The Risk Sharing Subcommittee sent a comment letter to the Center for Consumer Information and Insurance Oversight regarding the Department of Health and Human Services’ white paper on risk adjustment validation (RADV).
Legislative/Judicial/Regulatory Updates
The U.S. Court of Appeals for the 5th Circuit ruled the individual mandate of the Affordable Care Act (ACA) unconstitutional on Dec. 18. While the case rules the individual mandate unconstitutional, the federal appeals court also remanded Texas v. Azar back to the U.S. District Court for the Northern District of Texas to determine if or which parts of the law would stand. Since then, 19 states have petitioned the ruling to the U.S. Supreme Court. The Supreme Court ordered the Trump administration and states challenging the ACA to respond to the appeal on an expedited timeline by Jan. 10.
The U.S. Senate passed an omnibus spending bill Dec. 19, which included a repeal of three health care taxes originally enacted under the ACA. The spending bill was signed into law by President Trump on Dec. 20 and repeals an excise tax on high-cost employer-sponsored health coverage (also known as the Cadillac tax), and the medical device excise tax immediately. The health insurance providers fee (also known as the health insurance tax) had a moratorium placed on it during 2019, will go back into effect in 2020, and will be eliminated permanently beginning in 2021. For more, read the Academy alert.
The Department of Health and Human Services (HHS) on Dec. 18 released a draft proposed rule that would allow states to import prescription drugs from Canada. The proposed rule does not include intravenous drugs, controlled substances, infused drugs, or biological products as possibilities.
Kentucky Gov. Andy Beshear issued an executive order on Dec. 16 to repeal Medicaid work requirements in the state. Kentucky was the first state to have Medicaid work requirements approved by the Trump administration, but the requirements did not take effect due to a federal order blocking the measure.
The Centers for Medicare and Medicaid (CMS) on Dec. 23 authorized Utah’s request to expand the state’s Medicaid program to ACA enrollment levels. The expansion will extend Medicaid eligibility to Utah adults whose annual income is up to 138 percent of the federal poverty level.
In the News
In a subscriber-only Life Annuity Specialist story, Al Schmitz, chairperson of the Long-Term Care/Disability Committee, discussed the use of predictive analytics to potentially reduce long-term care costs.
An article published by the Center for American Progress cited the Health Practice Council’s December 2016 letter to Congress on potential adverse consequences of repealing provisions of the Affordable Care Act (ACA) without having a replacement approach in place.