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Healthcare Policy Unpacked: Episode 23
In our final episode of Healthcare Policy Unpacked, Chris Condeluci and Dennis Bolin share what to expect from Congress in the coming weeks and into 2023 and briefly summarize the most significant policy changes of 2022. This time of year, we are all waiting to see what Congress has planned for the year-end spending bill, which already has an extended deadline of December 23. Will this year’s spending bill be a “Christmas Tree” with several new policy items slipped in? The Administration also turned out some important regulations before the holiday season began, including requiring electronic exchange of prior authorization information between health plans and providers by January 1, 2026. Another was the 2024 Notice of Benefits and Payment Parameters (NBPP) which made notable changes to network adequacy standards for exchange plans and introduced special enrollment periods for beneficiaries rolling off Medicaid after the end of the public health emergency (PHE).
Healthcare Policy Brief: November 22, 2022
November has been an eventful month so far with election day becoming an election week-plus! It took until November 17 before all but eight races were called. We’ll get into some of my midterm election takeaways, what we might see from a healthcare policy perspective over the next two years, etc. But first let’s jump into the COVID Public Health Emergency (PHE). Again.
Healthcare Policy Unpacked: Episode 22
In this episode, Chris Condeluci and Dennis Bolin recap the election results and look ahead to the lame duck congress and 2023 as the administration finalizes a “ton” of regulations and guidance in these areas: Strengthening plan options like HSAs, ICHRAS, association plans, encouraging use of telehealth, incentivizing Medicare Advantage plan selection, transparency, cost sharing, AEOBs, provider directories, and CMMI’s commitment to value-based care models.
Healthcare Policy Brief: October 24, 2022
In this issue, Chris unpacks the latest regarding the midterm elections, healthcare policy, surprise billing and other provisions of the No Surprises Act.
Healthcare Policy Unpacked: Episode 21
In this episode, we unpack a final regulation fixing the ACA’s "family glitch," the official extension of the Public Health Emergency, a request for information in advance of implementing guidance for the Advanced Explanation of Benefits (AEOB), some Q&As on the Prescription Drug Reports due December 27, 2022, and a preview of the mid-term elections.
Healthcare Policy Unpacked: Episode 20
In this episode, Chris Condeluci and Dennis Bolin unpack the final surprise billing regulations, including the 23 frequently asked questions (FAQs) released alongside the final surprise billing regulations and FAQs regarding the transparency of coverage rule.
Healthcare Policy Brief: September 8, 2022
In this issue, Chris unpacks the final surprise billing regulations including the removal of the rebuttable presumption standard, unaddressed components, increased information when downcoding, federal arbiters’ written decisions, and the 23 FAQs released alongside the final surprise billing regulations.
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.