Archive: November 2010

Agency Profile: Office of Consumer Information and Insurance Oversight

Posted on November 29, 2010

The responsibilities for implementing the Affordable Care Act are spread across several federal departments and the offices within them. This is the latest in a series of briefs developed by HealthReformGPS describing the implementing agencies and their roles.

Continue Reading "Agency Profile: Office of Consumer Information and Insurance Oversight" »

IRS issues guidance, solicits comments on branded drug annual fees

Posted on November 29, 2010

The Internal Revenue Service (IRS) issued guidance and requested comments on annual fees paid by drug companies under the Affordable Care Act (ACA). The fees apply to covered entities who sell branded drugs to publicly-financed health care programs, such as Medicare & Medicaid, TRICARE, and the Veterans Administration (VA). The guidance includes a proposed methodology for calculating the fee. Public comments are due by June 2, 2011.

Continue Reading "IRS issues guidance, solicits comments on branded drug annual fees" »

CMS issues final rule on Prospective Payment System for hospitals

Posted on November 24, 2010

CMS issued a final rule on the Medicare Outpatient Prospective Payment System (OPPS) for hospitals. The rule aligns Medicare payments with new provisions in the Affordable Care Act and describes factors used to determine payment rates for Medicare hospital outpatient services.

Continue Reading "CMS issues final rule on Prospective Payment System for hospitals" »

Update: Medical Loss Ratio and Rebates in Private Health Insurance

Posted on November 23, 2010

This is an updated version of a brief originally published on August 25, 2010. This brief is current as of November 22, 2010.

A medical loss ratio (MLR) is the proportion of premium dollars that an insurer spends on health care services relative to health insurance premium paid by subscribers. Prior to the enactment of the health reform law, the federal government required Medicare supplemental insurance (or Medigap policies) to meet minimum federal loss ratio requirements, but did not establish federal standards to define how insurers should categorize losses, nor did those requirements apply to other types of private insurance policies.

Continue Reading "Update: Medical Loss Ratio and Rebates in Private Health Insurance" »

CRS issues memo marking key deadlines in first year of health reform

Posted on November 23, 2010

The Congressional Research Service (CRS) issued a Congressional Distribution Memorandum summarizing all deadlines that require specific federal action within the first year of the Affordable Care Act (ACA). The memo focuses on provisions in the law that require action be taken by a specific date falling between March 23, 2010 and March 23, 2011.

Continue Reading "CRS issues memo marking key deadlines in first year of health reform" »

AHIP issues summary highlighting key provisions of recent IFR related to MLR

Posted on November 23, 2010

America’s Health Insurance Plans (AHIP) released a summary document highlighting key provisions of the interim final rule (IFR) relating to MLR requirements under the Affordable Care Act (ACA). The document summarizes reporting requirements and activities, MLR calculation, and enforcement rules.

Continue Reading "AHIP issues summary highlighting key provisions of recent IFR related to MLR" »

HHS announces new funds to help address primary care workforce shortages

Posted on November 22, 2010

Today, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced $290 million in new funding from the Affordable Care Act (ACA) for the National Health Service Corps (NHSC) Loan Repayment Program to help increase the number of primary care providers in medically underserved areas. These funds will allow $60,000 in loan debt forgiveness to medical, dental, and mental health primary care providers who commit to practicing 2 years in an NHSC-designated service area. Additionally, the ACA allows for more leeway in administering NHSC funds, such as the opportunity to work full-time or half-time, as well as total loan forgiveness for a commitment of six years.

Continue Reading "HHS announces new funds to help address primary care workforce shortages" »

HRSA announces $8 million in new funds to modernize community health centers

Posted on November 22, 2010

On November 19, 2010, the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (HHS) announced $8 million in grant money to community-based organizations that support community health centers. These grants are funded out of the Affordable Care Act (ACA), and are designed to pay for enhanced training and technical assistance to help modernize community health centers.

Continue Reading "HRSA announces $8 million in new funds to modernize community health centers" »

HHS releases Medical Loss Ratio Interim Final Rule

Posted on November 22, 2010

The Department of Health and Human Services Office of Consumer Information and Insurance Oversight (OCIIO) has released an interim final rule with request for comment implementing the medical loss ratio requirements for health insurance issuers under the health reform law. Along with the regulation, OCIIO released a fact sheet and Regulatory Impact Analysis Technical Appendix.

For more, visit our updated Medical Loss Ratio Implementation Brief.

Continue Reading "HHS releases Medical Loss Ratio Interim Final Rule" »

Update: Health Insurance Exchanges

Posted on November 22, 2010

The Affordable Care Act establishes “American Health Benefit Exchanges” (serving individuals) and “SHOP” Exchanges (serving small employer groups), to be operated by states that elect to establish exchanges for individuals and employer groups through which they can buy “qualified health plans.”

Continue Reading "Update: Health Insurance Exchanges" »