TC wins Louisiana Medicaid modernization IV&V


PCG Technology Consulting (TC) was recently notified by the Louisiana Department of Health and Hospitals (DHH), Bureau of Health Services Financing (BHSF) of its intent to award PCG a contract to provide Independent Verification & Validation (IV&V) services. [More]


CMS and ONC update health IT goals


On January 19, 2016, the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) released a joint statement which defines guiding principles on promoting “meaningful use” of electronic health records (EHRs) for purposes of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). [More]

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Categories:Health and Human Services


Legislation to watch as Congress reconvenes next week


Several important pieces of legislation seeking child welfare finance reform were introduced during the first year of the 114th Congress. With Congress officially reconvening on Monday, January 11, 2016, for the second year of the 114th Congress, here are legislation updates and bills to watch in the coming year. [More]


CMMI announces AHC grant opportunities


On January 5, 2016, the Center for Medicare and Medicaid Innovation (CMMI) released a funding opportunity announcement (FOA) soliciting grant applications to test whether identifying health-related social service needs and promoting delivery of services to meet those needs can help reduce health care costs and improve health outcomes for Medicare and Medicaid beneficiaries. [More]


Implementing state payment reform strategies at FQHCs


Federally Qualified Health Centers (FQHCs) traditionally provide health care services primarily to low-income individuals who are covered by Medicaid or who are uninsured. As state Medicaid programs increase their focus on value-based payment, it is important to consider how FQHCs may participate in payment reform strategies. [More]


HHS finalizes new rules for eligibility IT systems


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published final rules in the Federal Register on December 4, 2015, authorizing 90 percent Medicaid Federal financial participation (FFP) for the design, development, installation (DDI) or enhancement of Medicaid eligibility and enrollment (E&E) systems. Additionally, the final rules authorize 75 percent Medicaid FFP for the maintenance and operation (M&O) of such systems. [More]

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Categories:Health and Human Services


Senate Finance Committee releases draft legislation


Earlier this year, in August 2015, Sen. Ron Wyden (D-OR) introduced “The Family Stability and Kinship Care Act of 2015” which marked the first legislative effort to address child welfare finance reform. While the legislation received significant bipartisan support among the Senate, Sen. Orrin Hatch (R-UT) never offered support instead stating that he would introduce additional legislation prior to the end of the year and this week, the Senate Finance Committee staff shared a draft version of child welfare finance reform. The proposed legislation, not yet introduced, is titled “The Family First Act.” The language of the legislation is consistent with Sen. Wyden’s bill on several points, however, additional aspects were added. Examples of the proposed changes include (but are not limited to) amendments to “Subtitle A: Investing in Prevention and Family Services” and “Subtitle B: Ensuring the Necessity of Placement that is not a foster family home.” [More]


CMS proposes ACA Benefits and Payments Parameters Rules for 2017


On December 2, 2015, the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) officially published its proposed “Notice of Benefits and Payments Parameters” rules for 2017. As in prior years, this annual rules notice proposes adjustments to a wide range of policy, operational, and information technology requirements applicable to health insurance coverage obtained through Exchanges, as well as other related topics under the Affordable Care Act (ACA). [More]


HHS issues 2016 Exchange enrollment data


On November 12, 2015, the U.S. Department of Health and Human Services (HHS) issued data on the first week of the 2016 open enrollment period (November 1, 2015 – November 7, 2015) for qualified health plans (QHPs) under the Affordable Care Act (ACA). This initial “snapshot” shows that 3,180,777 persons visited the website, 1,153,270 persons completed their eligibility applications, and 543,098 eligible persons selected a QHP in the first week. [More]


New York designs capitated Medicare/Medicaid plan for persons with developmental disabilities


The New York State Department of Health (DOH), the New York State Office for People with Developmental Disabilities (OPWDD), and the Centers for Medicare and Medicaid Services (CMS) formally agreed on November 5, 2015 to implement an innovative demonstration project integrating Medicare and Medicaid services for adults with intellectual and developmental disabilities. Service integration will be achieved through a capitated managed care organization (MCO). [More]