The Biden Administration used the annual rulemaking that governs health plans sold on the Affordable Care Act’s exchanges to lower health care costs for consumers and improve access to health care. Part 2 of the Notice of Benefit and Payment Parameters for 2022 Final Rule (the Payment Notice), issued April 30, 2021, is the second in a series of rulemakings addressing exchange plans.[1]  The Department of Health and Human Services (HHS) anticipates additional rulemakings on the 2022 Payment Notice later this year.[2] The rulemaking announced changes to out-of-pocket costs, special enrollment periods, risk adjustment, and HHS’s audit and oversight of exchanges, among other things.

Continue Reading Biden Administration Finalizes Lower Out-of-Pocket Costs for Exchange Plans, Targets Health Equity and Access

Late last month, the Biden Administration announced the second installment of its recovery plan, dubbed the “American Jobs Plan” (the “Plan”).  The Plan’s $2.3 trillion price tag includes
Continue Reading The American Jobs Plan and the American Rescue Plan: The Biden Administration Bets Big on Home and Community-Based Services

On Thursday, April 8, 2021, the Center for Medicare and Medicaid Innovation (the “Innovation Center”) announced its final list of 53 organizations set to participate in the Global and Professional Direct Contracting (“GPDC”) Model (previously named the Direct Contracting Model for Global and Professional Options).  The 53 Direct Contracting Entities (“DCEs”) are participating in the first Performance Year (“PY2021”) of the GPDC Model, which runs from April 1, 2021 through December 31, 2021. The DCEs will serve Medicare fee-for-service (“FFS”) beneficiaries in 38 states as well as in the District of Columbia and Puerto Rico.
Continue Reading CMS Announces Final Organizations for the Global and Professional Direct Contracting Model, Halts Additional Applications and Future Solicitations

With the uptick in the pace of vaccinations and lifting of restrictions in many states over the past few weeks, a clearer picture of the road ahead is coming into focus.  In a timely discussion, Los Angeles’ Association for Corporate Growth (ACG) hosted healthcare industry leaders to share lessons learned over the past year, what’s here to stay, and what’s on the horizon.  ACG dubbed the panel “Coming up for Air: Healthcare Investing and Growth in 2021 and Beyond,” which featured leaders from various healthcare sectors, including Shane Armstrong, President and General Counsel at American Vision Partners (AVP); John DiGiovanni, Investment Partner at Arsenal Capital; and Rob Mahan, CEO at Exer Urgent Care.  The panel was moderated by Aytan Dahukey, Partner and Private Equity Team Leader at Sheppard Mullin and Adam Abramowitz, Managing Director at Intrepid Investment Bankers.
Continue Reading ACG Panel Paints a Bright Future for Healthcare Investment and Growth

On March 10, 2021, President Biden signed into law the American Rescue Plan Act of 2021 (the “Act”). This $1.9 trillion COVID-19 relief package not only includes a whole host
Continue Reading The American Rescue Plan Act of 2021: A New Lease on Life for the Affordable Care Act?