Introduction This month, we are featuring a new report by the Health Policy News Team: “Innovative Approaches to Accountable Care”. This report aims to assist those states that are thinking about integrating alternative care delivery methods into their Medicaid program ...
Introduction Since publishing our summer edition, the Health Policy News team has attended various conferences. We were thrilled to see many subscribers in person at the National Conference of State Legislatures Legislative Summit, as well as the National Academy of ...
Introduction As in past years, Health Policy News is marking the summer season with the publication of one special edition. For summer 2019, we have prepared a roundup of pending federal legislation—in particular, efforts to protect consumers from rising health ...
Introduction This month, we are launching a new series of articles about alternative approaches to healthcare delivery—with a focus in this edition on approaches targeting social determinants of health, specifically nutrition, via health coverage. Stay tuned for an upcoming white ...
In 2018, it was estimated that 10 percent of the population was receiving care under an Accountable Care Organization (ACO) approach to health care delivery. Recent enrollment data from 2019 indicated that ACO enrollment is composed of 55% commercial ACO models, 7% Medicaid and 38% Medicare, which indicates a diverse approach to ACO integration across ...
In August, PCG attended and presented at a successful and informative National Home and Community-Based Services (HCBS) Conference in Baltimore, MD. This annual event is a unique opportunity for federal, state, and local policymakers to meet up with the people who administer, manage, and deliver HCBS programs across the country. This year, the conference hosted ...
The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), published a final rule in the September 10, 2019 Federal Register to implement program integrity enhancements to the provider enrollment process under Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The CMS rule will be effective November 4, ...
This month, Tennessee continued its pursuit of a Medicaid block grant, unveiling its draft Medicaid waiver amendment application on September 17th. Underpinning Tennessee’s months-long exploration of this model is the current federal administration’s interest in supporting these types of proposals—with implementation guidance expected to be released, but still under review, by the Office of Management ...
Medicaid agencies must assure the health and safety of their Home & Community-Based Services (HCBS) waiver program recipients by managing the reporting, investigation, and prevention of incidents. Failure to do so poses a host of risks around compliance, fraud, and the safety of Medicaid recipients. States’ Medicaid agencies have administrative authority of their Medicaid Waiver ...
Claiming administrative costs to Medicaid waivers has become a targeted area of review by the Office of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS). A number of state Medicaid agencies in various regions are facing potential disallowances or deferral of Medicaid administrative claims for failing to properly claim administrative costs to ...
The Health Policy News team continued our summer conference travels and spent time in Chicago from August 21st-23rd at the 32nd Annual #NASHPCONF19. While we heard from many of our clients and listened to them speak about projects with which we are presently assisting, we also met many newcomers who were attending for the first ...
Members of the Health Policy News (HPN) team attended the NCSL Legislative Summit in Nashville from August 5-8, 2019, learning and sharing our work with legislators and staff from across the country. The trending topics this year that related to PCG’s work were: the impact of recent court cases at both the state and federal ...
Unlike many topics under discussion in Congress this year, the issue of health care costs is a priority across party lines. With bills pending in both the U.S. House of Representatives and U.S. Senate, and a recent executive order issued on the topic, we have broken down the details on the latest cost control developments ...
Notable among the bills passed by the U.S. House of Representatives in recent months are two bills aimed at shoring up the Affordable Care Act (ACA). Below, we explore the content of both bills—though it is worth noting that neither bill has been, nor is expected to be, taken up by the Senate. H.R. 987 ...
