HHS Releases Funding Opportunity Announcement for Navigator Grants

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued a funding opportunity announcement (FOA) on April 15, 2015 related to grants to support health insurance eligibility and enrollment “navigators” in Federally-facilitated and State Partnership Marketplaces/Exchanges under the Affordable Care Act (ACA). [More]

 

HHS Proposes New Rules for Eligibility IT Systems

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published proposed rules in the Federal Register on April 16, 2015 which would authorize 90 percent Medicaid federal financial participation (FFP) for the design, development, installation or enhancement of Medicaid eligibility and enrollment (E&E) systems; and 75 percent Medicaid FFP for the maintenance and operation (M&O) of such systems. The proposed rules would also update requirements for federal prior approval of State Medicaid agencies’ Advance Planning Documents (APDs) for system enhancements, contract solicitation, and contract execution. [More]

Tags: , , , , , , , , , ,

Categories:Health and Human Services

 

1332 Waivers Will Allow State-Specific Variation to Health Care Reform Efforts

 

State Innovation Waivers authorized under Section 1332 of the Affordable Care Act will allow state-specific variations to health insurance marketplace rules. This PCG report, prepared for the Policy Innovations Committee of the Arkansas Health Insurance Marketplace Board, examines the role that so called ‘1332 Waivers’ could play in shaping future Arkansas health care reforms. [More]

 

HHS Initiates Health Care Payment Learning and Action Network

 

On March 25, 2015, U.S. Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell announced the creation of the Health Care Payment Learning and Action Network, a collaborative public, private initiative emphasizing quality of care and alternative payment models. According to a fact sheet published on that date at CMS.gov, “More than 400 Medicare ACOs participating in the Shared Savings Program and the Pioneer ACO Model have generated a combined $417 million in savings for Medicare.” Under the new Network project, the goals are to move 30 percent of Medicare payments into alternative payment models by the end of 2016 and 50 percent into alternative payment models by the end of 2018. [More]

 

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]

Tags: , , , , , , ,

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]

Tags: , , , , , , , , , ,

Categories:Health and Human Services

 

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]

Tags: , , , ,

Categories:Technology Consulting