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.

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

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.

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.

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.

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

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.

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.

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

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.

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.

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.

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.

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

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.

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

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

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

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

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.

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

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

The rule finalizes a number of provisions regarding health insurance marketplaces

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

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