Blue Cross Blue Shield sees ‘urgent’ need for Congress to stabilize ObamaCare markets

A leading health insurance group said Monday there is an “urgent” need for Congress to act to stabilize ObamaCare markets after the repeal of the individual mandate in December.

“There’s an urgent need to stabilize the market,” Justine Handelman, a senior vice president at the Blue Cross Blue Shield Association, told reporters at a briefing.

She said the most important action Congress could take is to provide funding for what is known as reinsurance, which helps cover the costs of especially sick patients, thereby bringing down premiums.

“Without the mandate we think that the single most important thing that can help offset that loss is dedicated funding for reinsurance,” Handelman said.

The group pointed in particular to a bill from Rep. Ryan Costello (R-Pa.) in the House to provide reinsurance funding, as well as funding for other ObamaCare payments known as cost-sharing reductions (CSRs).

Momentum has been building in Congress for a stabilization measure, which could be included as part of a long-term government funding deal in the coming weeks. Conservatives object to the idea as a “bailout” of insurers, but many Republicans, including leadership in both chambers, has expressed interest in the idea.

Blue Cross officials said, based on data from the consulting firm […]

By |February 8th, 2018|Health Reform, Industry News, National News|Comments Off on Blue Cross Blue Shield sees ‘urgent’ need for Congress to stabilize ObamaCare markets

Trump official: Medicaid work requirements a form of ‘true compassion’

A top Trump administration official says Medicaid work requirements are a form of “true compassion” that aim to help poor people overcome poverty.
“True compassion is lifting Americans most in need out of difficult circumstances,” Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said in a Washington Post column.
“This administration stands for a policy that makes Medicaid a path out of poverty by empowering states to tailor programs that meet the unique needs of their citizens,” Verma wrote.
On Friday, Indiana became just the second state in the 53-year history of the Medicaid program to gain federal approval to institute work requirements on Medicaid beneficiaries.
The Trump administration approved Kentucky’s request in January, and 11 other states are awaiting approval of similar requests to change their Medicaid programs. The administration released guidance last month that encouraged states to institute work requirements and detailed the types of policies the administration would be likely to approve.
“We applaud their efforts to strengthen the Medicaid program and are supportive of testing approaches to end poverty and improve outcomes,” Verma said in her column.
Some states previously asked the Obama administration for permission to institute work requirements but were denied. CMS officials in the Obama administration said they were […]

By |February 8th, 2018|Health Reform, Medicare/Medicaid, National News|Comments Off on Trump official: Medicaid work requirements a form of ‘true compassion’

CMS launches initiative to reduce Medicare appeals backlog: 3 things to know

CMS has started a new initiative to help clear the mounting Medicare appeals backlog at the Administrative Law Judge level.

Here are three things to know.

1. CMS announced the new low-volume appeals settlement option in November 2017, and the agency launched the first round of the new initiative on Monday.

2. The low-volume appeals settlement option is limited to those with fewer than 500 Medicare Part A or Part B claim appeals pending with the Office of Medicare Hearings and Appeals and the Medicare Appeals Council as of Nov. 3, 2017, with a total billed amount of $9,000 or less per appeal. CMS will settle eligible appeals at 62 percent of the net allowed amount.

3. CMS launched the new settlement option to clear the significant backlog of Medicare appeals that has resulted in a nearly three-year adjudication process for each Medicare claim that is denied.

From Becker’s

By |February 8th, 2018|Medicare/Medicaid, National News|Comments Off on CMS launches initiative to reduce Medicare appeals backlog: 3 things to know

 

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