HealthCheck, January 2019

Academy activities, legislative/regulatory updates, and more.

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January 16, 2019

Academy Activities

The Medicaid Subcommittee submitted comments Jan. 14 to the Centers for Medicare & Medicaid Services (CMS) on a proposed rule that would make changes to the Medicaid and Children’s Health Insurance Program (CHIP) managed care programs.

Legislative/Judicial/Regulatory Updates

check markU.S. Sens. Chuck Grassley and Amy Klobuchar introduced the bipartisan Safe and Affordable Drugs from Canada Act of 2019 on Jan. 10. The legislation would allow for the importation of prescription drugs from approved pharmacies in Canada.

check markWisconsin Gov. Tony Evers signed an executive order on Jan. 8 directing the Wisconsin Department of Health Services to develop a plan for expanding eligibility for coverage under the state’s Medicaid program.

check markWashington Gov. Jay Inslee announced on Jan. 8 that he and certain Washington state Democratic lawmakers will be introducing legislation that would establish a public health insurance option through the state’s Health Benefit Exchange.

check markMaine Gov. Janet Mills signed an executive order on Jan. 3, her first day in office, calling for the “expeditious implementation” of a November 2017 ballot initiative expanding eligibility for Medicaid coverage to working-age adults with incomes below 133 percent of the federal poverty level. Mills’ predecessor, Paul LePage, refused to implement the initiative after it was approved, and refused to comply with court rulings to require his administration to begin implementing the state’s Medicaid expansion.

check markA federal judge for the U.S. District Court for the Northern District of Texas issued an order on Dec. 30 allowing the Affordable Care Act (ACA) to remain in effect following a Dec. 14 ruling in Texas v. Azar that declared the law invalid. The stay of the Dec. 14 ruling is intended to prevent uncertainty regarding the administration and enforcement of the ACA if the decision is appealed to the U.S. 5th Circuit Court of Appeals (as it subsequently was). In addition to the Dec. 30 order, all proceedings on the litigation have been temporarily stayed due to the ongoing partial shutdown of the federal government. Read the Academy alert.

check markA tax bill passed by the U.S. House of Representatives by a 220-183 vote on Dec. 21 included provisions that would have affected taxes established under the ACA, including extending the suspension of an annual fee on health insurance providers until Dec. 31, 2021; delaying the excise tax on high-cost, employer-sponsored health insurance plans through 2022; and delaying the medical device excise tax through 2024. The bill did not reach a vote by the U.S. Senate before the end of the 115th Congress.

In the News / Media Activities

  • A Modern Healthcare subscriber-only story cited the Health Practice Employee Benefits Committee and Individual and Small Group Markets Committee’s Dec. 13 comment letter on the proposed rule regarding Health Reimbursement Arrangements (HRAs).

  • An American Action Forum research paper noted Senior Health Fellow Cori Uccello as one of the 21 experts that attended the Urban Institute and the American Action Forum’s one-day roundtable summit to discuss implications of calibrating the risk adjustment model using encounter data.

  • A story in The Actuary cited an Academy issue paper, Insights on the ACA Risk Adjustment Program, and a 2017 comment letter to the U.S. Department of Health and Human Services regarding the proposed rule for the 2019 benefit and payment parameters.

Available for Pre-Order: Life and Health Valuation Law Manual

Be one of the first to have the Life and Health Valuation Law Manual. This manual, also updated annually, is designed to help appointed actuaries know the requirements of the NAIC Model Standard Valuation Law and the Model Actuarial Opinion and Memorandum Regulation. Place your order today.

Save the Dates—Academy’s Annual Meeting and LHQ Seminar Set for November

The Academy’s Annual Meeting and Public Policy Forum, and the Life and Health Qualifications Seminar, will be held in November in and around the nation’s capital. The Annual Meeting and Public Policy Forum will be held Nov. 5–6 in Washington, D.C., and will feature multiple health policy breakout sessions. The LHQ Seminar, which provides the opportunity to obtain qualifications or relevant continuing education (CE) credit necessary to issue actuarial opinions for either the NAIC Life and Accident & Health (A&H) Annual Statement or the NAIC Health Annual Statement, will be held Nov. 10–14 in Arlington, Va., just outside of Washington.