Newsletters

01.04.23

What Health Plans Should Know About Federal Changes for Dual Eligibles

Designed to better coordinate care between Medicare and Medicaid programs, a D-SNP enrolls only dual-eligible individuals.


01.03.23

HHS Proposes New Rule to Align “Part 2” SUD Provider Confidentiality with HIPAA Privacy Standards

On November 28, the Department of Health and Human Services released a proposed rule that seeks to better align the Confidentiality of Substance Use Disorder Patient Records regulations under 42 CFR part 2 with the regulatory requirements under the Health Insurance Portability and ...


12.19.22

Working With Community Care Hubs to Address Social Drivers of Health

Health and well-being require far more than medical care.


12.15.22

CMS Approves Groundbreaking Section 1115 Demonstrations

The recent waiver approvals in Arizona, Arkansas, Massachusetts and Oregon promise, in varying degrees, to transform coverage and care while signaling to other states the types of waiver policies CMS is prepared to allow.


12.14.22

Closing the Digital Health Disconnect: A Blueprint for Optimizing Digitally Enabled Care

Catalyzed by the COVID-19 pandemic, we have entered an era of digitally enabled care—fully integrated in-person and virtual care models that hybridize care delivery based on clinical appropriateness and other factors, such as convenience and cost.


12.13.22

Abortion Pill Opponents Challenge FDA’s Approval of Mifepristone

Since the Supreme Court overturned the constitutional right to abortion in Dobbs v. Jackson Women’s Health Organization earlier this year, demand for medication abortion through the Food and Drug Administration approved drug mifepristone has exponentially increased.


12.12.22

Senate Finance Committee Releases “Mental Health Parity Improvements Act”

On December 1, the Senate Finance Committee released the fifth and final discussion draft of the Committee’s bipartisan mental health initiative.


12.08.22

Recent Updates to Section 1115 Waiver Budget Neutrality Policy: Overview and Implications for States

Section 1115 Medicaid demonstrations are a powerful tool for states to pursue a range of innovative programs aimed at improving the health and well-being of Medicaid enrollees by allowing the secretary of the Department of Health and Human Services to waive components of federal Medicaid law and ...


12.05.22

California DMHC Issues Two All Plan Letters Focused on Timely Access and Network Adequacy

On November 4 and 7, 2022, the California Department of Managed Health Care issued two All Plan Letters concerning compliance with the state’s network adequacy and timely access requirements, including new statutory and regulatory amendments enacted in October 2021 and January 2022, ...


11.29.22

Challenges to the Final August 2022 No Surprises Act Independent Dispute Resolution Rule

Controversy continues to surround the independent dispute resolution (IDR) provisions of the No Surprises Act.