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CMS Issues Final Rule on Navigators, Risk Corridors for 2015
The CMS on Friday issued its final rule for exchange and insurance market standards for 2015 and beyond, a potpourri of policies that address consumer notices, quality reporting and enrollee satisfaction surveys, the Small Business Health Options Program (SHOP), standards for navigators and other consumer assisters, and policies regarding the premium stabilization programs, among others.
The CMS on Friday issued its final rule for exchange and insurance market standards for 2015 and beyond, a potpourri of policies that address consumer notices, quality reporting and enrollee satisfaction surveys, the Small Business Health Options Program (SHOP), standards for navigators and other consumer assisters, and policies regarding the premium stabilization programs, among others.
Its navigator standards are likely to anger state officials who have tried to regulate navigators in their jurisdictions but it may bring smiles to insurers who will receive subsidies for high-cost enrollees at lower cost levels.
The agency is sticking by its plans to lessen state control over navigators by preempting state laws, or portions of them, if they “prevent the application of the provisions of Title I of the Affordable Care Act,” the CMS said.
Throughout 2013, numerous, mostly GOP-led states passed laws limiting navigator activities. Such measures included stringent restrictions on the advice navigators can offer consumers.
Read the full story here: http://bit.ly/1sLrGV0
Source: Modern Healthcare
Mental Health Diagnoses, Care Challenges Rise Among US Youth, Report Finds
April 26th 2024While behavioral health care utilization has been rising, the treatment landscape has been falling. New findings show that 20% of youths did not receive any form of treatment within 3 months of their initial behavioral health diagnosis.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Polatuzumab Vedotin and R-CHP Appropriate for Untreated DLBCL
April 24th 2024Population pharmacokinetic and exposure-response analyses revealed a favorable benefit-risk profilane for the treatment combination of polatuzumab vedotin and rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP).
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What We’re Reading: Abortion Privacy Rules; Alzheimer Drug Hurdles; Nursing Home Staffing Overhaul
April 23rd 2024New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.
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