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Setting new standards in information exchange for the pharmaceutical and biotech industry


Monday’s Medicaid Announcement from the CMS

  • January 16, 2013

  • The Centers for Medicare & Medicaid Services published a rule Monday detailing how states should coordinate certain elements of health exchanges and Medicaid.

    The New York Times: States Will Be Given Extra Time To Set Up Exchanges
    Under the law, the secretary of health and human services was supposed to determine “on or before Jan. 1, 2013,” whether states were prepared to operate the online markets, known as insurance exchanges. But the secretary, Kathleen Sebelius, working with the White House, said she would waive or extend the deadline for any states that expressed interest in creating their own exchanges or regulating insurance sold through a federal exchange (Pear, 1/14).

    Politico Pro: States See Flexibility In Proposed Medicaid Rule
    The 474-page rule CMS published Monday lays out requirements to streamline the Affordable Care Act consumer experience by requiring a single, clear, “one-stop-shopping” response for people wanting to know whether they are eligible for Medicaid, premium subsides or nothing. But not right away. In a nod to the technological and data barriers to aligning the federal and state roles in making Medicaid and exchange subsidy decisions, that single response requirement won’t take effect until the beginning of 2015 (Norman, 1/14).

    CQ HealthBeat: Medicaid Officials Release Rule Affecting Cost-Sharing And Coordination With Exchanges
    The proposed rule also affects a wide range of other Medicaid provisions, including appeals of eligibility determinations; coordination between Medicaid and the new health care law’s insurance exchanges; the role of counselors to assist people with their coverage applications; procedures to verify employer-sponsored coverage; and the use of updated Medicaid eligibility categories. Centers for Medicare and Medicaid Services Deputy Administrator Cindy Mann said on a call with reporters Monday that the new proposal would increase the amount that states could charge patients for non-preferred drugs, non-emergency care in emergency departments and some other services (Adams, 1/14).

    Meanwhile, Florida lawmakers explore various issues related to the health law —

    Miami Herald: Lawmakers Review Obamacare Impact On Medicaid, Small Business
    As lawmakers decide how — or whether — to move forward with parts of the federal Affordable Care Act, House and Senate select committees plunged Monday into issues such as a potential expansion of the Medicaid program and the law’s effects on Florida businesses. In back-to-back meetings, lawmakers heard testimony from people with far-different perspectives about the controversial health overhaul, which Florida Republican leaders resisted for more than two years (Saunders, 1/15).

    Also in the news, H & R Block is telling consumers to start planning now for the law’s future tax changes —

    Kaiser Health News: Capsules: Not Too Early To Plan For Health Taxes, H & R Block Says
    Even if you owe Affordable Care Act taxes, you probably won’t have to start paying them until next year. But H&R Block wants you to come in and talk about them now (Hancock, 1/14).

    This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.