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Category Archives: Health Care Reform

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Payment Reform and Maryland’s All Payer Agreement with CMS

Posted in Articles, Health Care, Health Care Reform

Payment reform is considered essential to the transformation underway across the United States. Catalyst for Payment Reform (CPR) indicates that almost 90% of all private sector payments are still provided on the basis of fee-for-service. CPR defines payment reform as “payment methods that reflect or support provider performance, especially the quality and safety of care that… Continue Reading

Is One Brand of Medicaid Expansion Waiver Better than Another?

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Different strokes for different folks as the old adage goes.  This saying, however, is particularly true when you look at the states that have chosen to expand their Medicaid programs under the Affordable Care Act (ACA) through waivers. States do not have to seek a waiver from the federal government in order to expand their… Continue Reading

New York State’s Budget Relies on Federal Medicaid Money –Expecting an Answer from CMS Soon

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In 2012, New York Governor Andrew Cuomo submitted to the federal Centers for Medicare & Medicaid Services (CMS) an amendment to New York’s existing Partnership Plan 1115 waiver that sought to “redesign” the state’s Medicaid program.  The amendment proposed to reinvest $10 billion of the $17 billion in savings the state anticipated it would achieve… Continue Reading

Informative and Entertaining Look at Health Reform Issues for 2014

Posted in Affordable Care Act, Health Care Reform

In a move previously thought nearly impossible to pull off, Kaiser Health News recently published a list of “8 Things To Know About Obamacare in 2014″ that is both informative and entertaining. This quick read highlights issues about which readers should be informed as they move into the new year, while injecting some levity into the… Continue Reading

The Impact of the ACA on the Health Insurance Market – By the Numbers

Posted in Affordable Care Act, Health Care Reform

On a recent MSNBC segment, Steve Rattner shared the following slides that illustrate ways in which the health insurance market will be impacted as a result of the Affordable Care Act (ACA). The first reflects how various populations will be affected by the individual mandate to have insurance. The second indicates that most Americans who… Continue Reading

The Governor’s Big Play: Pushing Ahead on Medicaid Expansion

Posted in Affordable Care Act, Behavioral Health, Health Care, Health Care Reform, Medicaid

By Sylvia Brown and Former State Senate President Tom Niehaus Anticipation is building as the battle over Medicaid expansion moves to the unlikely arena of the state Controlling Board. On Monday, October 21 at 1:30 p.m., Governor John Kasich will try to make good on his promise to take whatever action within his power to… Continue Reading

VHCA, Vorys to Present on Health Care Reform at OPRA Fall Conference

Posted in Health Care Reform

Vorys Health Care Advisors’ Maureen Corcoran and Daphne Saneholtz and Vorys partner Suzanne Scrutton will be presenting at the Ohio Provider Resource Association Annual Fall Conference on October 8, 2013.  The presentation is titled Health Care Reform Update: The Home Stretch and will discuss provider implementation issues associated with the Affordable Care Act, policy and… Continue Reading

More Premium Information for Health Insurance Marketplace Plans Released

Posted in Affordable Care Act, Health Care Reform

The federal government recently released a report detailing premium information for qualified health plans to be sold in those 36 states (including Ohio) in which the U. S. Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014.  Highlights of the report include the following: Individuals will have an… Continue Reading

Physician Payment Sunshine Act Sheds Light on Payments Made to Doctors

Posted in Affordable Care Act, Health Care Reform

A little-discussed provision of the Affordable Care Act is making physicians, hospitals and manufacturers in the health care industry reconsider how they do business.  The Physician Payment Sunshine Act requires certain drug, medical device and biological manufacturers to disclose to the Centers for Medicare & Medicaid Services (CMS) any payments or other transfers of value… Continue Reading

Resources Help Illustrate Actual Marketplace Subsidy and Premium Amounts

Posted in Affordable Care Act, Health Care Reform

This Washington Post blog post does a nice job of demystifying subsidy amounts that will be available to individuals who purchase health insurance in the Marketplace (formarly known as the Exchange), and also references actual premium amounts in the states where such information has been made public.  Additionally, it links to a very helpful Kaiser… Continue Reading

Essential Health Benefits: What are they and who decides?

Posted in Affordable Care Act, Health Care Reform

As we have discussed in previous posts, beginning in 2014, under the Affordable Care Act (ACA), Medicaid plans and small group and individual plans sold inside and outside of the Health Insurance Marketplace must cover a package of 10 categories of items and services known as Essential Health Benefits (EHBs).  These categories include: Ambulatory patient… Continue Reading

Health Insurance Options in 2014

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In a recent post, we discussed the insurance mandate itself.  That is, the requirement that most people have health insurance beginning in 2014 or face a financial penalty.  We also briefly mentioned the insurance options that will be available to you in order to fulfill this requirement.  They are— Have employer-sponsored insurance Be covered by… Continue Reading

Overcoming A Hurdle: Consumer Understanding Of What The Affordable Care Act Has To Offer

Posted in Affordable Care Act, Health Care Reform

Despite the recent announcement that the requirement for employers to offer health insurance to their employees has been delayed, the federal and state governments are ramping up for the largest open enrollment period in history.  Fueled by the mandate that almost every American have health insurance as of January 1, 2014, millions of previously uninsured… Continue Reading

CMS Addresses DSH Cuts; Impact on States That Do Not Expand Medicaid Remains Unclear

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that cuts federal payments to hospitals for uncompensated care.  What still remains unclear, however, is how these cuts will impact states that do not expand their Medicaid programs. The Affordable Care Act (ACA) requires significant cuts to Disproportionate Share Hospital… Continue Reading

HPIO Resources on Medicaid Expansion in Ohio

Posted in Affordable Care Act, Health Care Reform, Medicaid

The Health Policy Institute of Ohio (HPIO) has recently added to its collection of Medicaid resources a brief focused on projected new employment and new local general sales tax revenues due to Medicaid expansion.  Governor Kasich’s budget proposal includes language expanding Medicaid eligibility up to 138% of the federal poverty level, or $32,499 for a… Continue Reading

Arkansas Proposes Coverage Definition of Habilitative Services

Posted in Affordable Care Act, Health Care Reform

Despite states’ struggles to define coverage of services under the habilitative services category of Essential Health Benefits as required by the Affordable Care Act (ACA), Arkansas recently proposed a coverage definition of habilitative services. Under the ACA, health plans sold inside a state’s Health Insurance Exchange, as well as all individual and small group plans,… Continue Reading

No Enhanced Federal Funds For Partial Medicaid Expansion

Posted in Affordable Care Act, Health Care Reform, Medicaid

Last week, 11 governors – including those in Ohio, Arizona, Louisiana, Florida, Virginia, Iowa, Maine, Mississippi, South Dakota, Utah, and Wyoming - submitted a letter to Health and Human Services Secretary Kathleen Sebelius asking whether states that expand Medicaid eligibility to a level less than that included in the Affordable Care Act (ACA) are eligible to… Continue Reading

Feds Extend Deadline for State Exchanges Again

Posted in Affordable Care Act, Health Care Reform

On Thursday, Health and Human Services Secretary Kathleen Sebelius extended the deadline to December 14 for states to submit letters of intent to build state-based health insurance exchanges. The original deadline had been today, Friday, November 16. Secretary Sebelius’ letter announcing the extension was in response to a request by the Republican Governors Association for… Continue Reading

HHS Extends Deadline for State-Based Exchanges

Posted in Health Care Reform

In a letter to governors on Friday, Secretary Kathleen Sebelius of the U. S. Department of Health and Human Services (HHS) announced that HHS is extending the deadline for State-based Exchange Blueprint application submissions to Friday, December 14,2012. Read the letter or Kaiser Health News’ breaking news bulletin for full details.