Human Arc Blog

  • Dual/LIS Plans Penalized

    Shanna Hanson - April 16, 2015

    The 2016 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter that was issued April 6, 2015 did not implement the changes proposed by the Centers for Medicare and Medicaid Services (CMS) which would have mitigated the impact of Star Ratings for Medicare Advantage (MA) plans that enroll [...]

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  • Why Convert to ICD-10?

    Shanna Hanson - April 8, 2015

    Will 2015 be the year that the 10th revision of the International Classification of Diseases, Clinical Modification (ICD-10) is finally implemented in the US? The United States is the last major industrialized nation in the world to convert. We have been working on it since 2008, but the World Health Organization (WHO) adopted it in [...]

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  • Reconciliation of Premium Tax Credits

    Shanna Hanson - March 26, 2015

    It’s tax time and a “first” for the reconciliation of premium tax credits received to supplement a tax filer’s or dependent’s purchase of a qualified health plan through the Marketplace. This means new terminology, new forms, new requirements and new questions from tax filers before April 15, 2015. It also includes a glitch. Frustrations could [...]

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  • Medicare Advantage Payment Changes

    Shanna Hanson - March 4, 2015

    Medicare Advantage (MA) health plan leaders are likely to have finances on their mind after the Centers for Medicare and Medicaid Services (CMS) released the Advance Notice and draft Call Letter on February 20, 2015 proposing a 0.95% average payment cut for 2016. CMS, however, is promoting the payment cut as an “increase” by adding [...]

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  • Enrollment Extension Can Benefit Providers

    Shanna Hanson - March 3, 2015

    Shocking statistics Urban Institute’s December 2014 Health Reform Monitoring Survey (HRMS) of uninsured adults ages 18-64 with family income exceeding 100% of the Federal Poverty Level (FPL) revealed the following: 19.3% had heard a little about the penalty for not having coverage in 2014, 24.8% had heard nothing, and 53.5% had heard some or a [...]

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  • Hardship Exemptions for ACA’s Individual Mandate

    Shanna Hanson - February 17, 2015

    This is part 2 of 2 in a series on the health coverage mandate, penalties and exemptions. This posting takes a deeper look at the hardship exemption. Healthcare.gov lists 14 circumstances that entitle an individual to a hardship exemption: Homelessness Eviction in the past six months, facing eviction or foreclosure Receipt of a shut-off notice from [...]

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  • Penalty Exemptions under the ACA

    Shanna Hanson - February 3, 2015

    The Affordable Care Act (ACA) mandates that most United States citizens and eligible immigrants carry health insurance or incur liability for a shared responsibility payment, also commonly referred to as a tax or penalty. This coverage requirement is called the individual mandate. Enrollment is available year-round for Medicaid and the Children’s Health Insurance Program (CHIP), [...]

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  • Fate of ACA Subsidies Rests on Four Words

    Shanna Hanson - December 29, 2014

    A Supreme Court hearing will be held March 4, 2015, to evaluate four words in the Affordable Care Act (ACA): “established by the State.” At stake in the decision are the insurance subsidies provided by the federal government to eligible individuals in the 36 states that use the federal Marketplace. In a recent post, Legal [...]

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  • Additional Step for Some to Renew Medicaid/CHIP

    Shanna Hanson - December 10, 2014

    Some Medicaid or Children’s Health Insurance Program (CHIP) beneficiaries enrolled in coverage prior to the Affordable Care Act (ACA) implementation Jan. 1, 2014, now may need to supply additional information to renew coverage. This is a change from years past, and if recipients don’t provide the information needed to re-determine eligibility, they risk losing their [...]

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  • Enrollment Estimates: A Moving Target

    Shanna Hanson - December 1, 2014

    The second annual Marketplace open enrollment under the Affordable Care Act (ACA) began Nov. 15, 2014. Just days earlier, the Health and Human Services (HHS) scaled back its enrollment estimates. CBO Estimates The Congressional Budget Office (CBO) originally estimated a total of 25 million people would enroll in a Qualified Health Plan (QHP) through the [...]

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