Pennsylvania Wins CMS Waivers for Medicaid Expansion


The Centers for Medicare and Medicaid Services (CMS) notified the Pennsylvania Department of Public Welfare on August 28, 2014 that it has approved the Commonwealth’s “Healthy Pennsylvania” demonstration waiver. The Department is authorized under this waiver to expand Medicaid for over 500,000 non-aged adults with incomes up to 133 percent of the federal poverty level (FPL). Coverage under Pennsylvania’s “private coverage option” (PCO) will be offered through competing private health plans. [More]

Tags: , , , ,

Categories:Health and Human Services


NY Medicaid Selects PCG as Medicaid Reform Independent Assessor


Albany, NY, August, 2014 – The New York Department of Health recently awarded PCG Health a contract to serve as Independent Assessor for its Medicaid reform efforts. In April, 2014, the federal Centers for Medicare & Medicaid Services (CMS) approved New York State’s waiver, allowing it to redesign its Medicaid system through its new Department of Health Delivery System Reform Incentive Payment (DSRIP) Program. [More]

Tags: , , , , , ,

Categories:Health and Human Services


HHS Report Shows ACA Impact on Medicaid Enrollments


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), released on August 8, 2014 a report showing that 26 jurisdictions (25 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by June 2014 saw on average a 18.50 percent increase in Medicaid/CHIP enrollments for June 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. States which had not implemented Medicaid expansion saw on average a 4.01 percent increase as compared to their 2013 baselines. Aggregating data for all states shows a 12.43 percent increase overall as compared to 2013 baselines. Total reported Medicaid/CHIP enrollments as of June 2014 reached 66,112,314. [More]

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

Categories:Health and Human Services


RWJF Releases Reports on the Uninsured and Medicaid Expansion


The Robert Wood Johnson Foundation (RWJF) and the Urban Institute Health Policy Center released on July 29, 2014 a report entitled, “Who Are the Remaining Uninsured as of June 2014?” The report shows socio-economic, demographic, and geographic shifts in the composition of the uninsured population from September 2013 to June 2014, points-in-time before and after the Medicaid expansion in some states and the first open enrollment period under the Affordable Care Act (ACA). The national data in the report may help states formulate innovative outreach, consumer assistance, and enrollment strategies for 2015 and beyond taking into account the changing attributes of the remaining uninsured. State-specific data not available in that report can be used to supplement the data in the report. [More]

Tags: , , , , ,

Categories:Health and Human Services


NEJM Report Shows 10.3 Million Persons Gain Coverage


The New England Journal of Medicine (NEJM) published a special report on July 23, 2014 estimating a net increase of 10.3 million insured adults aged 18 - 64 during the October 2013 – March 2014 open enrollment period offered through health insurance Exchanges under the Affordable Care Act (ACA). The study used Gallup-Healthways Well-Being Index (WBI) survey data from 440,429 survey respondents and linear regression models accounting for socio-economic variables to calculate adjusted average rates of uninsured adults aged 18 – 64 before and after the 2013-2014 open enrollment period. [More]

Tags: , , , , ,

Categories:Health and Human Services


HHS Announces Health Care Innovation Awards


The U.S. Department of Health and Human Services (HHS), Center for Medicare and Medicaid Innovation (CMMI), announced a new batch of “round two” health care innovation awards on July 9, 2014. These are grants to applicants who have set forth compelling new ideas to improve care and control costs for persons enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). [More]

Tags: , , , , , , , , ,

Categories:Health and Human Services


Kaiser Commission Releases Report on Successful SBEs


The Kaiser Commission on Medicaid and the Uninsured released an excellent report on July 20, 2014 about the successful state-based health insurance Exchanges (SBEs) and Medicaid expansions in Colorado, Connecticut, Kentucky, and the State of Washington. The report, “What Worked and What’s Next? Strategies in Four States Leading ACA Enrollment Efforts,” includes interviews with stakeholders in each state about exemplary marketing, outreach and enrollment, consumer assistance, and systems/operations strategies, with insights on 2014 and lessons for 2015. It shows that each of the states marketed the coverage expansions as state-based initiatives; conducted statewide marketing via a wide range of methods, including social media and promotional materials; and emphasized the enrollment deadline in their marketing efforts. [More]


DHHS Providing $100 Million in Collaborative Effort with States to Reform Medicaid Systems


On July 14, 2014, US Department of Health and Human Services (DHHS) Secretary Sylvia M. Burwell announced a new innovative collaboration with states to improve care for Medicaid beneficiaries by accelerating efforts to reform health care systems. The new initiative, entitled the Medicaid Innovation Accelerator Program, follows recommendations by the National Governors Association (NGA) that The Centers for Medicare & Medicaid Services (CMS) identify opportunities for care improvement and address high-priority areas, such as mental health and emergency department utilization. [More]


HHS Launches Medicaid Innovation Accelerator Program


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), announced the Medicaid Innovation Accelerator Program (IAP) on July 14, 2014. The IAP’s goals are to improve health care delivery and patient outcomes while controlling costs through accelerated payment and service delivery reform in state Medicaid programs. It incorporates many recommendations from states, the National Governors Association (NGA), and the National Association of Medicaid Directors (NAMD), such as improvements in: Medicaid data analytics; quality metric development; service delivery model development; rapid cycle model evaluation; and coordination among various HHS components (the Center for Medicare, the Center for Medicaid and CHIP Services (CMCS), the Center for Medicare and Medicaid Innovation (CMMI), the Medicare-Medicaid Coordination Office (MMCO), etc.). [More]

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

Categories:Health and Human Services


HHS/CMS Releases Proposed Rules on Exchange Eligibility Redeterminations


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), published proposed rules in the July 1, 2014 Federal Register on health insurance Exchange/Marketplace eligibility redeterminations and re-enrollments in health plans for 2015 and beyond. The new proposed rules would modify final rules published in 2012. They would allow more flexibility in Federal Exchanges, at HHS’ discretion, and would also allow State-based Exchanges (SBEs) to devise alternative procedures, subject to HHS approval. [More]

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

Categories:Health and Human Services