The Daily Scan

June 19, 2018

Last Updated: 1:20 PM EST

Regulation

  • This morning the Department of Labor issued a final regulation under Title I of the Employee Retirement Income Security Act (ERISA) that establishes additional criteria under ERISA section 3(5) for determining when employers may join together in a group or association of employers that will be treated as the “employer” sponsor of a single multiple-employer “employee welfare benefit plan” and “group health plan.” According to the DOL, "the regulation facilitates the adoption and administration of AHPs and expands access to affordable health coverage, especially for employees of small employers and certain self-employed individuals." (DOL.gov: Final Rule, Press Release

Medicaid

  • Molina Healthcare, Inc. yesterday announced that its wholly owned subsidiary, Molina Healthcare of Florida, Inc., has been awarded Medicaid Managed Care contracts by the Florida Agency for Health Care Administration in Regions 8 and 11 of the Florida Statewide Medicaid Managed Care Invitation to Negotiate (ITN). The award comes after Molina filed protests of AHCA's Medicaid Managed Care awards in all eleven regions of Florida in May of this year. The Company currently serves approximately 105,000 Medicaid members in those regions, which include Miami-Dade, Monroe, Sarasota, DeSoto, Charlotte, Glades, Hendry and Collier Counties, representing approximately $550 million in annual revenue. Services under the new contract are expected to begin on January 1, 2019. (NASDAQ.com)

Medicare

  • The Medicare Payment Advisory Commission (MedPAC) released its June 2018 Report to the Congress: Medicare and the Health Care Delivery System on Friday. As part of its mandate from the Congress, each June MedPAC reports on issues affecting the Medicare program as well as broader changes in health care delivery and the market for health care services. This year’s report includes a mandated report on the effects of the Hospital Readmissions Reduction Program that revealed a significant decline in readmission rates, resulting in the Medicare program saving roughly $2 billion per year. (MedPac.gov: Press Release, Full Report)

Litigation

  • A U.S. Department of Health and Human Services Administrative Law Judge (ALJ) has ruled that The University of Texas MD Anderson Cancer Center (MD Anderson) violated the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules and granted summary judgment to the Office for Civil Rights (OCR) on all issues, requiring MD Anderson to pay $4,348,000 in civil money penalties to OCR. This is the second summary judgment victory in OCR’s history of HIPAA enforcement and the $4.3 million is the fourth largest amount ever awarded to OCR by an ALJ or secured in a settlement for HIPAA violations. (HHS.gov: Press Release, Full Decision)

 

  • A state appeals court has reinstated California’s law allowing terminally ill people to end their lives. The Fourth District Court of Appeals in Riverside issued an immediate stay Friday putting the End of Life Option back into effect. The court also gave opponents of its decision until July 2 to file objections. The law allows adults to obtain a prescription for life-ending drugs if a doctor has determined that they have six months or less to live. Riverside County Superior Court Judge Daniel Ottolia declared the law unconstitutional last month, stating that it had been adopted illegally because lawmakers passed it during a special Legislative session called to address other matters. (OCRegister.com)

Research

  • According to a new survey by UpWell Health, True Cost of Diabetes, 45 percent of diabetics have skipped care because of affordability issues. A similar number, 43 percent, paid up to $1,000 out of pocket in the past year for treating complications related to the condition. Sixteen percent paid $1,000 to $5,000. (USNews.com)

 

 

 

 

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