New white paper explores implications of the Zika virus for human services agencies

During the past year, the mosquito-borne Zika virus has captured the world’s attention as news of babies born with abnormally small heads and neurological defects made headlines across the western hemisphere. Human service agencies, including early intervention, child care, early childhood, and public welfare agencies will be responsible for supporting and assisting individuals and children affected by Zika. However, many agencies do not know where to start preparations, how to predict impact and prevalence, or how to connect with existing public health preparations. [More]

Family First Prevention Services Act: Paying for What Works

Historically, the federal government’s support for child welfare services through the Title IV-E program has been limited to a single service: placement in foster care. With decades of research and experience, we now know that foster care is not the only – nor the best – solution for many children who have experienced maltreatment.

The Family First Prevention Services Act (FFPSA) provides an opportunity for states and local communities to move towards more varied, proven interventions and services for children and families. It will also require many states to make significant changes in how they buy, manage, and fund services. Stakeholders are strongly encouraged to consider the benefits that will likely accrue to state systems, and to children and families, when considering the fiscal impact of the FFPSA. [More]

Summary of Proposed Notice of Benefit and Payment Parameters for 2018

In follow-up to the Centers for Medicare and Medicaid Services’ (CMS) release of the Proposed Notice of Benefit and Payment Parameters (NBPP) for 2018 at the end of August, members of PCG’s Health team produced a summary of notable changes relative to Qualified Health Plan (QHP) certification and health insurance regulation. Regulators across the country are reviewing these provisions to understand the changes and how they will impact their regulation of health plans and the markets in their states. To better support states as they analyze the impact of the proposed regulations for 2018, we welcome you to share this comprehensive summary with colleagues, clients and others. [More]

CMS offers options for MACRA participation in 2017

On September 8, 2016, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare clinicians will be offered four options for participating in the pay-for-quality program to be launched on January 1, 2017 under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Eligible physicians and other clinicians electing any of the four options for 2017 will avoid negative payment adjustments that would otherwise apply under MACRA beginning in 2019. In addition, options two through four offer the opportunity to qualify for positive payment incentives beginning in 2019. The four options are described here. Additional details on the four options and many other MACRA implementation requirements will be available in a final regulation expected to be published on or about November 1, 2016. [More]

U.S. Supreme Court affirms ruling that ERISA preempts Vermont’s health reporting statute

Recently, the U.S. Supreme Court affirmed a decision by the Second Circuit Court of Appeals that the Employee Retirement Income Security Act (ERISA) preempts Vermont’s reporting statute, which requires health plans to report detailed claims and member health data to enable the state to track health care utilization, costs, and resource capability. The case citation is Gobeille v. Liberty Mutual Insurance Company, 136 S. Ct. 936 (2016).
The six Justice majority decision authored by Justice Kennedy held that ERISA’s reporting and disclosure requirements for health plans are central to ERISA’s uniform system of plan administration and preempted the Vermont statutory reporting requirement despite the beneficial intent of the state’s statute. [More]

#PCGCares: Chicago office completes its first “30…for Thirty Years” effort!

As a part of PCG’s “30…for Thirty Years” campaign celebrating our 30th anniversary, the Chicago office partnered with the Elam Davies Social Service Center of Chicago Lights, a local social service organization, for a 30-day partnership of giving back. The organization helps provide resources and services to Chicago’s homeless population, providing food, clothing, programming, case management services, and more. For 30 days this summer, the team volunteered in the community, getting involved by: unloading food delivery trucks, organizing the Center’s food pantry, preparing emergency meals, and participating in the Center’s Good Neighbor street outreach program where staff passed out food and resources to people in need. At the same time, multiple boxes placed throughout the Chicago office collected donations of food, toiletries and cards. [More]

Tennessee District selects PCG to provide ELA curriculum

This fall, Shelby County Schools is launching an innovative trial program to accelerate English language achievement for all students in grades 9-12. The district selected PCG and Wiley’s Paths to College and Career 9-12 English Language Arts Curriculum (EngageNY) for their program in order to change teacher practice and improve student achievement. [More]

Proposed Benefit and Payment Parameters 2018 Released

This year, the Centers for Medicare and Medicaid Services (CMS) released its annual proposed Notice of Benefit and Payment Parameters earlier than in prior years in order to provide more market certainty. The draft regulations, which were released last week and published in the federal register on September 6, outline changes to operations and rules for health insurance Marketplaces and the commercial health insurance market generally for 2018. [More]

HHS report shows Medicaid expansion affects QHP premiums

On August 25, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE), released a report showing that premiums for qualified health plans (QHPs) offered through Exchanges were on average about seven percent lower in 2015 for states that had expanded Medicaid for persons with incomes up to 138 percent of the Federal poverty level (FPL) versus states that had not. As actuarial risk pools, hence premiums, vary based on many local area factors, the report focuses on QHP benchmark premiums in 94 paired counties on opposite sides of borders between expansion states and non-expansion states that had used Federal exchanges in 2015. [More]