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state-action

Covered California says the program will reduce out-of-pocket costs for more than 600,000 enrollees, eliminate silver plan deductibles, and assist those predicted to lose Medi-Cal coverage.

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policy

The FAQ respond to concerns about the definition of cost sharing and facility fees in the No Surprises Act and Affordable Care Act.

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policy

The proposed rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those disenrolled from Medicaid or CHIP.

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policy

The agency shared three sample formats to help hospital staff build machine readable files to comply with the Hospital Price Transparency Rule.

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policy

The Dec. 8 webcast will offer hospitals information and resources to prepare for publishing standard charges, including negotiated rates, for all services in a machine-readable format and display prices of shoppable services in a consumer-friendly format.

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policy

The rule sets content elements a plan or issuer must disclose for a covered item or service. The rule also finalizes changes to the medical loss ratio program to allow issuers offering group or individual health coverage to receive credit for certain savings they share with enrollees.

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policy

The webpage includes checklists, step-by-step instructions, and FAQs to help hospitals comply with the Hospital Price Transparency Rule, effective Jan. 1, 2021. It also offers information to help consumers use the data.

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policy

The agency published new requirements for hospitals to publicly post standard charges, including information based on rates negotiated with third-party payers. 

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Essential Insights

America’s Essential Hospitals, with support from the Robert Wood Johnson Foundation, has launched an online library of resources to help essential hospitals better communicate about cost of care.

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policy

Negotiations on the bill have stalled amid disagreements on certain provisions, such as including language barring abortion access as part of a package to stabilize the Affordable Care Act's insurance marketplace.

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policy

The legislative priorities include a health care extenders package, tax reform, and a long-term funding bill. Also, bipartisan House legislation to halt 340B payment cuts now has more than 50 cosponsors.

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policy

A bipartisan Senate bill would fund cost-sharing reduction payments; Congress has yet to renew funding for the Children's Health Insurance Program.

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The end of cost-sharing reduction subsidies poses an imminent threat to those who depend on marketplace plans. America’s Essential Hospitals thanks Sens. Alexander and Murray for their bipartisan leadership to create more certainty in the individual market.

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policy

The move jeopardizes coverage for millions of working Americans, could substantially raise premiums for those who remain in marketplace plans, and could increase uncompensated care costs at essential hospitals.

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policy

The Congressional Budget Office estimates premiums will increase 20 percent by 2018 and the uninsured population will increase by 1 million; 19 states and the District of Columbia filed a lawsuit arguing that withholding the payments violates current law.

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policy

Congress aims to pass legislation by Sept. 30 to stabilize the Affordable Care Act (ACA) insurance markets and reauthorize several health care programs; three senators plan to unveil new ACA repeal legislation.

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policy

Lawmakers return from the August recess to consider legislation and policy related to the Children’s Health Insurance Program, market stabilization, and cost-sharing reductions.

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policy

In this new policy brief, America's Essential Hospitals examines Section 1115 waivers that use a market-based approach to expanding Medicaid.

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policy

Lawmakers face an extensive agenda of legislative priorities, including health care and tax reform, and most urgent, a continuing resolution to prevent a government shutdown.

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policy

CMS is concerned that some providers might steer Medicare- and Medicaid-eligible patients into individual market plans to get higher payments.

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policy

NOTICE Act seeks to educate patients about impact of observation status, including on cost-sharing and skilled nursing facility eligibility.

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policy

Specifically, HHS will evaluate financial assistance programs, Medicaid expansion, pioneer ACOs, and marketplace payment systems.

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policy

Feb. 20 final rule and letter to issuers outline benefit and payment parameters for 2016 health insurance marketplace plans

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policy

CMS, NAIC documents contain important health insurance marketplace provisions, including cost-sharing requirements. Comments due to CMS Dec. 22, to NAIC by Jan. 12, 2015.

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policy

New association policy brief describes how cost-sharing assistance by hospitals helps vulnerable patients afford health insurance marketplace coverage and access vital health care services

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institute

Journal articles from the March and April editions of the New England Journal of Medicine explore issues including the usefulness of surgical safety checklists, the importance of promoting financial stewardship, and the impact of Medicaid cost sharing.

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policy

Eligibility notices, benefits in alternative benefit plans, appeals process among rule's provisions

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policy

The rule finalizes a number of provisions regarding health insurance marketplaces

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policy

Rule states mandate for Medicaid coverage in 10 categories of essential health benefits

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policy

Includes important changes to Medicaid and Medicare of interest to association members

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