Tag: CMS

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. ...

2020 Prediction: More State Waivers and Activity Related to Major Health Policy Litigation and Federal Regulations

Many major health policy developments in 2019 were related to state waivers, major health policy litigation, and federal health insurance regulations, with activity on these issues expected to continue into 2020. One of these developments—this week’s new ruling in the Texas vs United States case challenging the validity of the Affordable Care Act (ACA)—is certain ...

Health Policy News – November 2019

Introduction We hope many of you were able to join us for our second annual Fall Health Policy Webinar, which focused on innovative approaches to state Accountable Care Organization (ACO) Programs. If you were unable to attend (or would simply like to review Health Policy News’ report, tracking tool, and presentation materials), we have provided ...

Verma Announces Proposed Medicaid Fiscal Accountability Rule at National Association of Medicaid Directors (NAMD) Conference

On November 12th, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma kicked off the NAMD conference by announcing the CMS issuance of the proposed Medicaid Fiscal Accountability Rule (CMS-2392-P). In her opening remarks, Administrator Verma indicated that this proposed rule seeks to strengthen the Medicaid program through program integrity measures and equitable funding ...

National Association of Medicaid Program Integrity (NAMPI) 2019 Annual Conference

PCG staff members joined over 500 attendees at the 35th Annual NAMPI Conference in August. As always, the conference was an excellent way for program integrity (PI) leaders to network with one another while sharing best practices, lessons learned and innovative ideas within the Medicaid arena. The NAMPI conference covered a range of topics, from ...

HCBS Conference Recap: Topics, Trends, and Takeaways from PCG

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 ...

Health Policy News – September 2019

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 State Health Policy annual conference. In this edition, we share our insights (and relevant fact ...

CMS Issues New Regulations to Enhance Program Integrity

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, ...