Public Health

Supreme Court prevents enforcement of contraceptive mandate for religious organization

Posted on January 26, 2014

A Supreme Court action issued Friday bars the federal government from enforcing the Affordable Care Act’s (ACA) contraceptive mandate on Little Sisters for the Poor, a non-profit organization of Catholic nuns that operates nursing homes. The organization claims that filing the requisite form to waive the contraceptive coverage mandate for organizations holding themselves out as religious entities would enable third party payers to cover contraceptives, which is against the organization’s beliefs. The Supreme Court’s ruling prevents any legal action against Little Sisters for the Poor until the appeal can be heard.

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Community Health Centers restriced in ability to enroll uninsured under ACA

Posted on January 14, 2014

Irrespective of their increased efforts, a new study released today indicates that community health centers operating in states less receptive to the Affordable Care Act (ACA) are having difficulty performing outreach and enrolling uninsured individuals. The study, performed by the Geiger Gibson Program within The George Washington University School of Public Health and Health Services and RCHN Community Health Foundation, is the first to assess how state restrictions are impacting enrollment and coverage under the ACA. A press release describing key findings about the study may be accessed here.

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Insurance plans must cover breast cancer preventive medications

Posted on January 9, 2014

According to a set of FAQ’s issued by the Center for Consumer Information and Insurance Oversight (CCIIO), insurers are now required to fully cover medications that help reduce the incidence of breast cancer among women at high risk. Examples of these medications include tamoxifen and raloxifene. The policy change, arising from recommendations by the US Preventive Services Task Force (USPSTF), was decided in September 2013 and goes into effect for plan years beginning on or after September 24th, 2014.

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Update: Contraception Coverage Lawsuits Reach U.S. Supreme Court

Posted on January 6, 2014

As discussed in earlier Briefs, the ACA requires all individual and non-grandfathered group health plans to cover certain preventive services, including comprehensive contraceptive services. On August 3, 2011, the Departments of Treasury, Labor, and Health and Human Services (HHS) published an Amended Interim Final Rule incorporating HRSA’s guidelines to require mandatory coverage by non-grandfathered group and individual insurance plans of all preventive services (including contraception) without cost sharing beginning on August 1, 2012. Religious employers and other interested parties argued that requiring employers to sponsor insurance that included contraception violated religious liberty…

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TFAH report describes the Prevention and Public Health Fund

Posted on June 6, 2013

A new report published today by Trust for America’s Health (TFAH) contains key facts about the Prevention and Public Health Fund. The Truth about the Prevention Fund, describes the various components of the Prevention and Public Health Fund that utilize evidence-based research and partnerships to actively improve the health of Americans. The fund intends to expand preventative care and build upon community-based programs that address a multitude of preventable diseases by allocating $14.5 billion in mandatory spending over 10 years. The report contains evidence and examples of how the Prevention and Public Health Fund is already being successfully used in various communities throughout the country.

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TFAH report examines public health spending

Posted on April 16, 2013

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation recently released their April 2013 Issue Report, focusing upon public health spending. The study ultimately found an inadequacy in public health financing at national, state and local levels, citing that 29 states decreased their public health budgets between fiscal years 2010-2011 and 2011-2012. The report provides several recommendations to ameliorate the implications of varying health outcomes resulting from the underfunded public health infrastructure. These include increasing core public health funds and creating new financing models for public health services.

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Update: Medicaid Preventive Services Coverage Incentive for Traditional Adult Beneficiaries Covered Under the Standard Medicaid Program

Posted on February 21, 2013

Preventive services are optional for traditional Medicaid beneficiaries[1] ages 21 and older who are covered under the standard Medicaid program. Young adults ages 18-21 remain entitled to EPSDT benefits, which encompass periodic and as-needed health exams, all age-appropriate immunizations, and other preventive services.

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CMS suspends PCIP enrollment

Posted on February 16, 2013

Yesterday, the Centers for Medicare & Medicaid Services (CMS) suspended enrollment in pre-existing condition insurance plans (PCIPs), effective March 2 of this year. The letter, sent from Richard Popper, the director of Insurance Plan Groups, to PCIP contractors, also included language regarding benefit adjustment analysis.

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CMS releases preventive services State Medicaid Director letter

Posted on February 5, 2013

On February 1, 2013, the Centers for Medicare & Medicaid Services’ (CMS’) Center for Medicaid and CHIP Services released a State Medicaid Director letter regarding implementation of section 1406 of the Affordable Care Act (ACA). Section 4106(b) establishes a one percentage point increase in the federal medical assistance percentage (FMAP), effective January 1, 2013, applied to expenditures for adult vaccines and clinical preventive services for states that cover, without cost-sharing, the full list of ACA preventive services. Specifically, the preventive services covered under the policy are those assigned a grade of A or B by the U.S. Preventive Services Task Force and the approved vaccines are those recommend by the Advisory Committee on Immunization Practices. For a complete list of the preventive services covered under the policy, click here and for a complete list of covered vaccines, click here.

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CMS releases health homes guidance

Posted on January 18, 2013

The Centers for Medicare & Medicaid Services (CMS) issued a state Medicaid directors letter earlier this week that outlines quality measures to be used for health homes. The recommended health home core measures include:

1. Adult Body Mass Index (BMI) Assessment,
2. Ambulatory Care – Sensitive Condition Admission,
3. Care Transition – Transition Record Transmitted to Health care Professional,
4. Follow-up After Hospitalization for Mental Illness,
5. Plan- All Cause Readmission,
6. Screening for Clinical Depression and Follow-up Plan,
7. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment,
8. Controlling High Blood Pressure.

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