Academy activities, legislative/regulatory updates, and more.

Health Check Logo
November 9, 2016

Academy Activities

The Academy held its Annual Meeting and Public Policy Forum Nov. 3-4 in Washington, D.C. Health breakout sessions focused on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Affordable Care Act (ACA) implementation, and the rising costs of prescription drugs. Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services (CMS), gave the opening plenary address, providing a straightforward and comprehensive look at the effects of and challenges facing ongoing ACA implementation. His remarks were aired live by CSPAN3; see “In the News,” below.

Deadline Friday for ‘Actuarial Challenge’

This Friday, Nov. 11, is the deadline for those who intend to participate in the health care “Actuarial Challenge” to register their interest. The Academy is helping to promote this effort, which is being conducted by the Robert Wood Johnson Foundation in conjunction with Milliman Inc. This is an opportunity for actuaries to provide innovative ideas and proposals to increase stability in the individual health insurance market. Teams or individuals wishing to participate should complete an initial online application before 6 p.m. EST on Friday, Nov. 11; the challenge itself runs through April 2017. Visit the Actuarial Challenge website for more information.

Legislative/Regulatory Activities

check markCMS released a final rule on Oct. 14 implementing MACRA. According to the final rule, within the Merit-based Incentive Payment System, Medicare will pay providers based on quality of care and providers will be paid based on performance in four categories linked to quality and value. The final rule includes a comment period of 60 days, and is effective on Jan. 1, 2017.

check markOn Oct. 26, state and federal officials gave final approval for the state of Vermont to shift its health system to an all-payer accountable care organization (ACO) model beginning Jan. 1, 2017. The CMS agreement with Vermont is for five years.

check markSeveral federal agencies issued a final rule on Oct. 31 revising the definition of short-term, limited duration insurance to less than three months of coverage and requiring notice that it does not qualify as minimum essential coverage under the ACA. The final rule also clarifies the basis for determining benefits subject to the prohibition on lifetime and annual dollar limits. The final regulations are effective Dec. 30, 2016, and the new rules apply to group health plans and health insurance issuers on the first day of the plan or policy year beginning on or after Jan. 1, 2017.

In the News / Media Activities

Slavitt’s opening plenary address at the Academy’s Annual Meeting and Public Policy Forum was televised live on C-SPAN3, and the video was posted to C-SPAN’s website. It was also previewed in a story by The Hill, which discussed the ACA’s extended enrollment period for coverage in 2017. A daily Politico health care newsletter also cited the remarks.

Senior Health Fellow Cori Uccello provided an actuarial perspective on the impact of loosening the age-rating band ratio from 3:1 to 5:1 under the ACA in a subscriber-only Inside Health Insurance Exchanges story. The story was reprinted in the subscriber-only AIS Health.

A Risk & Insurance story addressing changes in the actuarial and underwriting assumptions for traditional long-term care (LTC) insurance quoted Bruce Stahl, vice chairperson of the Academy’s LTC Reform Subcommittee, on how assumptions have become more conservative since the 1980s and ’90s.

A Health Affairs Blog post promoting the Actuarial Challenge (see item, above) urged actuaries to be part of the friendly competition in which teams of actuaries develop and test solutions to improve the performance of the individual health insurance market. The challenge was also featured in an Insurance News Net article.