Tag Archives: CBO

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

CBO releases analysis on specialty drugs in Medicare Part D and Medicaid
The Congressional Budget Office (CBO) published “Prices for and Spending on Specialty Drugs in Medicare Part D and Medicaid: An In-Depth Analysis.” The report examines the net prices paid for specialty drugs and spending on those drugs in Medicare Part D and Medicaid over the 2010–2015 period. In each program, the net price for many drugs is lower than the amount paid to pharmacies, also referred to as the retail price, because of manufacturers’ rebates and other discounts.

For more information, click here.

Private health insurance enrollment report published
The Government Accountability Office (GAO) released “Private Health Insurance: Enrollment Remains Concentrated Among Few Issuers, Including Exchanges.” The report found that enrollment in private health insurance plans continued to be concentrated among a small number of issuers in 2015 and 2016.

In the overall large group market (coverage offered by large employers), small group market (coverage offered by small employers), and individual market (coverage sold directly to individuals), the three largest issuers held 80% of the market or more in at least 37 of 51 states. This is similar to what GAO previously reported for 2011 through 2014.

For more information, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

CBO analysis of coverage under the new rules for association health plans and short-term plans
The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released the report “SOURCE: “How CBO and JCT Analyzed Coverage Effects of New Rules for Association Health Plans and Short-Term Plans.” The report provided an analysis of the coverage effects of the recent final rule on association health plans and short-term, limited-duration health insurance.

To read the report, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

Agencies release final rule on short-rerm, limited duration health insurance
The Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA), the Department of Treasury, and the Department of Health and Human Services (HHS) issued a final rule amending the definition of short-term, limited-duration health insurance that individuals may purchase. The final rule permits insurers to sell policies that cover periods longer than the three-month maximum permitted under the Patient Protection and Affordable Care Act (ACA), allowing for an initial period of 364 days and for renewals of up to 36 months.

To read the entire final rule, click here.

Medicare Part D premiums continue to decline in 2019
The Centers for Medicare & Medicaid Services (CMS) announced that the average basic premium for a 2019 Medicare Part D prescription drug plan is projected to decline for the second year in a row. Earlier this year, CMS announced several changes in the Part D program aimed at further empowering Part D plans to drive a hard bargain with drug manufacturers and lower the cost of prescription drugs. CMS has been working to ensure that Medicare Part D plans can leverage all of the tools that are available to commercial plans in negotiations.

To learn more, click here.

CBO publishes report on the cost related to employer mandate repeal and Cadillac tax delay
The Congressional Budget Office (CBO) released estimates related to the cost of the “Employer Relief Act” (H.R.4616), which would suspend the collection of penalties on large employers that decline to offer qualifying health insurance coverage for plan years 2015-2018 and delay implementation of the excise (“Cadillac”) tax on high-premium insurance plans by one year. The report assessed the costs based on the legislative text approved by the House Ways and Means Committee on July 11.

To learn more, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

IRS releases final and temporary rule on health providers’ fee
The Internal Revenue Service (IRS) released final regulations that provide rules for the definition of a covered entity for purposes of the fee imposed by section 9010 of the Patient Protection and Affordable Care Act (ACA), as amended. The final regulations supersede and adopt the text of temporary regulations that provide rules for the definition of a covered entity. These regulations affect persons engaged in the business of providing health insurance for U.S. health risks.

To read the entire rule, click here.

Federal agencies propose rule on short-term, limited-duration insurance
The U.S. Departments of Treasury, Labor (DOL), and Health and Human Services (HHS) have released a proposed rule that would amend the definition of short-term, limited duration insurance for purposes of its exclusion from the definition of individual health insurance coverage.

The proposed rule would make it easier to obtain coverage through short-term health insurance plans by allowing insurers to sell policies that last under a year. The new rules stem from an executive order the president signed in October aimed at boosting competition, giving consumers more choices, and lowering premiums.

To learn more, click here.

How CBO and JCT analyze major proposals that would affect health insurance coverage
The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) released a report that estimates the budgetary effects of most types of major legislative proposals that would affect both spending and revenues using a process that involves many steps and many analysts. The report focuses on the process that the agencies use to analyze proposals affecting health insurance coverage for people under age 65, such as legislation that would make major changes to the ACA.

For more information, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

Issues and challenges in measuring and improving the quality of healthcare
The Congressional Budget Office (CBO) released a new paper providing an overview of the current state of measuring healthcare quality. The agency uses the Medicare program to illustrate the key issues and challenges that arise in doing so.

To download the paper, click here.

Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) enforcement report published
The Centers for Medicare and Medicaid Services (CMS) has published a new report to increase transparency with respect to enforcement of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Although CMS has taken action to ensure compliance with MHPAEA since its enactment in 2008, this report only includes MHPAEA investigations completed in 2016 and beyond.

To download the report, click here.

 

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

Employer shared responsibility appeal form released
The U.S. Department of Health and Human Services (HHS) issued a health insurance marketplace appeal request form for employers.

To download a copy of the form, click here.

Spending for Social Security and major healthcare programs
The Congressional Budget Office (CBO) published the report “The 2016 Long-Term Budget Outlook,” which describes the agency’s projections of federal spending, revenues, deficits, and debt over the next 30 years.

The CBO projects that spending for Social Security would increase noticeably as a share of the economy—from 4.9% of gross domestic product (GDP) in 2016 to 6.3% in 2046—if current laws generally remained unchanged. Spending for the major healthcare programs is projected to grow even faster—net outlays for those programs would increase from 5.5% of GDP now to 8.9% in 2046. The major healthcare programs include Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), as well as spending on subsidies for health insurance purchased through the marketplaces established by the Patient Protection and Affordable Care Act (ACA) and related spending. About three-quarters of the increase in spending for the major healthcare programs would be for Medicare.

To download the report, click here.