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HHS Publishes Rule Requiring Health Plans to Accept 3rd Party Payments from Ryan White

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On March 19, 2014, HHS published an interim final rule in the Federal Register that requires issuers of qualified health plans (QHPs), including stand-alone dental plans (SADPs), offered through the ACA’s Health Insurance Marketplaces to accept premium and cost-sharing payments made on behalf of enrollees by the Ryan White HIV/AIDS Program, other Federal and State…

CMS Invites Comments on Proposed Decision Regarding Coverage of Hepatitis C Screening

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This week, the Centers for Medicare and Medicaid Services (CMS) released their proposed decision memo for the National Coverage Analysis (NCA) on Medicare coverage for Hepatitis C virus (HCV) screening in adults. They find that “the evidence is adequate to conclude that screening for Hepatitis C Virus (HCV), consistent with the grade B recommendations by…

New Fact Sheets Available to Help Consumers with Marketplace Questions

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The Centers for Medicare and Medicaid Services (CMS) recently released some easy-to-understand consumer fact sheets for those who are enrolling or who have newly enrolled in healthcare plans through the Marketplace. These fact sheets are great resources for organizations working to help people living with HIV/AIDS and others apply and enroll in healthcare coverage through the…

CMS Invites Public Comment as it Considers National Coverage Determination for HCV Screening Under Medicare

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The Centers for Medicare and Medicaid Services (CMS) has initiated a National Coverage Determination (NCD) process for screening for hepatitis C virus (HCV) in adults. An NCD is a national policy statement granting, limiting, or excluding Medicare coverage for a specific medical item or service. CMS is allowed to add coverage of “additional preventive services”…

Save the Date: Ryan White HIV/AIDS Program and Essential Health Benefits Webcast

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The Affordable Care Act (ACA) ensures that health plans offered in the individual and small group markets, both inside and outside of the Health Insurance Marketplace, offer a comprehensive package of items and services, known as essential health benefits. The Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau and the Centers for Medicare and Medicaid…

$1 Billion Health Care Innovation Awards Initiative Includes Opportunities for Models to Improve Care for PLWHA

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Last week, U.S. Health and Human Services Secretary Kathleen Sebelius announced a nearly $1 billion initiative that will fund grant awards and evaluation to build on the Obama administration’s work to transform the health care system by delivering better care and lowering costs for taxpayers and patients. The Health Care Innovation Awards are funded by…

CMS Announces Opportunity to Apply for Marketplace Navigator Grants

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“Navigator” program will help consumers understand new coverage options as they enroll in new Marketplaces Editor’s Note: On April 9, CMS released the Navigators Funding Opportunity Announcement (FOA) below. “Navigators” are individuals and entities that will provide unbiased information to consumers about health insurance, the new Health Insurance Marketplace, qualified health plans, and public programs…

PACHA Blog: CMS Care Innovations Summit

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The Centers for Medicare and Medicaid Services (CMS) and the HHS Office of the National Coordinator are hosting the first “Care Innovations Summit” in Washington, DC today to “showcase innovative work in care delivery and payment.” The Summit will bring together leading innovators from inside and outside the healthcare industry to encourage and promote knowledge-sharing,…