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Healthcare Policy Unpacked: Episode 19
In this episode, Chris Condeluci and Dennis Bolin unpack the recent Inflation Reduction Act which includes a three-year extension of premium subsidies and drug pricing reforms. While the drug pricing reforms only apply to Medicare, they will have a halo effect on private insurers and exchanges. The reforms include authority to negotiate drug prices (10 of top 50 drugs in 2026 and 20 in 2029), cap on insulin pricing, and price increases tied to inflation rate.
Healthcare Policy Brief: August 5, 2022
The reconciliation bill is revived! We unpack the dials and how much money the bill raises in tax revenue and/or saves in spending reductions, Schumer and Pelosi’s plan B if they can’t get a majority vote on this latest bill and when we think this could all get done.
Healthcare Policy Brief: July 22, 2022
In this issue, Chris unpacks the ongoing motion over a “reconciliation” bill, the increased likelihood we will see “some form” of an extension of the “enhanced premium subsidies,” and drug-pricing reforms (what are they?).
Healthcare Policy Unpacked: Episode 18
In this episode, we unpack: the Dobbs decision and State laws impacting fully-insured and self-insured plans, Colorado’s 1332 Waiver for a “public option” plan, the latest news on the “enhanced premium subsidies,” acknowledgment of July 1st and the public disclosure on “machine-readable files” AND ALSO a discussion of the Rx reporting requirement under the NSA (Updated instructions were recently issued. We talk about what carriers, TPAs, and PBMs are currently trying to figure out.).
Healthcare Policy Brief: July 1st, 2022
An update on employer-sponsored health coverage in the wake of the Dobbs Decision: Will employer sponsored health plans cover abortions and/or abortion-related medical services? Does it matter if the coverage is fully insured or self-insured? Plus, we unpack the Supreme Court ruling that employers can limit reimbursements for certain medical items or services, the 1332 waiver for a public option is approved in Colorado, and whether or not we’ll see an extension of the Enhanced Premium Subsidies.
Healthcare Policy Brief: June 16, 2022
In this issue, Chris sheds light on why he suggested that there is a 1% chance that the enhanced premium subsidies will be extended before November 1. We also provide an update on transparency—how insurance carriers and self-insured plans are doing when it comes to meeting the July 1 deadline and posting all of their INN rates and OON-allowed amounts on machine-readable files.
Healthcare Policy Unpacked: Episode 17
In this episode, Chris Condeluci and Dennis Bolin discuss the reports of renewed discussions about a “reconciliation” package that includes climate change reforms, drug pricing reforms and deficit reduction; how the extended “enhanced premium subsidies” could fit into this package; speculation that we may finally see the surprise billing final regs before the July 4 holiday; and rumors that the COVID Public Health Emergency may extend through April 2023.
Healthcare Policy Brief: May 25, 2022
In this issue, we unpack the 10th extension of the COVID Public Health Emergency (PHE), the RAND Corporation’s studies and increased transparency of medical prices, and how the 2023 notice of benefit and payment parameters attempts to make narrow network plans not so narrow.
Healthcare Policy Unpacked: Episode 16
In this episode, Chris Condeluci and Dennis Bolin unpack the Federal Portal going “live”, “updated”/”revised” guidance on the Federal IDR process, the final 2023 NBPP, and an update on enhanced premium subsidies—it is looking less and less likely that they will be extended prior to Nov. 1st (the start of 2023 OE).
Healthcare Policy Brief: May 9, 2022
Insight and analysis about FAQs describing how alternative reimbursement arrangements should disclose information on their in-network file, and intel into when we will see an extension of the enhanced premium subsidies
Healthcare Policy Brief: April 28, 2022
Surprise billing update: the federal portal is finally live after being delayed for over a month and a half
Healthcare Policy Brief: April, 19 2022
ACA Update: After all these year, will the family glitch finally get fixed?
Healthcare Policy Brief: April 13, 2022
Despite March coming in like a lion with the State of the Union Address delivered on the 1st, it’s played out like a lamb with only a slow drip of news on things like “possible” renewed discussions on the re-branded Building a Better America Act. We did not see any guidance on the Federally developed arbitration process in response to the Texas District Court ruling, even though on Feb. 28th the Federal Departments said some form of guidance would be “coming out soon.” However, last Friday April 8th, the Federal Departments scheduled a webinar to discuss the process. Let’s dive in!
Healthcare Policy Unpacked: Episode 15
In this episode, Chris Condeluci and Dennis Bolin discuss the impact of the recent District Court case out of Texas on the No Surprises Act (NSA) arbitration process, what the health coverage implications could be if and when the public health emergency ends, Biden’s recently released 2023 budget, the Federal Portal.
Healthcare Policy Unpacked: Episode 14
In this episode, Chris Condeluci and Nicole Fultz discuss the impact of the recent District Court case out of Texas on surprise billing requirements and the Federal arbitration process, how payers should develop their "Qualifying Payment Amount," and how the arbitration process will work, especially the Federal Portal (a government-run website intended to administer the Federally-developed arbitration process).