Policy

Under the Affordable Care Act, millions of Americans will gain access to affordable health coverage through Affordable Insurance Exchanges (also known as health insurance marketplaces) and improvements in Medicaid and the Children’s Health Insurance Program (CHIP) in 2014. Health and Human Services (HHS) Secretary Kathleen Sebelius has announced a proposed rule that promotes consistent policies and processes for eligibility notices and appeals in Medicaid, the Children's Health Insurance Program (CHIP) and Exchanges, and give states more flexibility when operating their Medicaid programs.

Doctors and health care providers have formed 106 new Accountable Care Organizations (ACOs) in Medicare, ensuring as many as four million Medicare beneficiaries now have access to high-quality, coordinated care across the United States, Health and Human Services (HHS) Secretary Kathleen Sebelius announced.

At a time of rancorous political divisions, it’s worth noting that most Americans are deeply concerned about the quality of healthcare—in particular, medical research. In a poll by Research!America, 72 percent of respondents say the new Congress and the President should take immediate action to expand medical research within the first hundred days of the 113th Congress. Their views are relevant as Congress considers funding cuts that could affect medical research, but it also suggests that healthcare issues in general are topmost on many people’s minds.

A Harvey L. Neiman Health Policy Institute study shows that fewer than one in five healthcare providers meet Medicare Physician Quality Reporting System (PQRS) requirements. Those that meet PQRS thresholds now receive a 0.5 percent Medicare bonus payment. In 2015, bonuses will be replaced by penalties for providers who do not meet PQRS requirements. As it stands, more than 80 percent of providers nationwide would face these penalties.

The Centers for Medicare & Medicaid Services' (CMS) Office of E-Health Standards and Services (OESS) announced this week that HIPAA-covered entities will have an extra 90 days to comply with operating rules for checking eligibility for health plan coverage and the status of healthcare claims electronically.