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SEBELIUS: MOST STATES WILL PARTICIPATE IN MEDICAID EXPANSION
In a speech on July 11, Health and Human Services Secretary (HHS) Kathleen Sebelius expressed confidence that most states will participate in the expansion of the Medicaid program provided for in the Patient Protection and Affordable Care Act (PPACA). …
Read More Healthcare Update: Sebelius: Most States will Participate in Medicaid Expansion; New Funding Made Available for Health Insurance Exchanges

In perhaps the most widely anticipated Supreme Court decision since Bush v. Gore in 2000, the Patient Protection and Affordable Care Act (“PPACA”) was upheld on Thursday in a narrow 5 to 4 decision. Many believed that the Court would hold the law unconstitutional because of a provision known as the “individual mandate,” which requires most U.S. citizens to purchase health insurance or pay a penalty. …
Read More Healthcare Update: Supreme Court Upholds Constitutionality of Affordable Care Act

In June 2012, the Senate Committee on Insurance passed Assembly Bill 999 by a vote of five to three.  The bill, sponsored by Commissioner Jones and the California Department of Insurance, modifies the long-term care insurance premium rate development process and requires that consumers be permitted to review policy language before purchasing a policy. …
Read More California Senate Committee Passes Long-Term Care Bill

NEW HHS REPORTING RULE WILL HELP DEFINE “ESSENTIAL HEALTH BENEFITS”
On June 1, the U.S. Department of Health and Human Services (HHS) released a proposed rule that would require the three largest small-group health insurance issuers in each state to report detailed benefit information to HHS, as well as prescription drug coverage information and any limits on the benefits offered. …
Read More Healthcare Update: New HHS Reporting Rule Will Help Define “Essential Health Benefits”; CMS Ends Marketing Outreach for High-Risk Pools

CMS DELAYS DATA COLLECTION UNDER SUNSHINE ACT
In a May 3 notice on its official blog, the Centers for Medicare & Medicaid Services (CMS) announced that it will not require data collection under the Physician Payments Sunshine Act, part of the Patient Protection and Affordable Care Act (PPACA), until January 1, 2013. …
Read More Healthcare Update: CMS Delays Data Collection Under Sunshine Act; New Rules to Ease Burdens on Providers; MA Bills Target Healthcare Costs; CMS Proposes Medicaid Payment Increase; New Bill Proposes Repeal of SGR

The NRCMS, overseen by the Ministry of Health, is a basic health social security system, started in 2003, that combines insurance and social assistance, and targets all farmers and rural residents in China. …
Read More China to Outsource Management of the New Rural Co-operative Medical Scheme (NRCMS) to Commercial Insurers

CMS ISSUES PROPOSED IPPS RULE
On April 24, the Centers for Medicare and Medicaid Services (CMS) issued its proposed Inpatient Prospective Payment Systems (IPPS) rule setting forth hospital payment rate changes for the 2013 fiscal year, which begins October 1, 2012. …
Read More Healthcare Update: CMS Issues Proposed IPPS Rule; PPACA Expected to Save $200 Billion Through 2016

CMS ANNOUNCES FIRST ACO PARTICIPANTS
On April 10, the Centers for Medicare & Medicaid Services (CMS) announced the first 27 accountable care organizations (ACOs) that will participate in the Medicare Shared Savings Program (MSSP), established under the Patient Protection and Affordable Care Act (PPACA). …
Read More Healthcare Update: CMS Announces First ACO Participants; HHS Proposes Delaying ICD-10 Compliance Deadline, Adopts Unique Health Plan Identifier; New York Governor Issues Executive Order for Health Exchange

According to media reports, California Insurance Commissioner Dave Jones will introduce legislation shortly that will set minimum permissible amounts for stop-loss policies to self-insured small businesses.  While the minimum amount has not been finalized, it is anticipated that it will be set at $40,000 per employee. …
Read More California Insurance Commissioner Plans Legislation to Set Minimum Permissible Amounts for Stop-Loss Policies