GAO Report Finds HHS 1115 Waiver Program Lacks Transparency

 

On Wednesday, May 13, 2015, the Government Accountability Office (GAO) issued a report which concluded that the waiver process for Section 1115 of the Social Security Act, which gives the U.S. Department of Health and Human Services (HHS) authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs, “lacks transparency.” [More]

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PCG SME Co-Authors Article on Racial Disparities in Post-Release Recidivism and Employment

 

PCG Human Services Senior Consultant Katie Knutson, along with former Indiana Department of Correction colleagues Susan Klinker Lockwood and John M. Nally and former graduate school professor Taiping Ho at Ball State University, co-authored an article that was published in the June, 2015 edition of the Journal of Prison Education and Reentry. [More]

 

Medicaid/CHIP Enrollments Exceed 70 Million

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) has released a May 1, 2015 report showing that 29 jurisdictions (28 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by February 2015 saw on average a 26.99 percent increase in Medicaid/CHIP enrollments for February 2015, as compared to their average monthly enrollments in a July – September 2013 baseline period. [More]

 

GAO Evaluates High-Cost Medicaid Recipients

 

The U.S. Government Accountability Office (GAO) issued a report to Congress on May 8, 2015 entitled, “A Small Share of Enrollees Consistently Account for a Large Share of Expenditures.” GAO used the Centers for Medicare and Medicaid Services (CMS) Medicaid Statistical Information System (MSIS) to analyze the distribution of Medicaid expenditures in three years across all states using Medicaid-only beneficiaries’ diagnosis codes and service categories. [More]

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Pioneer ACO Model Approved for Potential Expansion

 

The U.S. Department of Health and Human Services (HHS) reported on May 4, 2015 that it has obtained actuarial certification that expansion of the Pioneer ACO model would reduce net Medicare spending. Actuarial certification of this “pay-for-performance” pilot is a prerequisite under the Affordable Care Act for HHS to expand the model to a larger group of Medicare beneficiaries. [More]

 

Pennsylvania Governor Outlines ACA Contingency Plan

 

Pennsylvania Governor Tom Wolf submitted a letter to U.S. Secretary of Health and Human Services Sylvia Burwell on May 1, 2015 declaring the Commonwealth of Pennsylvania’s intent to implement a State-based individual and SHOP Marketplace using the federal platform for plan year 2016. [More]

 

Florida Sues HHS Over Planned End to Low Income Pool Hospital Funding Program

 

On Tuesday, April 28, 2015, Florida Governor Rick Scott instituted a lawsuit against the U.S. Department of Health and Human Services in an attempt to prevent a threatened end to an optional federal program, providing Florida and eight other states with hospital funds for low income people (LIP). (Rick Scott v. United States Department of Health and Human Services, Case 3:15-cv- 00193-RS-CJK Document 1, filed 4/28/15). [More]

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HHS Proposes New Inpatient Hospital Payment Rules

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued proposed rules on April 17, 2015 to update its Medicare reimbursement methods under inpatient prospective payment systems for 3,400 acute care hospitals and 435 long term care hospitals. [More]

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U.S. Senate Finance Committee Writes to Governors on Foster Care Placements

 

On April 27, Senator Orin Hatch (R-Utah) and Senator Ron Wyden (D-OR) authored a letter to all state governors seeking detailed information about the use of private for profit and not-for-profit providers for the state’s foster care populations. The Senate Finance Committee has jurisdiction of Title IV of the Social Security Act which includes federal foster care and adoption assistance. [More]

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HHS Proposes New Rules on Medicare Nursing Facility Quality and Reimbursement

 

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 20, 2015 to update its Medicare skilled nursing facility prospective payment system (SNF PPS) and quality reporting program (SNF QRP). The proposed rules would offer, on average, a 1.4 percent increase in SNF PPS rates for Federal fiscal year 2016 (October 1, 2015 - September 30, 2016), a $500 million aggregate increase in Medicare payments as compared to FFY 2015. [More]

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