Administration Issues Interim Rule on Surprise Billing
The U.S. Departments of Health and Human Services (HHS), Labor, Treasury, and the Office of Personnel Management, issued an interim final rule with comment period that will restrict surprise billing for patients in job-based and individual health plans and who get emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. The interim final rule implements certain provisions of the No Surprises Act, which was enacted as part of the Consolidated Appropriations Act, 2021. Health care providers and facilities must provide patients with a plain-language consumer notice explaining that patient consent is required to receive care on an out-of-network basis before that provider can bill at the higher out-of-network rate. Balance billing, when a provider charges a patient the remainder of what their insurance does not pay, is currently prohibited in both Medicare and Medicaid. This rule will extend similar protections to Americans insured through employer-sponsored and commercial health plans. The law will go into effect on January 1, 2022. Fact sheets on this interim final rule can be found here and here.
CMS Releases Medicaid and CHIP Quality Report to Congress
The Centers for Medicare & Medicaid Services (CMS) released the Quality Report to Congress identifying efforts undertaken to improve the quality of health care for children and adults enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). This report provides information on activities undertaken between 2017 and 2019, including changes in performance in the quality measures included in the Medicaid and CHIP Child and Adult Core Sets.
Cost Containment Strategies for State Employee Health Plans
This report by the Georgetown University Health Policy Institute reviews the landscape of state employee plans around the country, assesses a range of cost containment strategies implemented by state employee health plans, and shares lessons for building on those that appear most promising. The study reflects a comprehensive survey of 47 state employee health plan administrators and in-depth interviews with 11 of them. In general, state employee health plan administrators point to hospital prices as the primary driver of the steady increase in the cost of employee health benefits yet remain focused on secondary drivers such as excessive or inappropriate utilization.
HHS Awards $250 Million to Fight COVID-19, Improve Health Literacy
The Department of Health and Human Services (HHS) announced $250 million in grant awards to 73 local governments as part of a new, two-year initiative to identify and implement best practices for improving health literacy to enhance COVID-19 vaccination and other mitigation practices among underserved populations.
Altarum Institute Releases Report on Health Care Spending
National health spending in April 2021 increased by 32.4 percent relative to spending in April 2020. Since January 2020, before the pandemic-induced drop began, net growth in national health spending was 1.5 percent through April 2021. The magnitude of the drop and subsequent recovery has varied by category of spending, with only home health care, prescription drugs and hospital spending reaching levels in April 2021 that exceeded their January 2020 levels. Altarum is a nonprofit health care research and consulting organization.
Medicaid and State Financing
This brief by the Kaiser Family Foundation presents the most current data for key indicators to help understand how various economic factors that could affect Medicaid enrollment and spending are changing in light of the pandemic as well as efforts to address the pandemic and the start of economic recovery.