HcTrends RSS Article Feed https://www.hctrends.com/rss/rss.aspx HCTrends.com - Resource Postings en-us All materials © Copyright 2002 - 2017, HCTrends.com 3931 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=7DF28CCA-FFE2-42C9-989B-F67BE669CE68 webmaster@hctrends.com Building blocks: Block grants, per capita caps, and Medicaid reform Recent changes in the U.S. political environment have once again stirred up discussions of major reforms to the healthcare market. While a main topic in news discussions has been proposed reforms to health insurance exchanges created by the Patient Protection and Affordable Care Act (ACA), Medicaid reform has the potential to affect more people than any other source of coverage. By Justin Birrell, Jennifer L. Gerstorff, Nicholas Johnson, Brad Armstrong | 31 January 2017 PDF Download the PDF Recent changes in the U.S. political environment have once again stirred up discussions of major reforms to the healthcare market. While a main topic in news discussions has been proposed reforms to health insurance exchanges created by the Patient Protection and Affordable Care Act (ACA), Medicaid reform has the potential to affect more people than any other source of coverage. 2017-02-09T12:29:31-06:00 3929 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=F2D5E54A-29F3-4BAF-97FB-DD5E045220CB webmaster@hctrends.com FAQs about Affordable Care Act Implementation - Part XXXVII (1/2017) ACA FAQ Part 37 Addresses HRAs, Interpretation of "Health Insurance Coverage" The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury released Affordable Care Act (ACA) Implementation Frequently Asked Questions (FAQs) Part 37 discussing four specific questions related to health reimbursement arrangements (HRAs) and interpretation of "health insurance coverage". The four questions address: •Integration of HRAs with group health plans sponsored by the employer of a spouse of an employee; and •Coordinated and Consistent Interpretation of "Health Insurance Coverage" Other included discussions relate to: •HRAs and employer payment plans; •Code Section 162(m)(6); •Application of Code Section 162(m)(6) to Certain Clinical Risk-Bearing Entities; and •Medical Loss Ratio (MLR) Guidance Provided in CCIO Technical Guidance 2012-002. 2017-01-13T06:23:21-06:00 3928 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=A1BFBE67-E159-4038-B206-EC8828F07407 webmaster@hctrends.com FAQs about Affordable Care Act Implementation - Part XXXVI (1/2017) COVERAGE OF PREVENTIVE SERVICES - Section 2713 of the Public Health Service Act (PHS Act), as added by the Affordable Care Act and incorporated into the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code (the Code), requires that non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage provide coverage of certain specified preventive services without cost sharing. The Senate adopted a “Women’s Health Amendment,” adding a new category of preventive services specific to women’s health. This provision requires coverage without cost sharing of preventive care and screenings for women provided for in comprehensive guidelines supported by the Health Resources and Services Administration (HRSA). Supporters of the Women’s Health Amendment emphasized that it would reduce unintended pregnancies by ensuring that women receive coverage for “contraceptive services” without cost-sharing. 155 Cong. Rec. at 29,768 (Sen. Durbin). 2017-01-13T06:20:55-06:00 3925 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=DFF2EDD2-E9CD-4998-BAE5-2EA56334E2AE webmaster@hctrends.com FAQs about Affordable Care Act Implementation - Part XXXV (12/2016) This set of FAQs addresses the following: HIPAA Special Enrollment when there is a loss of coverage from a Marketplace plan; Qualified Small Employer Health Reimbursement Arrangements (QSEHRA) | Employer Payment Plans (EPP); Updated Women's Preventive Services guidelines. 2016-10-28T05:06:37-05:00 3924 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=A0F71D10-C730-4DEA-A726-DF1B51FBFBEC webmaster@hctrends.com Q&A on the 2017 Summary of Benefits and Coverage Applicability Date This guidance addresses the applicability date of the Summary of Benefits and Coverage (SBC) template and associated documents that were published on April 6, 2016 (available at: https://www.cms.gov/cciio/Resources/Forms-Reports-and-Other-Resources/index.html#Summary of Benefits and Coverage and Uniform Glossary). The SBC instructions provide that: “Health plans and issuers that maintain an annual open enrollment period will be required to use the April 2017 edition of the SBC template and associated documents beginning on the first day of the first open enrollment period that begins on or after April 1, 2017, with respect to coverage for plan years (or, in the individual market, policy years) beginning on or after that date. For plans and issuers that do not use an annual open enrollment period, this SBC template and associated documents is required beginning on the first day of the first plan year (or, in the individual market, policy year) that begins on or after April 1, 2017.” 2016-07-08T07:56:39-05:00 3923 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=ED0E177C-B924-4ABD-9B29-37CE52B9E91F webmaster@hctrends.com THE PERILS OF SELF-FUNDING Self-funding conversions do not necessarily save money. The potential savings that plan sponsors could realize from administrative costs, premium taxes and plan design flexibility can quickly be erased if the coordination of care is weakened or if there is a new network arrangement with inferior provider discounts. In general, the potential savings are greatest if the fully insured plan being replaced has high administrative costs and/or margins and if the network design remains unchanged (i.e., there is no change to the existing network or a preferred provider network is replaced by another preferred provider network). 2016-07-06T08:42:38-05:00 3922 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=70CDF9D4-03E0-4B80-92E9-CB4A4C01DD0A webmaster@hctrends.com Counting Seasonal Workers Under Pay or Play 6.30.2016 Employers that hire seasonal workers are reminded that there is an exception when measuring workforce size to determine whether they are an applicable large employer (ALE) subject to the Affordable Care Act's employer shared responsibility ("pay or play") and corresponding information reporting provisions. 2016-06-30T06:14:25-05:00 3915 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=7BF7A2DF-25B7-4A07-826A-2B750AD81785 webmaster@hctrends.com FAQs about Affordable Care Act Implementation - Part XXXII Q: The COBRA model election notice contains information about enrollment in the Marketplaces. Is it permissible for a group health plan administrator to include additional information about Marketplace coverage in or along with this notice? Yes. An individual who experiences a qualifying event and therefore becomes eligible for COBRA continuation coverage (for example, a covered dependent who ages out of her parents’ health plan or a covered worker who loses his job), also becomes eligible to apply for Marketplace coverage as a result of the same event.(9) As explained in the COBRA model election notice, for certain qualified beneficiaries, coverage obtained through a Marketplace may be a less expensive healthcare coverage option than enrollment in COBRA continuation coverage. 2016-06-28T10:12:39-05:00 3914 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=E4D3DBC6-D24D-41FA-8510-9E5866383BD4 webmaster@hctrends.com Deadlines to File ACA Information Returns With IRS Approaching (5/16) Due Date to File Paper Returns is May 31, 2016 Employers subject to the new Affordable Care Act (ACA) information reporting requirements are reminded that the deadlines for filing the first ACA information returns with the IRS are quickly approaching. 2016-05-13T06:31:48-05:00 3913 https://www.hctrends.com/library/lib_article_display_by_id.aspx?id=E9857A17-F807-40C6-A41B-ED70CC974AE8 webmaster@hctrends.com FAQs about Affordable Care Act Implementation - Part XXXI Included are 12 FAQ's on Coverage of Preventive Services;Coverage of Food and Drug Administration (FDA)-approved Contraceptives; Rescissions; Out-of-Network Emergency Services; Coverage for Individuals Participating in Approved Clinical Trials; Limitations on Cost-Sharing under the Affordable Care Act; Mental Health Parity and Addiction Equity Act of 2008; Medication Assisted Treatment for Opioid Use Disorder; The Women's Health and Cancer Rights Act. 2016-04-28T10:06:55-05:00