Archive for the 'Affordable Care Act' Category

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HHS Releases Final ACO Rules

After much anticipation and an outpouring of feedback on the proposed rule released last March, the Department of Health and Human Services (HHS) released its final rule on the Accountable Care Medicare Shared Savings Program late last week. This program was created by one of a few key delivery system reform provisions in the health care reform law, to better align financial incentives in Fee-For-Service Medicare to strive for cost savings while protecting and improving quality of care. Provider groups had many concerns with the proposed rule, largely stemming from the lack of flexibility in initial funding that is required to develop a new ACO model and keep it running. The general analysis was that the potential upside offered through the program would not be sufficient to support the development of ACOs in the Medicare Fee-For-Service market – and the potential downside risk too great. Continue reading ‘HHS Releases Final ACO Rules’

IOM releases report on the essential health benefits package

 

The Institute of Medicine (IOM) released its recommendations for the essential health benefits (EHB) package this morning.  Continue reading ‘IOM releases report on the essential health benefits package’

IOM report on essential health benefits expected this week

The Institute of Medicine (IOM) announced that its report on recommended essential health benefits will be released October 7. The Affordable Care Act (ACA) requires the Department of Health and Human Services (HHS) to delineate the essential health benefits that must be offered by all carrier participants in the state health insurance exchanges. All health plans must cover these health benefits to be certified and offered in the proposed state health insurance exchanges. In addition, Medicaid state plans must cover these services by 2014. Continue reading ‘IOM report on essential health benefits expected this week’

Making health benefit choices more understandable for consumers

Last Wednesday, the Departments of Health and Human Services (HHS), Labor, and the Treasury released proposed rules regarding a Uniform Summary of Benefits and Coverage to be used by all health plans across the nation, as required by the Affordable Care Act.  The goal of the Uniform Summary of Benefits and Coverage and accompanying glossary of terms is to increase the transparency of health plan benefits, while enabling consumers to easily understand the health coverage offered under each plan.