Better Care Reconciliation Act of 2017, an amendment in the
More informationThe Affordable Care Act: A Summary on Healthcare Reform. The Wyoming Department of Insurance
The Affordable Care Act: A Summary on Healthcare Reform The Wyoming Department of Insurance The ACA is a federal law that impacts Wyoming and its citizens. The State of Wyoming has filed a lawsuit against
More informationM E N T A L H E A L T H P A R I T Y A N D A D D I C T I O N E Q U I T Y A C T ( M H P A E A )
H E A L T H W E A L T H C A R E E R M E N T A L H E A L T H P A R I T Y A N D A D D I C T I O N E Q U I T Y A C T ( M H P A E A ) N E W M E X I C O B E H A V I O R A L H E A L T H C O L L A B O R A T I
More informationHealth Care Reform. Navigating The Maze Of. What s Inside
Navigating The Maze Of Health Care Reform What s Inside Questions and Answers on Health Care Reform Health Care Reform Timeline Health Care Reform Glossary Questions and Answers on Health Care Reform I
More informationHow it helps individuals and families who live with mental illness
Health Care Reform: How it helps individuals and families who live with mental illness Health Care and Mental Illness Today, recovery is the expectation for people who experience mental illness. We know
More informationAlternative Strategies for Medicaid Revenue Maximization in Behavioral Health. January 20, 2017
Alternative Strategies for Medicaid Revenue Maximization in Behavioral Health January 20, 2017 Strategies used by states Maximizing federal funds Use the State Plan to maximize the reach of Medicaid 1.
More informationU.S. Senate Finance Committee Coverage Policy Options Detailed Section by Section Summary May 18, 2009
U.S. Senate Finance Committee Coverage Policy Options Detailed Section by Section Summary May 18, 2009 This document outlines the 61-page report, Expanding Health Care Coverage: Proposals to Provide Affordable
More informationFederal Health Care Reform
Federal Health Care Reform Presentation to Behavioral Health Collaborative Katie Falls, HSD Secretary May 26, 2010 1 Health Care Reform Areas of Impact Insurance Reforms Medicare Medicaid Quality Improvement
More informationSummary of House Discussion Draft, February 10, 2017
Summary of House Discussion Draft, February 10, 2017 This summary describes key provisions of House Discussion Draft, dated February 10, 2017, reported in the media as a plan to repeal and replace the
More informationHealth Care Reform, Substance Abuse Prevention and Treatment. DAS Professional Advisory Committee Meeting June 18, 2010
Health Care Reform, Substance Abuse Prevention and Treatment DAS Professional Advisory Committee Meeting June 18, 2010 The Patient Protection and Affordable Care Act The Patient Protection and Affordable
More informationHere are some highlights of the revised Senate language released July 13:
The Better Care Reconciliation Act of 2017, Version 2.0 July 17, 2017 On July 13, Senate Republican leaders released a second working draft of the Senate version of H.R. 1628, the American Health Care
More informationImpact on the State Health Insurance Program of the Patient Protection and Affordable Care Act
Impact on the State Health Insurance Program of the Patient Protection and Affordable Care Act Adopted August 20, 2012 by the Self-Insurance Estimating Conference Prepared by: Florida Department of Management
More informationSenate Health Bill Unveiled
Senate Health Bill Unveiled Thursday, June 22, 2017 Senate Republican leaders today unveiled a draft of legislation the Better Care Reconciliation Act to repeal and replace parts of the Affordable Care
More informationNew Rules, New Opportunities: Medicaid Managed Care Regulations
New Rules, New Opportunities: Medicaid Managed Care Regulations Lindsey Browning National Association of Medicaid Directors Alicia Smith HMA Rebecca Farley National Council for Behavioral Health Medicaid
More informationWORKING DRAFT February 24, 2017 GOVERNORS ACA REPLACE AND REFORM WORKING PAPER 1: MEDICAID
WORKING DRAFT February 24, 2017 GUIDING PRINCIPLES GOVERNORS ACA REPLACE AND REFORM WORKING PAPER 1: MEDICAID Obamacare is unsustainable. Replace and reform must be simultaneous with repeal. It is better
More informationPRINCIPLES AND POLICES TO SUPPORT REPEAL AND REPLACE
GUIDING PRINCIPLES PRINCIPLES AND POLICES TO SUPPORT REPEAL AND REPLACE Obamacare is unsustainable. Replace and reform must be simultaneous with repeal. It is better to get it right than go too fast avoid
More informationACA in Brief 2/18/2014. It Takes Three Branches... Overview of the Affordable Care Act. Health Insurance Coverage, USA, % 16% 55% 15% 10%
Health Insurance Coverage, USA, 2011 16% Uninsured Overview of the Affordable Care Act 55% 16% Medicaid Medicare Private Non-Group Philip R. Lee Institute for Health Policy Studies Janet Coffman, MPP,
More informationIMPACTS OF ACA REPEAL ON NEW HAMPSHIRE
IMPACTS OF ACA REPEAL ON NEW HAMPSHIRE The Potential Impact of an ACA Repeal and Replace with Block Granting or Per Capita Caps Holly Stevens The Potential Impact of an ACA Repeal and Replace with Block
More informationBehavioral Health Claims and Mental Health Parity
Behavioral Health Claims and Mental Health Parity Alan Tawshunsky Tawshunsky Law Firm PLLC Willard Office Building 1455 Pennsylvania Avenue NW, Suite 400 Washington, DC 20004 (202) 621-1781 alan@tawshunsky.com
More informationProtecting Against Catastrophic Loss Post-Health Care Reform Legal Aspects
Protecting Against Catastrophic Loss Post-Health Care Reform Legal Aspects IFEBP Annual Conference Session 214 November 16, 17, 2010 Presented By Paul A. Green Mooney, Green, Washington, DC Statutory Restrictions
More informationMedicaid s Future. National PACE Association Spring Policy Forum. MaryBeth Musumeci
Medicaid s Future National PACE Association Spring Policy Forum MaryBeth Musumeci March 20, 2017 Figure 2 The basic foundations of Medicaid are related to the entitlement and the federal-state partnership.
More informationPERFORMANCE AUDIT REPORT
PERFORMANCE AUDIT REPORT Medicaid: Evaluating KanCare s Effect on the State s Medicaid Program A Report to the Legislative Post Audit Committee By the Legislative Division of Post Audit State of Kansas
More informationThe Parity Act: Putting it to Use. June 18, 2015 Colorado Center on Law and Policy 789 Sherman St., Suite 300, Denver, CO 80203
The Parity Act: Putting it to Use June 18, 2015 Colorado Center on Law and Policy 789 Sherman St., Suite 300, Denver, CO 80203 Growing commitment toward behavioral health The World Health Organization
More informationComparison of the House and Senate Repeal and Replace Legislation
Comparison of the House and Senate Repeal and Replace Legislation Key topic INSURANCE CHANGES ACA Insurance Subsidies ACA Cost-Sharing Subsidies Health Savings Accounts (HSA) Eliminates the ACA s income-based
More informationThe Health Insurance Marketplace 101 August 2013
The Health Insurance Marketplace 101 August 2013 Thursday, September 12, 2013, 7:00 pm Health Insurance Marketplace Elissa Balch is a Management Analyst for the Centers for Medicare & Medicaid Services
More informationThe Affordable Care Act: Opportunities to Influence Implementation
The Affordable Care Act: Opportunities to Influence Implementation Dylan H. Roby, PhD Assistant Professor of Health Policy and Management UCLA Fielding School of Public Health Director of Health Economics
More informationConnecticut Health Reform in the Wake of Federal Action:
Connecticut Health Reform in the Wake of Federal Action: Federal Reforms & SustiNet Vicki Veltri Office of the Healthcare Advocate September 28, 2010 Overview of the Patient Protection and Affordable Care
More informationGovernor s FY 2014 Budget: Articles. Staff Presentation to the House Finance Committee February 13, 2013
Governor s FY 2014 Budget: Articles Staff Presentation to the House Finance Committee February 13, 2013 1 Introduction Articles in Governor s FY 2014 Budget Four articles today Office of Health and Human
More informationUpdate on Implementation of the Affordable Care Act
Update on Implementation of the Affordable Care Act Yvonne Knight, J.D. ADEA Senior Vice President Advocacy and Governmental Relations ADEA Policy Center The Affordable Care Act On March 23, 2010, President
More informationWashington, DC Washington, DC 20510
September 13, 2017 The Honorable Lindsey Graham The Honorable Bill Cassidy United States Senate United States Senate Washington, DC 20510 Washington, DC 20510 Dear Senators Graham and Cassidy: On behalf
More informationThe Affordable Care Act: Where it Stands Now, and What the Future May Bring
Pennsylvania Homecare Association Annual Conference & Exposition May 3, 2017 The Affordable Care Act: Where it Stands Now, and What the Future May Bring Thomas G. Collins, Esq. Buchanan Ingersoll & Rooney
More information2016 Medicaid Managed Care Final Rule 1 Summary
2016 Medicaid Managed Care Final Rule 1 Summary The final Medicaid Managed Care rule retains nearly all of the requirements of the proposed rule and does not make substantial changes to it. In particular,
More informationSeventh Floor 1501 M Street, NW Washington, DC Phone: (202) Fax: (202) MEMORANDUM
Seventh Floor 1501 M Street, NW Washington, DC 20005 Phone: (202) 466-6550 Fax: (202) 785-1756 MEMORANDUM To: ACCSES Members cc: John D. Kemp, CEO From: Peter W. Thomas and Theresa T. Morgan Date: Re:
More informationPatient Protection and Affordable Care Act of 2010 (P.L )
Premium Subsidy Established income-based, sliding scale premium subsidies for individuals/families making 133 400% federal poverty level (FPL) to purchase qualified health plans on exchanges; subsidies
More informationProgram Update. October 26, 2017
Program Update October 26, 2017 HIP Waiver Extension Submitted extension request in January 2017 Amendment filed in July 2017. State is in negotiations with CMS for waiver changes. Waiver content is subject
More informationREPORT OF THE COUNCIL ON MEDICAL SERVICE
REPORT OF THE COUNCIL ON MEDICAL SERVICE CMS Report -A- Subject: Presented by: Referred to: Essential Health Care Benefits (Resolution 0-A-0) William E. Kobler, MD, Chair Reference Committee A (Joseph
More informationThe Affordable Care Act. Jim Wotring, Gary Macbeth National Technical Assistance Center for Children s Mental Health, Georgetown University
The Affordable Care Act Jim Wotring, Gary Macbeth National Technical Assistance Center for Children s Mental Health, Georgetown University The Affordable Care Act We are Going to Talk About Today What
More information(Senate Bill 387) Health Insurance Health Care Access Program Establishment Individual Market Stabilization (Maryland Health Care Access Act of 2018)
Chapter 38 (Senate Bill 387) AN ACT concerning Health Insurance Health Care Access Program Establishment Individual Market Stabilization (Maryland Health Care Access Act of 2018) FOR the purpose of requiring
More informationGraham-Cassidy Section by Section
1 Graham-Cassidy Section by Section Title I Section 101: Recapture of Excess Advance Premiums Tax Credits Would not apply IRC Section 36B(f)(2)(B), relating to limits on the excess amounts to be repaid
More informationFREQUENTLY ASKED QUESTIONS (FAQS) PART 34 FINAL REGULATIONS EXCEPTED BENEFITS, LIFETIME/ANNUAL LIMITS, SHORT TERM MEDICAL POLICIES
Issue One Hundred Twenty-Six November 2016 November 29, 2016 FREQUENTLY ASKED QUESTIONS (FAQS) PART 34 FINAL REGULATIONS EXCEPTED BENEFITS, LIFETIME/ANNUAL LIMITS, SHORT TERM MEDICAL POLICIES The government
More informationWashington Health Benefit Exchange
Washington Health Benefit Exchange AFFORDABLE CARE ACT 101 APRIL 26, 2013 Christine Brown Navigator/In-person Assister Program Today s Agenda History of the Affordable Care Act (ACA) Highlights of the
More informationERISA: Title I, Part 7
ERISA: Title I, Part 7 U.S. Department of Labor Employee Benefits Security Administration Gerald Grasso, Benefits Advisor **This draft is current as of January 2016. Although EBSA makes every effort to
More informationAffordable Care Act Affordable Care Act
Affordable Care Act 2010 Affordable Care Act Objectives Overview of the Affordable Care Act (ACA) 2010 Background Medicare Parts A, B, C, and D Medicaid and Medicare: Dually Eligible Social Security Benefits
More informationMaterials To Support Presentations
Health Reform and Parity Speaker s Bureau 1 Materials To Support Presentations 12/1/2010 Slides On Health Reform and Parity 2 This slide deck is designed to provide component pieces that can be used to
More informationMental health matters
Mental health matters Understanding mental health parity Aetna Behavioral Health Mental health makes up a big part of overall health. We believe mental health concerns should be treated like any other
More informationOverview of New Reform Law. Federal Healthcare Reform: Impacts on Employer-Sponsored Plans. Agenda
: Impacts on Employer-Sponsored Plans June 3, 2010 Employee Benefits Planning Association Jack McRae SVP, Congressional and Legislative Affairs Premera Blue Cross Jim Grazko VP and General Manager, Underwriting
More informationInsurance (Coverage) Reform
Arkansas Health Law Check Up Insurance (Coverage) Reform Create Insurance Marketplaces For individuals & small businesses Expand Medicaid to 138% FPL Arkansas alternative = Private Option, not Arkansas
More informationKnow Your Parity Rights
Know Your Parity Rights Produced by: Federal Parity 1. What is mental health parity? Mental health parity generally refers to the concept that insurers must offer the same coverage for mental health/substance
More informationAffordable Care Act: Impact on the Indiana Market
1 Affordable Care Act: Impact on the Indiana Market Seema Verma President SVC, Inc 2 Affordable Care Act Key accomplishment is access ~48.6 million uninsured in America* ~800 thousand uninsured in Indiana*
More informationImplications of the Affordable Care Act for the Criminal Justice System
Implications of the Affordable Care Act for the Criminal Justice System August 14, 2013 Julie Belelieu Deputy Mental Health Director, Health Policy Center for Health Care Strategies, Inc. Allison Hamblin
More informationHealth Care Reform: Get Informed
Health Care Reform: Get Informed October 27, 2012 Denise Camp, Project Director, Health Care Reform Peer Education Initiative, On Our Own Of Maryland denise@onourownmaryland.org Leni Preston, Chair Maryland
More informationPotential Budget Savings and Revenue Gains from Medicaid Expansion in Florida: A Snapshot Based on FY Data. Esubalew Dadi January 2018
Potential Budget Savings and Revenue Gains from Medicaid Expansion in Florida: A Snapshot Based on FY 2016-17 Data Esubalew Dadi January 2018 Overview The Takeaway The Context By the Numbers Potential
More informationMedicaid at 50: Evolution from Public Assistance to Health Insurance. Presentation to the National Association of Social Insurance June 23, 2015
Medicaid at 50: Evolution from Public Assistance to Health Insurance Presentation to the National Association of Social Insurance June 23, 2015 Growth in Medicaid Market Share and Influence 2 Now single
More informationIt Ain t All Good, but It Ain t All Bad
It Ain t All Good, but It Ain t All Bad President Donald J. Trump Likes golf and block granting Medicaid Hates Hillary Clinton, the Terminator & the ACA Secretary Tom Price CMS Director Seema Verma House
More informationParity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children s Health Insurance Programs
Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children s Health Insurance Programs January 17, 2017 Acknowledgements This report was prepared
More informationFinal Benefit and Payment Parameters Regulations Have Wide Ranging Implications Cost-Sharing Limits
» 3/19/15 2015-03 Regulatory Roundup: Flex Credit/Cash-in-Lieu Potential Impact on Plan Affordability and New Guidance on Cost- Sharing Limits, Reinsurance, Essential Health Benefits, and More Flex Credits
More informationStates Focus on Quality and Outcomes Amid Waiver Changes
States Focus on Quality and Outcomes Amid Waiver Changes Findings from the Annual Kaiser 50-State Medicaid Budget Survey Robin Rudowitz Associate Director, Kaiser Program on Medicaid and the Uninsured
More informationMental Health Parity: Promises and Issues
: Promises and Issues Gary M. Henschen, MD, LFAPA Chief Medical Officer for Behavioral Health Texas Association of Health Plans Sep. 23, 2008: The Parity Bill Passes the Senate 2 Nov. 8, 2013: Final Rule
More informationOregon Health Authority - Agency Totals
Oregon Health Authority - Agency Totals 2013-15 Actual 2015-17 Legislatively Approved* Current Service Level Governor's Recommended General Fund 1,933,379,158 2,169,921,934 3,190,659,426 2,167,928,460
More informationUnderstand and Enroll in the Affordable Care Act
You deserve quality healthcare, and MHC will help you find the best plan for you and your family. How can Memphis Health Center assist me in enrolling into the affordable healthcare program? Memphis Health
More informationKENTUCKY HEALTH: GOVERNOR BEVIN S 1115 MEDICAID WAIVER
KENTUCKY HEALTH: GOVERNOR BEVIN S 1115 MEDICAID WAIVER WHAT IS IT? Kentucky HEALTH is Governor Bevin s signature Medicaid program that stands for Helping to Engage and Achieve Long Term Health. Also called
More informationJuly 2017 Revised July 25, 2017
July 2017 Summary of the Better Care Reconciliation Act Discussion Draft Revised by the U.S. Senate July 13, 2017 On July 13, 2017 Senate Republican leaders released a revised discussion draft of the Better
More information- It s Time for a Legislative Update -
- It s Time for a Legislative Update - AGENDA FEDERAL LEGISLATION UPDATE CALIFORNIA LEGISLATION UPDATE B&P NEWS CARRIER NEWS CONSTANT CHANGES Both federal and state legislation efforts are constantly changing.
More informationThe Federal Medicaid Agenda: Considerations and Concerns for New York State
1 The Federal Medicaid Agenda: Considerations and Concerns for New York State Prepared for New York Mental Health Association October 19, 2017 Agenda 2 Medicaid in New York Federal Proposals to Alter Medicaid
More informationNASMHPD and NASDDDS Legal Divisions 2011 Joint Annual Meeting November 15, Washington Update. Joel E. Miller Senior Director of Policy
NASMHPD and NASDDDS Legal Divisions 2011 Joint Annual Meeting November 15, 2011 Washington Update Joel E. Miller Senior Director of Policy Outline The Budget Control Act of 2011 Health Care Reform Implementation
More informationACA Regulations: Insurance Exchanges and EHBs
ACA Regulations: Insurance Exchanges and EHBs 1 Insurance Exchanges Insurance Exchanges: Exchanges are online marketplaces More than 20 million individuals and employees of small businesses may purchase
More informationT H E P O L I C Y P A G E
T H E P O L I C Y P A G E An Update on State and Federal Action 900 Lydia Street, Austin,, 78702 PH: 512.320.0222 www.cppp.org September 22, 2005 For more information: Anne Dunkelberg, dunkelberg@cppp.org
More informationAn Employer s Guide to Health Care Reform
An Employer s Guide to Health Care Reform Background On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA). Less than a week later, Congress passed the
More informationState Innovation Waivers:
State Innovation Waivers: An Overview of Section 1332 Activity and Opportunities to Advance People-Centered Health December 2017 Table of Contents Section 1332 Waiver Landscape - Overview of ACA s Section
More informationOregon Health Authority Metrics and Key Performance Measures
Oregon Health Authority Metrics and Key Performance Measures Presented to the Human Services Legislative Sub-committee on Ways and Means April 18, 2017 Leslie Clement, Health Policy and Analytics Division
More informationKey Medicaid Financing Changes in Repeal and Replace Legislation
Key Medicaid Financing Changes in Repeal and Replace Legislation Medicaid and More Alliance for Health Policy July 7, 2017 Overview of Better Care Reconciliation Act (BCRA) Key Changes to Medicaid 2 Like
More informationState of California Health and Human Services Agency Department of Health Care Services
State of California Health and Human Services Agency Department of Health Care Services JENNIFER KENT DIRECTOR EDMUND G. BROWN JR. GOVERNOR DATE: September 21, 2017 TO FROM: DIANA S. DOOLEY Secretary Jennifer
More informationJim Frizzera, Principal Health Management Associates
Jim Frizzera, Principal Health Management Associates Established the Medicaid disproportionate share hospital (DSH) adjustment. Required States to set Medicaid reimbursement rates for hospital inpatient
More informationACA Implementation and Impact in Michigan
ACA Implementation and Impact in Michigan Marianne Udow-Phillips, Director Center for Healthcare Research & Transformation February 21, 2017 1 Health Insurance Coverage in Michigan 2 Michigan Health Insurance
More informationHealth Reform in Minnesota
Health Reform in Minnesota 1 AUTISM SOCIETY OF MINNESOTA ALYSSA VON RUDEN HEALTH POLICY ADVISER AUGUST 8, 2013 Changes Already in Place 2 If you are a parent You can keep young adult children on your policy
More informationHealth Care Reform: What Changes Are We Facing?
Health Care Reform: What Changes Are We Facing? 1 Health Care Reform: What Changes Are We Facing? A. Care Delivery Accountable Care Organization (ACOs) ACOs are groups of doctors, hospitals, and other
More informationBENEFITS. Preventive Services. Essential Health Benefits. Exceptions. The Affordable Care Act: A Working Guide for MCH Professionals.
The Affordable Care Act: A Working Guide for MCH Professionals Section 6 BENEFITS In addition to expanding access to affordable health coverage options, the Affordable Care Act (ACA) makes several changes
More information