Newsletters

07.31.18

CMS Liberalizes Medicare Advantage and Part D Marketing Rules

On July 20, the Centers for Medicare & Medicaid Services (CMS) issued the new “Medicare Communications and Marketing Guidelines” (MCMG), which governs Medicare Advantage organizations (MAOs) and Part D plan sponsors.


06.20.18

Healthcare Fraud Enforcement Trends

Despite the uncertainty and divisiveness in the political realm, there is one issue that appears to be bipartisan—the government’s continued focus on prosecuting healthcare fraud.


04.23.18

Connecting Justice-Involved Populations to Health Coverage and Care

Although the Constitution requires states and localities to provide healthcare to people in prisons and jails, many still fail to receive needed care.


03.20.18

The Promise of Data-Driven Healthcare: Megatrends for 2018

There is a quote by science fiction writer Amelia Atwater-Rhodes that is the ideal lead-in to any discussion about healthcare data and analytics: “Life is nothing without a little chaos to make it interesting.”


02.21.18

Hospitals and Health Systems Prepare for a Value-Based Future

There are six key drivers of the movement to a risk-based healthcare environment:


05.22.17

A Closer Look at Wisconsin’s Premium Proposal

The State of Wisconsin recently proposed a Medicaid waiver that includes a number of precedent-setting features, including a 48-month time limit on enrollment (with the limit paused for periods of employment or job training), and mandatory drug screening, testing and treatment (as necessary), as ...


03.23.17

The Future of Essential Health Benefits

EHB defines what healthcare benefits plans in the Marketplaces, as well as certain other plans, must cover—and goes to the heart of what it means to have health insurance.


12.19.16

Balancing Gene Therapy’s Promise and Price

Gene therapy is the therapeutic delivery of polymers into a patient’s cells for the purpose of treating a disease. Polymers interfere with gene expression or correct mutations.


06.13.16

CMS Clarifies Medicaid Managed Care Prescription Drug Access

The recently finalized Medicaid managed care regulations clarify an important point about prescription drug coverage in Medicaid managed care plans. Just as is the case in fee-for-service (FFS) Medicaid, beneficiaries enrolled in Medicaid managed care plans are entitled to any medically necessary ...


12.18.15

Lessons from Hawaii's Trailblazing ACA 1332 Waiver Proposal

Section 1332 of the ACA authorizes states to request waivers from the U.S. Department of Health and Human Services (HHS) and U.S. Department of the Treasury of key components of the ACA's coverage provisions.