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$2.4 billion ACA medical loss ratio consumer rebates

November 20, 2015 By Kevin Knauss Leave a Comment

The Centers for Medicare & Medicaid Services (CMS) released a new report today showing that consumers have received more than $2.4 billion premium rebates since 2011 because the Affordable Care Act requires that health insurance companies spend at least 80 percent of premium dollars on health care. For 2014 alone, over 5.5 million consumers received nearly $470 million in rebates, for an average of $129 per family.

Filed Under: CMS Tagged With: CMS, MLR, Rebates

Feds urge drug makers and states to make Hepatitis C drugs available

November 9, 2015 By Kevin Knauss Leave a Comment

Recognizing that we need both access and affordability, today we issued a notice to all 50 state Medicaid directors and sent letters to the CEOs of several drug manufacturers about providing access to therapy for Hepatitis C patients. Our notice to state Medicaid directors reminds states of their obligation to provide access to these promising therapies (consistent with section 1927 of the Social Security Act) based on the medical evidence, and that they have tools available to manage their costs. Our letter to manufacturers asks them to provide us with information on pricing arrangements and asks them for ideas to support the provision of these lifesaving medications to Medicaid programs at sustainable prices.

Filed Under: CMS, Medi-Cal, Medicaid Tagged With: Drugs, Hepatitis C, Medi-Cal, Medicaid

Almost 1 million consumers use SEP to get health coverage in 2015

August 14, 2015 By Kevin Knauss Leave a Comment

Between February 23 and June 30, 2015, about 944,000 new consumers made plan selections through HealthCare.gov using a SEP. Eighty-four percent of plan selections occurred via three types of SEPs: 50 percent of plan selections occurred via SEPs for the loss of health coverage or “minimum essential coverage”, 19 percent occurred via SEPs for being determined ineligible for Medicaid, and 15 percent were as a result of tax season SEP (Table 1). The remaining 16 percent of plan selections were attributable to other types of SEPs (see glossary).

Filed Under: CMS, Healthcare.gov Tagged With: Health, Insurance, Qualifying Event, Special Enrollment Period

Medicare prescription drug premiums projected to remain stable

July 30, 2015 By Kevin Knauss Leave a Comment

Centers for Medicare & Medicaid Services (CMS) projected today that the average premium for a basic Medicare Part D prescription drug plan in 2016 will remain stable, at an estimated $32.50 per month.

Filed Under: CMS, HPN, Medicare, PDP Tagged With: CMS, Medicare, PDP, Premiums, Rates

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