CMS eliminates barrier to ACA Individual Mandate Exemption

Consumers who abandoned the Obamacare exchanges this year are entitled to a “hardship” exemption to the individual mandate penalty, CMS publicized Wednesday. This will directly affect people who chose to go uninsured or who enrolled in coverage that doesn’t comply with Obamacare protocols. This follows the agency’s April guidance that expanded the exemption to people who live in rural counties or have claims going back to 2016, but applicants still had to give a written explanation for why they required the exemption.

(more…)

Continue Reading

Texas ACA lawsuit to begin: What you need to know

Today, a Texas lawsuit will be heard determining pivotal laws and regulations concerning the Affordable Care Act. Republican attorney generals, led by Texas’ Attorney General Ken Paxton, will go against the Democratic party, led by California’s Attorney General Xavier Becerra, to debate the fate of the ACA. U.S District Judge Reed O’Connor will hear both sides and determine whether the health law should be put on hold while the case is being contested. GOP Plaintiffs are looking for a “preliminary injunction” on the law.

(more…)

Continue Reading

NPAG 2018 Recap

Excellus Blue Cross Blue Shield was pleased to host the 2018 National Plan Automation Group (NPAG) Conference in picturesque Lake Placid, NY. The event showcased 4 days of interactive sessions exploring opportunities in EDI, electronic payments, health records, “HEDIS,” and the past, present, and future of authorization transactions. While NPAG sponsored a progressive networking retreat, attendees took advantage of Lake Placid Golf Club, Ausable Chasm, and an adventurous BobSled Experience.

In case you were not able to attend, here’s our recap of what was discussed:

(more…)

Continue Reading

CMS to accelerate Medicaid waiver process and allocate $8.6 million in funding to states to steady health insurance markets

The Centers of Medicare and Medicaid Services (CMS) revealed on August 16th, 2018 changes to the Medicaid Review Process, unveiling substantial reduction in approval times. The new updates will generate faster processing of state requests to streamline changes to their Medicaid program through the state plan amendment and section 1915 waiver review process. Less than 1 week following this move, CMS announced $8.6 million in funding to 30 states and the District of Columbia to help reinforce and stabilize corresponding health insurance markets under the Affordable Care Act (ACA).  

(more…)

Continue Reading

MESC 2018 Recap

The annual Medicaid Enterprise Systems Conference (MESC) showcased 4 days of interactive sessions discussing health information technology, MMIS implementations, and Medicaid innovations. Set in the picturesque city of Portland, Oregon, the conference welcomed industry experts from all over the country. Day 1 set the tone by asking the audience: “What’s your next big idea in Medicaid?” All sessions to follow explored that overarching question.  

(more…)

Continue Reading

Section 1115 Waivers: The effects of Medicaid expansion under the Affordable Care Act

To date, 33 states and the District of Columbia have expanded their programs, 8 utilizing a Section 1115 Waiver.  Another 17 are not currently expanding, however, their interest will soon be measured on ballots this Fall.   

Overall, the impacts have been significant; coverage, access to care, and delivery system reform have all seen changes. Medicaid expansion has positively affected utilization of services, the affordability of care, and financial security among the low-income population. According to Kaiser Family Foundation (KFF), Medicaid expansion states have also experienced significant coverage gains and reductions in uninsured rates – among the low-income population broadly and within specific vulnerable populations.  

(more…)

Continue Reading

MESC 2018 Recap: Day 2

The annual Medicaid Enterprise Systems Conference (MESC) began day 2 with a deep dive into Machine Learning for Medicaid Payers and Providers, followed by sessions on successful modular MMIS implementations and best practices from state reuse initiatives, including that of New Jersey and Pennsylvania.

If you weren’t able to attend, check out our MESC recap of key takeaways.

(more…)

Continue Reading

MESC 2018 Recap: Day 1

The annual Medicaid Enterprise Systems Conference (MESC) kicked off with a boom. Set in beautiful Portland, Oregon, the event welcomed the who’s who of Medicaid. Nearly 100 sessions are packed into 4 days of fun- filled announcements and discussions about Medicaid and where the industry is headed.

Day 1 rang in with an overarching theme: “What’s your next big idea in Medicaid?” If you weren’t able to attend, check out our MESC recap of key takeaways:

(more…)

Continue Reading

CMS restores Affordable Care Act risk-adjustment transfers for 2017 benefit year

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released a final rule designed to allow and reissue payments under the Affordable Act risk-adjustment program to balance the insurance market. According to CMS Administrator Seema Verma, “This rule will restore operation of the risk adjustment program and mitigate some of the uncertainty caused by the New Mexico litigation.”  

(more…)

Continue Reading
Close Menu