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Prison Health Care is Broken Under the Medicaid Inmate Exclusion Policy

Bill of Health

Incarcerated individuals need health care, but punitive policies make securing access to care particularly difficult among this population, which numbers about 2.1 million as of 2021. Gamble (1976), affirmed that incarcerated individuals have the constitutional right to health care.

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Addressing Ghost Networks in Mental Health Care

Bill of Health

Considering these substantial consequences for patients’ access to mental health care, developing solutions to prevent ghost networks is critical. Federal legislative solutions The federal No Surprises Act , approved in 2021, mandates that health insurers update the information in their provider directory at least every 90 days.

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Churntables: A Look at the Record on Medicaid Redetermination Plans

Bill of Health

In August 2021, CMS released guidance giving states up to 12 months following the end of the PHE to redetermine whether Medicaid enrollees were still eligible and renew coverage. What States Are Doing Now.

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2022 MHPAEA Annual Report Illuminates Tri-agency Review and Enforcement Priorities in a Post-Consolidated Appropriations Act World

C&M Health Law

The Employee Benefits Security Administration (“EBSA”) released an FY 2021 MHPAEA Enforcement Fact Sheet alongside the annual report. The 2022 annual report is only the beginning of the post-2021 CAA era. But plans and issuers need additional agency guidance.

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Large Employers’ Focus on Prescription Drugs: Costs, Coupons and Communication

Health Populi

One-third of employers were already doing this in 2019, with another 20% adding in 2020 and 16% considering for 2021-22. Some 15% of companies will consider this tactic in 2021-22. 18% of large eployers offered rebates at POS in 2019, and 40% are considering incorporating this patient-Rx payment tactic in 2021-22.

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Systemic Failures Need Systemic Solutions: COVID-19 and Macromedical Regulation

Bill of Health

Today’s pandemic destabilized hospital care because hospitals were neither coordinated nor managed systemically in order to meet population demands. We also recognize that policymakers, specifically the U.S. president and state governors, enjoy emergency powers to contain behavior that otherwise would cause infections to spread.

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HHS Finalizes Health Plan Price Transparency Rule

C&M Health Law

On October 29, 2020, the Departments of Health and Human Services, Labor, and the Treasury (“the Departments”) issued a final rule requiring private-sector health insurers and self-insured health plans to disclose treatment prices and cost-sharing information with consumers.