July 22, 2020

Around the nation: Court holds up Trump admin's expansion of short-term health plans

Daily Briefing

    The U.S. Court of Appeals for the District of Columbia Circuit on Friday upheld a final rule issued by the Trump administration that eased restrictions on short-term health plans that do not comply with the Affordable Care Act, in today's bite-sized hospital and health industry news from California, the District of Columbia, and Massachusetts.

    • California: Los Angeles County officials on Friday announced that at least 15 children in the county have developed reported cases of multi-system inflammatory syndrome (MIS-C), a rare and potentially fatal condition that's believed to be associated with the new coronavirus. According to CDC, MIS-C can cause inflammation in different parts of the body, including the heart, lungs, kidney, brain, skin, eyes, and gastrointestinal organs (Lin, Los Angeles Times, 7/19).

    • District of Columbia: A panel of the U.S. Court of Appeals for the District of Columbia Circuit on Friday upheld a final rule issued by the Trump administration that eased restrictions on short-term health plans that do not comply with the Affordable Care Act (ACA). The court ruled that the administration has the legal authority to issue the regulation, and Judge Thomas Griffith in the court's majority option wrote that the short-term health plans serve as an affordable coverage option for some Americans. However, Judge Judith Rogers in a dissenting opinion wrote that the final rule allows insurers selling the short-term plans to "cut costs by denying basic benefits, price discriminating based on age and health status, and refusing coverage to older individuals and those with preexisting conditions," which conflicts with Congress' intent under the ACA. The Association for Community and Affiliated Plans, an insurer group that filed the lawsuit challenging the final rule, said it will appeal the panel's ruling to the full appeals court (Sherman, AP/ABC News, 7/17; Lotven, Inside Health Policy, 7/17 [subscription required]; Armour, Wall Street Journal, 7/17).

    • Massachusetts: Blue Cross Blue Shield of Massachusetts has announced plans to pilot a global payment model for primary care practices in 2021. The model will provide primary care practices with a pool of money to use for patients instead of paying them for each individual visit, procedure, or test. The clinics will also receive incentive payments if they meet certain targets, like lowering costs or vaccinating a certain number of pediatric patients (Haefner, Becker's Hospital Review, 7/16).
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