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AFFORDABLE CARE ACT
MASSACHUSETTS IMPLEMENTATION UPDATE

January 26, 2011
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These Updates, published by the Executive Office of Health and Human Services (EOHHS) in consultation with the other state agencies involved in ACA implementation, will bring you news related to the implementation of provisions of the ACA here in Massachusetts.

Grants

 

The ACA provides funding opportunities to transform how health care is delivered, expand access to care and support healthcare workforce training.

 

Grant Announcements

 

Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges. §1311.Funds will help states continue work to establish exchanges. States that make progress can apply for funding each year. States can use the Exchange establishment grants for a number of different activities including conducting background research, consulting with stakeholders, making legislative and regulatory changes, governing the exchange, establishing information technology systems, conducting financial management and performing oversight and ensuring program integrity. FOA 1/19/11. Multiple opportunities to apply, with the first deadline in March 2011 and the final deadline in June 2012.

The announcement can be viewed at: Grants.Gov

 

Childhood Obesity Research Demonstration. §4306. Childhood Obesity Demonstration Project. Funds demonstration projects to determine whether an integrated model of primary care and public health approaches in the community can improve underserved children's risk factors for obesity. Also funds research and evaluation to generate recommendations. Public and private institutions of higher ed, non-profit and for-profit organizations, health centers, providers, governments, CBO's and tribal organizations are eligible. FOA 1/19/11. Due 4/8/11. Up to 4 awards of $5,250,000 may be available.

The announcement can be viewed at: Grants.Gov

 

Guidance

 

1/26/11 CMS published a notice outlining the new role of the Center for Consumer Information and Insurance Oversight within CMS, which follows the disestablishment of OCIIO. The notice outlines the functions of the new center and can be read at:  

http://www.gpo.gov/fdsys/pkg/FR-2011-01-26/pdf/2011-1580.pdf

  

1/24/11 CMS filed a final rule, to be published 2/2/11, regarding §6401 of the ACA, provider screening in Medicaid and CHIP, and is seeking comments by 4/2/11 on the fingerprinting provision. The Federal Register notice can be found at:

http://www.gpo.gov/fdsys/pkg/FR-2011-02-02/pdf/2011-1686.pdf
 

Note that the guidance listed in this section dates back to January 18, 2011. Prior guidance can be viewed at www.healthcare.gov

 

News

 

11/24/11 HHS Secretary Sebelius and U.S. Associate Attorney General Thomas J. Perrelli announced a new report (which can be found at: http://oig.hhs.gov/publications/hcfac.asp) showing that federal health care fraud prevention and enforcement efforts recovered more than $4 billion in taxpayer dollars in Fiscal Year 2010- the highest annual amount ever recovered from people who attempted to defraud seniors and taxpayers. The report highlights new efforts to fight healthcare fraud through improved cooperation between the HHS and DOJ, heightened attention to fraud hot spots and new anti-fraud tools provided by the ACA, including an additional $350 million for HCFAC (Health Care Fraud and Abuse Control Program) activities. HCFAC is a joint effort of the two departments to coordinate Federal, State, and local law enforcement activities to fight health care fraud and abuse. The Administration is already using tools authorized by the ACA, including enhanced screenings and enrollment requirements, increased data sharing across government, expanded overpayment recovery efforts, and greater oversight of private insurance abuses. For more information on these efforts visit: http://www.stopmedicarefraud.gov/

 

1/18/11 President Obama issued an executive order directing agencies to ensure that new and existing regulations are not unduly costly to business interests. The White House is portraying the order as a positive step in a series of those designed to make certain that business costs are balanced against the public good as agencies write new regulations. Agencies are also being directed to re-evaluate old regulations based on this new guidance and to modify or rescind them when appropriate. However, the rules specifically implementing the ACA are believed to be among the regulatory targets of the House GOP majority. President Obama's executive order and memo are all linked from the latest Office and Management (OMB) blog entry found here: http://www.whitehouse.gov/blog/2011/01/18/regulatory-strategy

 

1/13/11 the Department of Defense (DOD) announced the introduction of the Tricare Young Adult Program, which will extend coverage to young adults up to age 26 under their family policies. Tricare was excluded from the ACA requirements that private insurance plans allow families to include their dependents up to age 26 in their policies. Until the change (which was included in the 2011 defense authorization signed last month by President Obama,) Tricare covered dependents up to age 21 (or age 23 if they were in school.) The program is expected to begin this spring and will require payment of a premium (unlike some military health programs). Young adults will be able to purchase coverage if they are unmarried and not eligible for their own employer-sponsored coverage. Read the DOD press release at: http://www.defense.gov/releases/release.aspx?releaseid=14200

 

1/21/11 HHS announced that in 2010, as a result of the ACA, 3 million Medicare beneficiaries who fell into the drug coverage gap known as the "doughnut-hole" received a one-time $250 rebate check for prescription drug costs. Read the press release at: http://www.hhs.gov/news/press/2011pres/01/20110121a.html

 

EOHHS News

 

1/26/11 The state national health reform website has been revised and now features new consumer-friendly updates and improved navigation. Among the changes, the grants section includes new information about grants the Commonwealth has received as well as new ACA-related grant announcements from the federal government. You can also read previous ACA Implementation Updates. Be sure to check out the changes at our website: mass.gov/national health reform

 

Upcoming Events

 

Next Quarterly Stakeholder Meeting

Patient Protection and Affordable Care Act Implementation meeting
Wednesday March 2, 2011 from 3:00-4:00 P.M. 
1 Ashburton Place, 21st floor, Boston