HHS Launches New ACO Model


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), announced on March 10, 2015 that accountable care organizations (ACOs) soon will have an opportunity to participate in Medicare under the “Next Generation ACO” model, another important step under section 3021 of the Affordable Care Act (ACA) toward paying for services based on value to patients rather than volume of services. [More]

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Categories:Health and Human Services


New ACA Enrollment Figures Announced in Mar HHS Report and CBO Announces Lower ACA Cost Estimates


In a report released on March 10, 2015 by the U.S. Department of Health and Human Services (HHS), almost 11.7 million consumers nationwide selected or were automatically enrolled in health insurance coverage through the Affordable Care Act (ACA) marketplace as of February 22, 2015. According to the report, 8.84 million (76%) of the enrollees were in states using the HealthCare.gov platform, while 2.85 million (24%) were in the 14 states (including DC) using their own marketplace platforms. [More]


HHS Report Updates ACA Impact on Medicaid/CHIP Enrollments


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), released on February 23, 2015 a report showing that 27 jurisdictions (26 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by December 2014 saw on average a 27.01 percent increase in Medicaid/CHIP enrollments for December 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. [More]

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U.S. Supreme Court Hears Oral Argument in Significant ACA Case of KING v. BURWELL


On Wednesday, March 4, 2015, the U.S. Supreme Court heard oral arguments in the case of King v. Burwell. This case considers the issue of whether the language in the Affordable Care Act (ACA), “an Exchange established by the State,” requires a finding that the subsidies established by the ACA may only be provided in states where the health insurance exchange is founded by the states themselves and not by the federal government. [More]


CMS Issues Final Rule for ACA Marketplace Standards in 2016


In the February 27, 2015 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a final rule establishing new consumer standards as well as requirements for issuers in the Affordable Care Act (ACA) marketplaces for 2016. (80 Fed. Reg. 10750). Pursuant to current requirements, health insurance issuers seeking a rate hike of 10% or more in the individual or small group market must publicly disclose and justify the increases. [More]


AL Medicaid Agency Awards TC Significant Contract Amendment


The State of Alabama is leveraging both the Affordable Care Act (ACA) regulations and the A-87 exception to create a single centralized eligibility system to replace multiple antiquated less functional systems. This approach will lower costs to both the state and its federal partners while improving the experience for users as well as creating a more flexible, easily configurable system. This expanded effort for the AL eligibility system will impact 12 legacy systems. [More]

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Categories:Technology Consulting


OMB Releases Proposed FY 2016 Budget


President Obama’s Executive Office of Management and Budget (OMB) released the President’s proposed federal fiscal year 2016 budget on February 2, 2015. The $4 trillion budget includes $944 billion for Social Security and $1.107 trillion for health care unrelated to veterans’ programs, including $589 billion for Medicare and $365 billion for Medicaid and the Children’s Health Insurance Program (CHIP). [More]

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Hawaii DHS Extends PCG Technology Consulting's IV&V Contract through December 2015


In 2012, the Hawaii Department of Human Services (DHS) decided to replace its legacy Medicaid eligibility system with a solution to modernize its system and support the Affordable Care Act requirements. The first phase of the project, known as the Kauhale (Community) Online Eligibility Assistance (KOLEA) project, went live on Oct. 1, 2013 when the state converted a majority of the Medicaid functionality from the legacy system to KOLEA. [More]

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U.S. Supreme Court Denies Review of Another ACA Individual Mandate Challenge


On January 12, 2015, the U.S. Supreme Court refused to review a D.C Circuit case challenging the Affordable Care Act’s (ACA’s) individual mandate. See, ASSOCIATION of AM. PHYSICIANS & SURGEONS v. BURWELL, No. 14-350 (U.S. REVIEW DENIED JAN. 12, 2015). [More]

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U.S. Supreme Court Will Hear Oral Arguments in ACA Subsidy Case on March 4, 2015


On December 22, 2014, the U.S. Supreme Court announced that it will hear oral arguments in KING v. BURWELL, No. 14-114, in the case challenging the position that subsidies under the Affordable Care Act (ACA) are permitted in states with federally facilitated marketplaces as well as in states with state-based marketplaces. [More]

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