September 8, 2021
Payers
  • The CMS announced it will distribute $452 million to support 13 states’ reinsurance programs. The new funds, which Congress approved in the American Rescue Plan, range from $2.5 million to $139 million per state based on the size of the state’s program. In August, Colorado became the first state to receive approval from the CMS and the Treasury Department for a five-year extension of the state’s current section 1332 waiver for a reinsurance program. Alaska, Hawaii, Maine, Oregon, and Wisconsin also submitted letters signaling their intent to apply for five-year waiver extensions or amendments but no changes to their current programs. (Press release here; Article here)
  • The AHA and AHIP submitted comments to the Biden administration regarding the first regulation stemming from the No Surprises Act. AHIP said that “there are too many outstanding implementation questions that require answers in short order” and that making the qualifying payment amounts workable will take more than three months alone. The AHA asked regulators to cut them a break while they educate their staff, design new workflows, and figure out how to share information with health plans. (AHIP letter here; AHA letter here; Article here)
  • Humana announced it has recorded more COVID-19 hospitalizations among its Medicare Advantage members in the past few weeks due to rising cases. As a result, non-COVID inpatient and outpatient care also appears to be declining. Humana didn’t increase its profit projections for the rest of the year. (Article here)