CMS issued the 2021 final notice of benefit and payment parameters rule and letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS provides detailed options for issuers to adopt value-based designs for marketplace plans.
view more »In its March report to Congress, the Medicaid and CHIP Payment and Access Commission included chapters analyzing Medicaid disproportionate share hospital payments, state readiness to report on core quality measure sets, and Section 1115 waiver evaluations.
view more »CMS issued the 2021 notice of benefit and payment parameters proposed rule and draft letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS is not proposing any changes to network adequacy standards.
view more »This partnership worked to improve vulnerable patients’ access to high-quality health care and help groups of providers navigate health reform.
view more »The new guidance outlines the types of rules association health plans must follow under the Employee Retirement Income Security Act and reiterates that states and the Department of Labor have a joint responsibility to regulate such plans.
view more »The Department of Labor has issued a final rule expanding the definition of "employer" for purposes of establishing association health plans.
view more »The Centers for Medicare & Medicaid Services noted that the provisions aim to increase flexibility, improve affordability, strengthen program integrity, empower consumers, promote stability, and reduce regulatory burden in the individual and small group marketplaces.
view more »Hospitals have until Aug. 22 to petition the Centers for Medicare & Medicaid Services for inclusion on the list for the 2020 plan year.
view more »In a March 6 comment letter, America's Essential Hospitals urged federal officials to ensure association health plans have proper oversight and cover all necessary services for beneficiaries.
view more »Hospitals serving low-income, underserved patients have until Dec. 22 to submit a petition for inclusion on the Centers for Medicare & Medicaid Services’ final 2019 essential community provider list.
view more »The association emphasized access to essential community providers within qualified health plan networks in its comments on the 2019 draft letter to issuers.
view more »The calendar year 2019 draft letter to plans offered through federally facilitated marketplaces also provides deadlines for qualified health plan certification.
view more »The association encouraged the Centers for Medicare & Medicaid Services to ensure that state plans cover essential health benefits and include sufficient access to essential community providers.
view more »Discover the Vermont Blueprint for Health, a state-led initiative to transform care delivery and financing, and hear from state and essential hospital leaders about this initiative’s challenges and successes.
view more »Take a deep dive into “anchor institutions” and learn about the Hospitals Aligned for Healthy Communities toolkit series, an online resource hub for strategic planning and community investment.
view more »Participants learned how Henry Ford Health System collaborates with local partners to revitalize community infrastructure and act on social determinants of health.
view more »Attendees learned about PRAPARE, an innovative tool that helps essential providers track, measure, evaluate, and respond to the social determinants of health.
view more »Attendees learned how East Alabama Medical Center’s innovative Faith Community Nurse program creates a bridge between faith communities and the medical community through spiritual and physical healing.
view more »Participants learned how Regions Hospital’s community paramedic program works to reduce emergency calls and unnecessary hospital readmissions.
view more »America’s Essential Hospitals expressed concerns about proposed changes that could harm the integrity of qualified health plan networks.
view more »The proposed rule aims to provide flexibility by targeting network adequacy reviews & inclusion of essential community providers in qualified health plans.
view more »CMS finalized a proposal to continue the current methodology, which qualified health plans use to satisfy the minimum essential community provider standard.
view more »America's Essential Hospitals expressed continued concerns about qualified health plan network adequacy in federally facilitated marketplaces.
view more »The letter provides operational and technical guidance to issuers of qualified health plans through the federal health insurance marketplace for 2018.
view more »Hospitals eligible for the essential community providers list are participants in the 340B and DSH programs, critical access hospitals, and others.
view more »Hear insights and lessons learned regarding value-based care from representatives of the foundation of Hennepin Health.
view more »Hear about findings and future plans that have developed from the Robert Wood Johnson Foundation population health grant.
view more »Comments on the proposed Notice of Benefit and Payment Parameters for 2018 are due by Oct. 6.
view more »HHS finalizes 2017 Notice of Payment and Benefit Parameters rule and letter to issuers offering qualified health plans on the federally facilitated marketplace.
view more »Comments urge CCIIO to require that ACA marketplace plans include willing essential community provider (ECP) hospitals and ensure payment rates support access to care.
view more »Dec. 23 letter provides operational, technical guidance to qualified health plans (QHPs) and outlines network adequacy standards for plans offered through the federally facilitated health insurance marketplace.
view more »Model law would update requirements for insurance carriers in the health insurance marketplaces, particularly regarding provider directories, mental health services, telehealth, and nondiscrimination.
view more »Honoring school nurses for National Nurses Week - showing how they provide value to the community.
view more »The association submitted comments to CCIIO and NAIC calling for more robust standards for including ECPs in health insurance marketplaces.
view more »America's Essential Hospitals urged HHS to improve ECP standards in the marketplaces to ensure patients have access to quality, affordable health care.
view more »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.
view more »Association researcher Janelle Schrag explores insights from APHA's annual meeting, which targeted neighborhood factors as important health indicators.
view more »Learn how human capital management and retention strategies can support quality care initiatives
view more »Learn how to support your hospital through important and influential contacts in the community
view more »The association submitted comments to the Departments of Labor, Health and Human Services, and the Treasury regarding their request for information on provider nondiscrimination.
view more »The association said that CMS should implement the QRS in a way that protects consumer access to ECPs in the marketplaces. It also urged CMS to ensure the measures used in the QRS are endorsed by the National Quality Forum and risk adjusted for socioeconomic factors.
view more »Staff from our members held 100 meetings with their senators and representatives to discuss what defines an essential hospital and the key issues facing essential hospitals. Issues included: protecting essential hospital payments, ensuring essential hospitals are included in marketplace health insurance plan networks, and preserving support for training future clinicians at essential hospitals.
view more »Association members explained what makes an essential hospital and the key issues facing essential hospitals to their policymakers on the Hill. The event also included reflections from senior Capitol Hill and administration staff and two award ceremonies that recognized members of Congress and congressional staff for their commitment to essential hospitals.
view more »Members learned about the fundamental challenges driving industry workforce shortages
view more »For 2015, each qualified health plan (QHP) network must include at least 30 percent (up from 20 percent in 2014) of all available ECPs in its service area to meet network adequacy requirements. CMS is also implementing a reasonable access review standard.
view more »America’s Essential Hospitals protects access to care among marketplace plans. The association urged CCIIO to ensure an adequate number of ECPs are included in QHP networks. It also asked CCIIO to ensure patients have access to all hospital services in their plan’s network.
view more »We will continue to fight for changes to the Medicaid DSH cuts that are scheduled to begin in FY 2016. At the same time, we will take action on other issues that are important for essential hospitals, including ensuring marketplace health insurance plan network adequacy and protecting vital hospital funding.
view more »These FAQs further clarify the Nov. 4, 2013 FAQ, which stated that the U.S. Department of Health and Human Services encourages issuers to reject premium payments from third parties such as hospitals, other health care providers, and other commercial entities.
view more »Responding to input from America’s Essential Hospitals to strengthen the essential community provider (ECP) requirements, CCIIO notes an enhanced ECP standard. America’s Essential Hospitals is pleased CCIIO recognizes that more protection is needed for ECP patients’ access to care but believes that the requirements should be strengthened further.
view more »Of particular interest to members of America's Essential Hospitals, we are pleased to see CCIIO account for the concerns raised by our member hospitals and enhance its essential community provider standard.
view more »Held nearly 100 meetings, educated Congress about work to ensure patient access to high quality care
view more »Siegel, Gremminger highlighted the importance of delaying, reconsidering scheduled Medicaid DSH cuts
view more »Despite standards, inclusion of essential hospitals and other providers not certain
view more »Letter urges HHS to place a special emphasis on robust essential community provider participation
view more »Plans must meet standards for quality measures, improvement strategies, consumer information
view more »Project to help essential providers prepare for ACA coverage expansion
view more »Says new name reflects members' common purpose to serve all people, communities with essential services
view more »Urges CMS to keep nation's safety net in mind as agency fine tunes marketplace framework
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