HHS estimates 22 percent increase in 2017 ACA premiums

On October 24, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE), issued a report estimating that premiums for health plans offered through health insurance Exchanges will be about 22 percent higher on average for 2017 than they were for 2016. That estimate is based on ASPE’s comparison of 2017 to 2016 premiums for 38 states using the HealthCare.gov (Federal Exchange) website in both years, as well as state-reported premium data made available to ASPE by four states and the District of Columbia, representing 60 percent of consumers enrolled in State-based Exchanges (SBEs). [More]

California health care provider to pay more than $2 million to settle HIPAA violation

Recent media reports have stated that St. Joseph Health in Irvine California has agreed to pay $2.1 million to settle allegations that its 14 hospitals and other health care operations left personally identifiable records of 31,800 people exposed on a newly-installed computer server. As reported, this marks the 12th Health Insurance Portability and Accountability Act (HIPAA) violation settlement this year, a record number. [More]

CMS finalizes rules on new Medicare payment methodologies for clinicians

On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) issued final rules to implement a new Quality Payment Program which includes the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). The new program is authorized under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). That landmark bipartisan legislation: repealed Medicare’s flawed sustainable growth rate (SGR) formula, replaced three prior Medicare incentive programs, consolidated Medicare quality reporting requirements beginning in 2017, and authorized new pay-for-performance adjustments beginning in 2019 for eligible clinicians paid under the Medicare Part B physician fee schedule. [More]

#PCGCares: Announcing our fourth “30 for 30” grant!

To commemorate our 30th year of service, and to offer some very humble thanks to our clients and the communities that we serve, PCG has pledged to donate $30,000 to six selected charities throughout 2016.

August marks the next grant in our yearlong campaign and as such, we are pleased to announce the fourth “30 for 30” grant recipient, National Park Foundation, the philanthropic arm of the National Park Service. [More]

HHS finalizes ACA non-discrimination rules

On May 18, 2016, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), finalized rules in the Federal Register on non-discrimination under federally-funded health care programs and activities. The final rules implement section 1557 of the Affordable Care Act (ACA), which broadly prohibits discrimination based on race, color, national origin, sex, age, or disability, in order to advance health care equity and reduce health care disparities. The final rules reflect OCR’s evaluation of 24,875 public comments on proposed rules that were published on September 8, 2015. [More]

Children and families legislative updates

Since the beginning of the 114th Congress, many bills have been drafted, a few have been introduced on either the House or Senate floor, and to date, no legislation has been actually passed. The legislation listed below reflect several themes of growing concern but none that have reached the level of attention for a hearing to be held. Continuous monitoring of these bills will be reported. [More]

HHS and USDA Issue Additional Guidance on Eligibility Integration

The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) issued a joint letter on July 20, 2015 to directors of state health and human services, state Medicaid and Children’s Health Insurance Programs, and health insurance Exchanges, about a limited exception to OMB A-87 cost allocation requirements for integrated eligibility systems serving multiple programs. [More]

HHS approves three additional state-based Exchanges

The U.S. Department of Health and Human Services (HHS) notified the Governors of Arkansas, Delaware, and Pennsylvania on June 15, 2015 that HHS has conditionally approved the establishment of state-based health insurance exchanges (Exchanges) by those states. The conditional approvals for Delaware and Pennsylvania are for state-based individual and small business Exchanges in 2016. The conditional approval for Arkansas is for a state-based small business Exchange in 2016 and an individual Exchange in 2017. [More]