Study Demonstrates Value of Coordination of Care for Patients with Complex Health Needs

The Commonwealth Fund released a study on November 9 based on surveys of 18,000 adults aged 18 or older in fair or poor health in eleven countries demonstrating that, in every country, persons with complex health needs who receive care through a medical home (an accessible primary care practice that knows their medical history and helps coordinate their care) report substantially fewer medical errors and duplication of diagnostic tests, better arrangements for follow-up care after a hospitalization, better relationships with their physicians, and greater satisfaction with their care. [More]

CMS Announces $1 Billion Health Care Innovation Challenge

The Centers for Medicare and Medicaid Services (CMS) announced on November 14 that it will award up to $1 billion in March 2012 to fund innovative service delivery and payment strategies beyond the models defined in the Affordable Care Act (ACA). CMS released a funding opportunity notice via on the “Health Care Innovation Challenge,”a competitive solicitation for locally based, creative ideas supported by viable work plans and budgets that can begin to improve care within six months of the award date and create a sustainable pathway to achieve savings under Medicare, Medicaid, and/or the Children’s Health Insurance Program (CHIP) within two to three years. [More]

The First NCLB Waivers Requests Are Submitted to ED

In a November 15, 2011 press release, the U.S. Department of Education (ED) announced that 11 states have requested waivers from key provisions of the No Child Left Behind Act (NCLB) (aka the Elementary and Secondary Education Act). The requests were submitted seven weeks after President Obama offered states more flexibility under NCLB in exchange for the states’ commitments to implement education reforms consistent with his March 2010 Blueprint for Reform. [More]

US Supreme Court Agrees to Take Up Constitutionality of ACA

On Monday, 11/14/11, the U.S. Supreme Court agreed to take on the legal issues concerning the Affordable Care Act (ACA) by considering the split decisions of various Courts of Appeal. The significance afforded by the Justices to the issues to be decided is reflected by the Court’s announcement that it would allot 5 and 1/2 hours for oral argument rather than the usual 1. [More]

States, CMS Forge Ahead on “Health Home” Service Coordination Initiatives

The Missouri Department of Social Services (DSS) has become the first state Medicaid agency to win approval from the Centers for Medicare and Medicaid Services (CMS) of a state plan amendment under which the state will qualify for 90 percent federal financial participation (FFP) on expenditures for “health home” services under section 2703 of the Affordable Care Act (ACA). [More]

CMS Approves Rate Cuts in CA Medi-Cal (Medicaid) Program

On October 27, 2011, the California Department of Health Care Services announced that the Centers for Medicare and Medicaid Services (CMS) has approved a number of provider reimbursement cuts in the state’s Medicaid program. The specific proposals approved by CMS are a 10 percent provider payment reduction on a number of outpatient services, including physicians, clinics, optometrists, therapists, laboratories, dental, durable medical equipment, and pharmacy; a 10 percent payment reduction for freestanding nursing and adult subacute facilities; and a 10 percent provider payment reduction and rate freeze for distinct part/nursing facility-B services. [More]

Another Fed Appeals Court Upholds Mandate in ACA

On November 8, 2011, a panel of the U.S. Court of Appeals in Washington, D.C., on a split vote, upheld the constitutionality of the mandate provision in the Affordable Care Act. The dissenting judge found that there was a lack of timeliness, since the mandate does not go into effect until 2014. Media reports indicated that the U.S. Supreme Court may have met in secret on November 9 to consider whether to take up any or all of the appellate decisions dealing with the Act. [More]

Foster Children Opportunity Act

On November 3, Representative Pete Stark (D-CA) introduced legislation H.R. 3333 that would amend Title IV-E and require states to help alien children in the child welfare system apply for all available forms of immigration relief. Rep. Stark’s presentation to the House of Representatives provided the historical perspective of why this legislation is necessary. When children are brought into the child protection system as illegal immigrants, the status of Special Immigrant Juvenile Status (SIJS) is available to a child in foster care who is under the age of 21 and cannot safely return to his or her family or return to country of origin. [More]