Updates on the State-Level Responses to COVID-19

As the U.S. continues battling the COVID-19 pandemic, individual states have enacted policy mandates and taken action to ensure patients have access to medication, healthcare, and COVID-19 testing and treatment—while minimizing barriers to these resources and/or the pre-approval needed to access them. With social distancing and the stay-at-home order still in effect, a nationwide focus ...

Care During a Crisis: How to Leverage Critical Incident Management Systems to Ensure Health and Welfare When It Matters Most

State Medicaid agencies have been hit hard during the COVID-19 crisis.  Over the last several weeks, there has been an unprecedented increase in member enrollments, as well as significant disruptions in care delivery due to stay-at-home orders.  As states shift their focus to implementing new policies to ensure continuity of services and mitigate the risk ...

Health Policy Responses to COVID-19

In this unprecedented time, much attention has been paid to Congressional response to the clinical and economic needs resulting from the COVID-19 pandemic. At the same time, Congress, the Centers for Medicare and Medicaid Services (CMS) and other federal agencies have actively put forth legislation and guidance aimed at providing greater flexibility to states and ...

Health Policy News – February 2020

Introduction On January 31, 2020, the Centers for Medicare and Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters (NBPP) and the draft Letter to Issuers in the Federally-facilitated Exchanges, as well as accompanying guidance and timelines. The March 2nd deadline for comment on the proposed policy changes included in the annual ...

An Interview with Retired Deputy Fire Chief Ken Riddle, PCG’s Emergency Medical Services Subject Matter Expert

Health Policy News often features Medicaid-related policy topics; this month, we are featuring the first in a series of pieces that touch on Medicare policy—specifically, Emergency Medical Services (EMS). PCG is fortunate to have retired Las Vegas Deputy Fire Chief Ken Riddle leading our work in this area. We spent time with Ret. Deputy Chief ...

Medicaid Updates: Regulations, Guidance and Litigation

The last several weeks saw a number of Medicaid policy-related developments. In our round-up below, we share key takeaways from each. Centers for Medicare and Medicaid Services Block Grant Guidance As we shared in our newsletter last month, CMS recently released a State Medicaid Director Letter with long-awaited guidance on Medicaid block grants. Earlier this ...

Comments on 2021 Proposed Payment Notice and Draft Letter to Issuers in the FFM Due March 2nd

On January 31, 2020, the Centers for Medicare and Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters (NBPP) and the draft Letter to Issuers in the Federally-facilitated Exchanges (hereafter “the Letter”)[1] as well as accompanying guidance and timelines.[2] CMS is accepting comments on these items through 5pm on March 2, 2020. ...

Health Policy News – January 2020

Introduction Happy 2020 Health Policy News readers! We hope you all had an enjoyable and relaxing holiday season. As we continue to await the proposed Marketplace guidance for 2021, we wanted to take this opportunity to share recent health policy developments from the federal and state levels. In breaking news, our first article includes our ...

UPDATED: Centers for Medicare and Medicaid Services releases Long-Awaited Block Grant Guidance

2/7/2020 Update: Click here for a detailed analysis of the Healthy Adult Opportunity (HAO) guidance (SMDL 20-001) from PCG’s Health Policy News subject matter experts. The Centers for Medicare and Medicaid Services (CMS) released its long-awaited guidance promoting block grant waivers – being referred to as the Healthy Adult Opportunity (HAO) – yesterday. As expected, under guidance, in exchange for funding limited to an ...

Chronic Care Alternative for Marketplace Enrollees: State Complex Care Plan

Over the past four years, thirteen states have received approval to implement State Innovation Waivers (renamed “State Relief and Empowerment Waivers” by CMS in October 2018) under the authority of Section 1332 of the Affordable Care Act. Twelve of those states (all except Hawaii) leveraged Section 1332 to implement reinsurance programs aimed at reducing premiums. ...

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