• 07.24.18

    Market Stability Remains a Work in Progress

    As the 47 states, including the District of Columbia (DC), that conduct their own rate reviews continue their review processes, many have released at least some details about what insurers proposed in their rate filings for the 2019 individual market.

  • 07.10.18

    State Telehealth Laws and Medicaid Policies: 50-State Survey Findings

    The use of telemedicine services is growing nationwide as providers and payors seek to improve access and better manage patient care, while reducing health care spending.

  • 05.17.18

    State Action on Market Stabilization

    During the open enrollment period for the 2018 plan year, approximately 11.8 million people enrolled in Marketplace coverage and 74 million people enrolled in Medicaid, leading to an uninsured rate in the U.S. of 12.2 percent.

  • 04.11.18

    States Choosing Divergent Paths for Individual Market Coverage

    With Congress failing to reach agreement on a stabilization package for the individual market and repeal of the individual mandate set to take effect for 2019, states are considering different strategies, some that will stabilize their Affordable Care Act (ACA) compliant markets and others that ...

  • 02.26.18

    The President’s Budget and Shifting Policy on Prescription Drugs

    On February 12, the Trump administration released the President’s Budget (or, “the Budget”) outlining spending priorities for FY 2019.

  • 01.10.18

    What’s Ahead in 2018

    Congress returned from recess with a large agenda for the new year.

  • 12.12.17

    North Carolina: Amended 1115 Waiver Application

    On November 20, 2017, North Carolina submitted an amended 1115 waiver application to the Centers for Medicare & Medicaid Services (CMS) seeking authority to invest $1.2 billion over five years in a range of targeted initiatives that, taken together with a transition from fee-for-service to ...

  • 11.14.17

    2018 Updates to the MACRA Quality Payment Program

    On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule with Comment updating the Quality Payment Program (QPP) under the Medicare and CHIP Reauthorization Act of 2015 (MACRA).

  • 11.14.17

    2019 Notice of Benefit and Payment Parameters

    On October 27, 2017, the Department of Health and Human Services (HHS) released its annual proposed Notice of Benefit and Payment Parameters, containing proposed changes to the regulation of the individual and small group health insurance markets for 2019 and beyond (and in some cases, sooner).

  • 10.11.17

    Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary

    On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its MassHealth Section 1115 demonstration.



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