On March 20, Governor Jerry Brown signed AB 369, mandating that plans allow Californians whose individual health plans were canceled by the Affordable Care Act to continue to receive coverage for their non-participating providers through treatment for pregnancy, cancer, and chronic conditions, among others. The bill passed unanimously and as an urgency measure, allowing it

Marisa E. Adelson
Marisa Adelson is an associate in Crowell & Moring's San Francisco office, where she practices in the Health Care and Antitrust groups. In her health care practice, Marisa represents managed care payors and provides counseling on regulatory compliance. Marisa's antitrust practice primarily involves complex antitrust recovery litigation. Marisa has an active pro bono practice and currently represents a client from South Asia seeking asylum in the United States.
Obama Administration Authorizes Renewal of Non-ACA Compliant Individual and Small Group Policies; State Regulatory Response Varies
On November 14, 2013, under increasing political pressure, President Obama announced that the Administration temporarily will allow insurers to renew some individual and small employer policies for 2014—even if these plans do not meet certain Affordable Care Act requirements, such as Essential Health Benefits. The new rules permit insurers, until October 1, 2014, to renew …
OPM Issues Proposed Rule on Exchange-based Healthcare for Congress and Congressional Staffers
On August 7, 2013, the Office of Personnel Management (OPM) released a proposed rule on federal employee health benefits for members of Congress and congressional staff. The Affordable Care Act (ACA) contains a provision requiring Congress and their staff to obtain health insurance coverage via an Affordable Insurance Exchange or a health plan created by …
CCIIO Issues Marketplace FAQ on Consumer Income Verification
On August 5, 2013, the Centers for Consumer Information & Insurance Oversight (CCIIO) issued a new Question and Answer (Q&A) on whether Marketplaces will verify consumer income as part of the eligibility process for advance payment of premium tax credits and cost-sharing reductions. The Q&A explained that Marketplaces will verify this information via documentation submitted …
Final Rule on Coverage of Preventive Health Services Issued
On July 2, 2013, the Department of Health and Human Services (HHS) issued a final rule on coverage of certain preventive services under section 2713 of the Public Health Service Act, added by the Patient Protection and Affordable Care Act and incorporated into the Employment Retirement Income Security Act of 1975 and the Internal Revenue …
CCIIO Issues FAQ on State Rate Review Grants
On June 6, 2013, the Center for Consumer Information and Insurance Oversight (CCIIO) published a new set of frequently asked questions about Cycle III of CMS’s state rate review grant program. Through this program, CMS gives grants to states to support health insurance rate review and increase transparency in health care pricing. Rate review activities …
Medicare Advantage and Part D MLR Final Rule Issued
On May 20, 2013, the Centers for Medicare and Medicaid Services (CMS) released the final regulations on the Affordable Care Act’s (ACA) medical loss ratio (MLR) requirements for Medicare Advantage and Medicare Prescription Drug Benefit Programs (PDP). The final MLR rule is largely identical to the proposed rule and generally tracks the requirements of the …