No ACA Regulations Coming on Provider Non-Discrimination On April 29th, in response to frequently asked questions about implementing the Affordable Care Act, the Obama administration said it does not intend to propose regulations to implement the health law’s provider nondiscrimination requirements.  Describing the provisions of Section 2706(a) of the ACA as “self-implementing,” the administration said in ACA Implementation FAQs – Set 15 that “group health plans and health insurance issuers offering group or individual coverage are expected to implement the requirements of…section 2706(a) using a good faith, reasonable interpretation of the law.”  The administration adds that it will work together with employers, plans, states, and providers “to help them come into compliance with the provider nondiscrimination provision and will work with families and individuals to help them understand the law and benefit from it as intended.”

To the extent that an item or service is a covered benefit in health plans, the new guidance states that “a plan or issuer shall not discriminate based on a provider's license or certification, to the extent the provider is acting within the scope of the provider's license or certification under applicable state law.”  The administration adds that the law does not require plans or issuers to accept all types of providers into their network, nor does it “govern provider reimbursement rates, which may be subject to quality, performance, or market standards and considerations.”

Republican Leaders Call for Capping Medicaid Spending Released May 1st, the blueprint “Making Medicaid Work” by House Energy and Commerce Committee Chairman Fred Upton (R-MI) and Senator Orrin Hatch (R-UT), the top Republican on the Senate Finance Committee, said  their plan is based on the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, the welfare reform law that was a key provision of Republican's Contract with America.

Shorter Coverage Applications On April 30th, responding to criticism from states and consumers, the Obama administration unveiled new shorter application forms to assist individuals and families enrolling in health insurance exchanges.  The simpler “Marketplace Consumer Application” forms received positive reviews from many stakeholders.

The revised forms ask for information on income, employment, disability, immigration status and current access to health insurance. They also include a page of instructions.  Agency officials said the new forms take an average of seven minutes to fill out, pointing out that applications for private insurance are often about 17 pages long.

House to Vote Again on ACA Repeal As federal agencies and states prepare for enrollment in health insurance exchanges and Medicaid expansion, House Republican leaders plan to renew efforts to repeal the Affordable Care Act.  On May 3rd, in a memorandum to his House colleagues, House Majority Leader Eric Cantor (R-VA) promised a “full legislative agenda in May” and another vote in the “near future” on repealing Obamacare.  The House is also expected to vote on separate legislation to strike down portions of the health reform law including a tax on medical device manufacturers and the Independent Payment Advisory Board, better known as “IPAB.”

As always, your federal team is here to answer your questions. Please feel free to contact any of us at FederalPolicy@aanp.org.

Federal Policy Team members: MaryAnne Sapio, VP Federal Government Affairs Debra Swan, Associate VP Federal Government Affairs Jan Towers, Sr. Policy Advisor Dave Mason, Federal Consultant