Physicians encouraged to familiarize themselves with exchange plan changes heading into Covered California open enrollment Covered California began enrollment for its second year on November 15 and exchange officials are predicting a 45 percent jump in enrollment, from 1.2 million in 2014 to 1.7 million in 2015. Last year, open enrollment was a six-month process, this year it will be half as long, starting Nov. 15 and ending Feb. 15. In anticipation of this year's open enrollment, some payors have updated their exchange plan offerings for 2015, including plan types and plan names. The California Medical Association (CMA) will be publishing details of these changes ... November 17, 2014 Managed Care Affordable Care Act, Health Insurance Exchange, ACA, Covered California 0 0 Comment Read More »
ACA meets goal of covering more Americans A little over 10 million uninsured have gained health care coverage throughout the U.S., either through Medicaid or state and federal exchanges, since the Affordable Care Act (ACA) coverage expansion programs opened for enrollment last year, according to a new report from U.S. Department of Health And Human Services’ (HHS). According to the report, the uninsured rate among adults ages 18 to 64, as of June 2014, was 15.1 percent, down 5 percent from September 2013. The percentage of those with health coverage improved most among blacks and Latinos throughout the ... November 14, 2014 General Affordable Care Act, ACA 0 0 Comment Read More »
Supreme Court to hear ACA subsidy case Last Friday, the U.S. Supreme Court unexpectedly said it will hear King v. Burwell—a case that questions whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government. The lawsuit has the potential to affect 36 states that use the federal health care exchange, but would not change the subsidies in states like California that run their own exchanges. The decision to hear the case comes just one week before the second exchange open enrollment ... November 14, 2014 General Affordable Care Act, Health Insurance Exchange, United States Supreme Court, ACA 0 0 Comment Read More »
Supreme Court delays hearing ACA subsidy case The U.S. Supreme Court has declined to hear King v. Burwell—a case the questions whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government. The lawsuit has the potential to affect states that use the Federal health care exchange, but would not change the subsidies in states like California that run their own exchanges. The question asked in King v. Burwell is whether the language of the ACA law allows consumers to receive premium tax ... November 6, 2014 General Affordable Care Act, Health Insurance Exchange, ACA 0 0 Comment Read More »
Feds propose compromise to ACA birth control rule to accommodate religious groups Last week, the Obama administration proposed a compromise to provide contraceptive coverage under the Affordable Care Act (ACA) to employees of whose employers object on religious grounds to providing contraceptives to their employees. The administration is hoping to quell the controversy around the ACA contractive coverage that has yielded dozens of lawsuits, while ensuring that all women are able to get coverage of recommended preventive services without cost sharing, as intended under the health care law. “Women across the country deserve access to recommended preventive services that are important to ... September 3, 2014 General ACA, Contraception, Affordable Care Act 0 0 Comment Read More »
Two federal courts issue conflicting rulings on ACA premium subsidies Two federal appeals courts issued conflicting rulings last week on whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government. The rulings will not, however, impact states like California that run their own exchanges. The U.S. Court of Appeals for the District of Columbia Circuit, in a 2 to 1 vote, majority opinion said that the ACA’s language unambiguously restricts premium subsidies to insurance purchased on exchanges “established by the State,” and that the IRS’ ... August 4, 2014 General Affordable Care Act, Health Insurance Exchange, ACA 0 0 Comment Read More »
Medicare's financial outlook improves Trustees overseeing Medicare’s Hospital Insurance Trust Fund, which finances about half the health program for seniors, said Monday in a report that the program won’t run out of money until 2030 – that’s four years later than projected last year and 13 years later than projected at the passage of the Affordable Care Act (ACA). The outlook for Medicare improved largely because of lower-than-expected hospital spending and savings resulting from the ACA. The effect of the new law encouraged providers and Medicare Advantage insurers to deliver care more cost-effectively and ... August 4, 2014 Medicare Affordable Care Act, Medicare, ACA 0 0 Comment Read More »
Legislation introduced to restore Medi-Cal funding Today Assembly Budget Chair Nancy Skinner and Assembly Health Chair Richard Pan, M.D., introduced two bills, one that would restore the 10 percent Medi-Cal physician payment cut that went into effect this year and another that would extend the temporary Medi-Cal primary care rate increases called for under the Affordable Care Act (ACA). “I have sought to make the Medi-Cal program more cost-effective, transparent and accountable,” said Dr. Pan. “The legislation that we are introducing today continues this effort.” Medicaid rates in California are the lowest in the nation, while the ... February 20, 2014 Medi-Cal ACA, Insurance/Reimbursement, Medi-Cal, Medi-Cal Cuts, State Legislative Advocacy, Affordable Care Act, We Care for California 0 0 Comment Read More »
DHCS pays over $100 million to primary care physicians in initial retroactive Medi-Cal rate increase payment The Department of Health Care Services (DHCS) has now made several retroactive interim payments to primary care physicians who have attested to their eligibility for the rate increases called for under the Affordable Care Act (ACA). These primary care payment increases have been put in place by the federal government in an effort to recruit more primary care physicians to treat low-income patients who will be newly eligible for health coverage in 2014. Although under the ACA the rate increases took effect on January 1, 2013, DHCS had been waiting ... February 7, 2014 Medi-Cal Affordable Care Act, Insurance/Reimbursement, Medi-Cal, ACA 0 0 Comment Read More »
Noridian sends out another wave of Medicare revalidation requests As called for under the Affordable Care Act (ACA), Medicare Administrative Contractors (MACs) have been requiring physicians to revalidate their Medicare enrollments. Between now and March 23, 2015, MACs will continue reaching out to physicians, notifying them of the need to revalidate. The most recent round of revalidations requests went out by December 30, 2013. The revalidation requirement is necessitated by new screening criteria called for under the ACA. Newly enrolling and revalidating providers will be placed in one of three screening categories representing the level of risk to the ... February 7, 2014 Medicare Affordable Care Act, Medicare, Noridian, PECOS, ACA, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
