Author: Tom Entrikin | Posted: 2. May 2013 12:53
On April 23, 2013, Governor Mike Beebe signed into law Senate Bill 1020, which authorizes the Arkansas Department of Human Services to explore design options that would reform the Medicaid program using private plans certified by the Department of Insurance that will offer coverage through the Exchange. Most persons aged 19-65 qualifying as newly eligible Medicaid recipients under the Affordable Care Act would have an opportunity to obtain coverage through such private plans, while persons with exceptional medical needs could still obtain coverage through programs addressing those needs under Arkansas Medicaid. S.B. 1020 authorizes the Department of Human Services to submit state Medicaid plan amendments, to seek federal waivers, and to pay premiums and supplemental cost-sharing directly to qualified health plans (a payment approach allowed under section 1906 of the federal Medicaid law on a case-by-case basis if such payments are cost-effective for each enrollee, and for children obtaining benchmark coverage under section 2103 of the Children’s Health Insurance Program law). [More]
Author: Tom Entrikin | Posted: 2. May 2013 12:52
The Centers for Medicare and Medicaid Services (CMS) released proposed rules on April 26, 2013 that would update Medicare payment methods and rates for federal fiscal year 2014 under the inpatient prospective payment system (PPS) for acute care hospitals and the long-term care hospital PPS. The proposed rules also expand quality of care and patient safety reporting requirements for acute care hospitals, PPS-exempt cancer hospitals, long-term care hospitals, and inpatient psychiatric facilities. [More]
Author: Sam Fish | Posted: 2. May 2013 12:45
On April 25, 2013, the Centers for Medicare & Medicaid Services (CMS) released a guidance document, in the form of frequently asked questions (FAQs), that provides information about what state costs qualify for the 75% FFP for maintenance and operations of improved Medicaid eligibility determination systems under the Affordable Care Act (ACA). [More]
Author: Sam Fish | Posted: 1. March 2013 06:10
On February 22, 2013, the Centers for Medicare & Medicaid Services (CMS) announced a final rule on five major health insurance market reforms mandated by the Affordable Care Act (ACA). The rule is published in the February 27 Federal Register. [More]
Author: Sam Fish | Posted: 15. February 2013 11:00
The Centers for Medicare & Medicaid Services (CMS) has posted additional guidance on the types of increased Federal Medicaid percentages (FMAPs) that will be available to states that expand their Medicaid programs pursuant to the ACA. The guidance was issued in the format, “Questions and Answers: Medicaid and the Affordable Care Act, February 2013”. [More]
Author: Sam Fish | Posted: 30. January 2013 10:00
The Kaiser Commission on Medicaid and the Uninsured, an entity within the Kaiser Family Foundation, published on January 23, 2013 (Publication Number 8401) its 12th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, and cost-sharing policies. The study identified many gaps in Medicaid coverage across the U.S. On the positive side, the survey showed that coverage for children and pregnant women was stable. However, it showed that adults with no dependent children qualify for benefits in only nine states, and eligibility for adults with children was often far below the poverty line. [More]
Author: Patsy Crawford | Posted: 30. January 2013 09:36
In a January 24, 2013 news release, the Kaiser Family Foundation (KFF) reported that a new poll shows that more Americans support, rather than oppose, Medicaid expansion under the Affordable Care Act (ACA). According to the poll, 52 percent of Americans believe that their states should expand Medicaid; 42 percent do not believe their states should expand Medicaid. [More]
Author: Ryan Paiva | Posted: 23. January 2013 07:16
Boston, MA, January, 2013 – The U.S. Department of Health and Human Services (HHS) has awarded $1.5 billion to states to support health insurance marketplace building efforts. The Affordable Care Act (ACA) requires that each state have a health insurance exchange (Exchange) operating beginning in 2014. Among the grants awarded, the state of Delaware, a PCG Health client, has received two Level One Exchange Establishment Grants. [More]
Author: Ryan Paiva | Posted: 15. January 2013 10:00
Boston, MA, January, 2013 – The Hawaii Health Connector (Connector) recently awarded PCG Health an additional project to provide a Project Management Office to oversee the design, development, and implementation of its state-based health benefits exchange (Exchange). PCG Health was already engaged to help Hawaii navigate the complexities of the Affordable Care Act and procure both an Exchange solution and integrated eligibility solution. [More]
Author: Tom Entrikin | Posted: 26. December 2012 04:22
The U.S. Department of Health and Human Services (HHS) published proposed rules in the Federal Register on November 26, 2012 to implement health insurance market reforms under sections 1302, 1312, 1321, and 1560 of the Affordable Care Act (ACA) and amendments to the Public Health Service Act. Beginning in 2014, the ACA and the proposed rules would require that “non-grandfathered” health insurance plans in the individual and small group markets limit variations in premiums to factors such as family composition, geographic rating areas, age, and tobacco use. [More]
