In the Health Reform Update for the past three weeks, a Senate report concludes that the Department of Health and Human Services (HHS) ignored consultant warnings that most of the non-profit insurance cooperatives created with Affordable Care Act (ACA) loans would fail.
High attrition rates cause Marketplace enrollment figures for 2015 to come in 3.5 percent below HHS projections. New rules require federal Marketplace plans to be rated according to network adequacy. An HHS proposal to alter payment formulas for Medicare Part B drugs draws swift opposition from provider groups, drugmakers, and Republican lawmakers.
The Utah legislature approves only a partial Medicaid expansion in an effort to break a two-year impasse. New figures show early enrollment and revenue from Montana’s Medicaid expansion far exceeds projections. Indiana’s governor signs a bill preventing future changes to that state’s Medicaid expansion without legislative approval.
Florida is expected to become the first state to protect consumers from surprise out-of-network bills when receiving care from an in-network provider.