In the final episode of 2022, Chris Condeluci and Dennis Bolin discuss the latest healthcare policy news.

In this episode, Chris Condeluci and Dennis Bolin recap the election results and look ahead to the lame duck congress and 2023 as the administration finalizes a “ton” of regulations and guidance in these areas: Strengthening plan options like HSAs, ICHRAS, association plans, encouraging use of telehealth, incentivizing Medicare Advantage plan selection, transparency, cost sharing, AEOBs, provider directories, and CMMI’s commitment to value-based care models

In this episode, we unpack a final regulation fixing the ACA’s “family glitch,” the official extension of the Public Health Emergency, a request for information in      advance of implementing guidance for the Advanced Explanation of Benefits (AEOB), some Q&As on the Prescription Drug Reports due December 27, 2022, and a preview of the mid-term elections.

In this episode, Chris Condeluci and Dennis Bolin unpack the final surprise billing regulations, including the 23 frequently asked questions (FAQs) released      alongside the final surprise billing regulations and FAQs regarding the transparency of coverage rule.

In this episode, Chris Condeluci and Dennis Bolin unpack the recent Inflation Reduction Act which includes a three-year extension of premium subsidies and drug pricing reforms. While the drug pricing reforms only apply to Medicare, they will have a halo effect on private insurers and exchanges. The reforms include authority to negotiate drug prices (10 of top 50 drugs in 2026 and 20 in 2029), cap on insulin pricing, and price increases tied to inflation rate.

In this episode, we unpack: the Dobbs decision and State laws impacting fully-insured and self-insured plans, Colorado’s 1332 Waiver for a “public option” plan, the latest news on the “enhanced premium subsidies,” acknowledgment of July 1st and the public disclosure on “machine-readable files” AND ALSO a discussion of the Rx reporting requirement under the NSA (Updated instructions were recently issued. We talk about what carriers, TPAs, and PBMs are currently trying to figure out.).

In this episode, Chris Condeluci and Dennis Bolin discuss the reports of renewed discussions      about a “reconciliation” package that includes climate change reforms, drug pricing reforms and deficit reduction; how the extended “enhanced      premium subsidies” could fit into this package; speculation that we may finally see the surprise billing final regs before the July 4 holiday; and      rumors that the COVID Public Health Emergency may extend through April 2023.

In this episode, Chris Condeluci and Dennis Bolin unpack the Federal Portal going “live”, “updated”/”revised” guidance on the Federal IDR process, the final 2023 NBPP, and an update on enhanced premium subsidies—it is looking less and less likely that they will be extended prior to Nov. 1st (the start of 2023 OE).

In this episode, Chris Condeluci and Dennis Bolin discuss the impact of the recent District Court case out of Texas on the No Surprises Act (NSA) arbitration process, what the health coverage implications could be if and when the public health emergency ends, Biden’s recently released 2023 budget, the Federal Portal.

In this episode, Chris Condeluci and Nicole Fultz discuss COVID-related guidance, the impact of the recent District Court case out of Texas on surprise billing requirements and the Federal arbitration process, how payers should develop their "Qualifying Payment Amount," and how the arbitration process will work, especially the Federal Portal (a government-run website intended to administer the Federally-developed arbitration process).