Academy Activities

On Jan. 3, the Rate Review Practice Note Work Group submitted technical comments to the Center for Consumer Information and Insurance Oversight (CCIIO) on the most recent version of the Unified Rate Review Template (URRT) for quarterly 2014 and annual 2015 filings. The letter reiterates several other technical comments on both the URRT and the actuarial memorandum instructions that were included in a letter sent to CCIIO in early December.

The Health Practice Council responded on Dec. 20 to a proposed rule by the U.S. Department of Health and Human Services regarding benefit and payment parameters for 2015. The letter represents input from three Academy work groups on issues associated with composite rating, proposed changes to the actuarial value calculator and methodology, and the three risk-sharing mechanisms.

Legislative and Regulatory Updates

On Jan. 1, coverage purchased under the Affordable Care Act’s (ACA’s) health insurance marketplaces, or exchanges, began. The exchanges provide a one-stop shop for consumers to compare coverage options and premiums for a variety of insurers. Jan. 1 also signaled the full implementation of several provisions in the ACA, including various market reforms, premium and cost-sharing subsidies, the requirement to obtain minimum coverage, and the expansion of Medicaid.

President Obama on Dec. 26 signed the Bipartisan Budget Act of 2013, H.J.R. 59, which included a provision to extend the Medicare physician payment schedule through March 2014. This extension of the payment schedule prevented the imposition of a 23.7 percent payment cut to Medicare physicians scheduled to take place on Jan. 1. In addition to addressing other funding concerns associated with Medicare, the extension of the “doc-fix” gives Congress additional time to come to an agreement on a permanent solution to the payment problem.

The Centers for Medicare and Medicaid Services released a proposed methodology on Dec. 23 to determine federal assistance to states establishing a Basic Health Plan. The proposed methodology is the first step in setting the amount of federal funding that will be made available for states creating these programs. Comments on the proposed methodology are due by Jan. 22.

In the News

• A U.S. News & World Report reporter mentioned the Academy’s response to insurance cancellation reversals in his account of purchasing health insurance on a state-run exchange. The story also ran in the New Haven Register.
• Past President Cecil Bykerk told the Washington Post about trends in high-risk pool enrollees’ transition to new coverage.
• The Academy’s work related to Medicaid expansion was referenced in a column that appeared in the Omaha World-Herald on Dec. 17.
• America’s Health Insurance Plans’ “Time for Affordability” campaign cites the Academy’s issue brief, “How Will Premiums Change Under the ACA?”

Upcoming Events

Healthier and Wealthier, or Sicker and Poorer? Prospects for Medicare Beneficiaries Now and in the Future
Briefing: Jan. 13, Washington
Sponsor: Alliance for Health Reform (no fee charged)

For a complete listing of upcoming and recent health care reform events click here.