CMS announces expansions in value-based payment programs

On December 15, 2016, the Centers for Medicare and Medicaid Services (CMS) announced upcoming application opportunities to participate in its on-going Comprehensive Primary Care Plus (CPC+) and Next Generation Accountable Care Organization (ACO) demonstration programs. Both announcements outline a series of challenging steps scheduled for 2017 aimed at broadly expanding participation in these innovative programs by January 2018. The CPC+ program is designed to align Medicare, state Medicaid agencies, and commercial insurance payers to achieve more comprehensive, coordinated primary and preventive care, especially for patients with complex medical or behavioral health needs. Participating providers can qualify for incentive payments related to clinical quality/patient experience metrics as well as utilization/cost containment metrics. [More]

Miami-Dade Chooses PCG’s Paths to College and Career (EngageNY) to Ensure Student ELA Success

Miami, FL. [December 19, 2016] — Public Consulting Group (PCG) announced today that their EngageNY English Language Arts (ELA) curriculum is now being used by 12,000 grade 11 students in the Miami-Dade County Public Schools. The new curriculum will aid Miami-Dade educators as they work to build the skills and understandings of high school students striving to meet Florida’s graduation requirements.
EngageNY ELA 6-12 is a rigorous, standards-based curriculum that combines rich literature, engaging learning experiences, and personalized scaffolding to build all students’ abilities as readers, writers, and thinkers. It was originally developed by PCG for the New York State Education Department and is published by John Wiley and Sons as Paths to College and Career. [More]

Looking ahead: Key considerations for the future of health policy

There has been much discussion on the future of the Affordable Care Act (ACA) and health policy in general, since the election. While it is tempting to try to predict the future of health policy, in reality it is still too early to know how policy will change, via which vehicles, and according to what timeline. There are, however, some key themes to be mindful of as we approach inauguration day... [More]

Update on House v Burwell case

On December 5, 2016, the District of Columbia Circuit Court of Appeals accepted a Congressional request to postpone further proceedings in House v Burwell pending motions due February 21, 2017, turning the continued proceedings in this case over to the next administration and Congress.

In November 2014, the House of Representatives filed suit against the current administration claiming the cost-sharing reduction payments made to issuers for silver level Marketplace enrollees, with incomes of less than 250% of the Federal poverty level, are not lawful because Congress has not appropriated the funds. [More]

CMS issues final rule on eligibility, appeals, and enrollment in Medicaid, the Children’s Health Insurance Program (CHIP), and Exchanges pursuant to the Affordable Care Act (ACA)

On November 30, 2016, a final rule issued by the Center for Medicare and Medicaid Services (CMS) was published in the Federal Register (81 Fed. Reg. 86382), which, according to the preamble of the regulation, “continues our efforts to assist states in implementing Medicaid and CHIP eligibility, appeals, and enrollment changes required by the ACA.” [More]

House passes 21st Century Cures bill

On November 30, 2016, the U.S. House of Representatives passed an amended “21st Century Cures” bill by a 392-26 vote. The bill covers a diverse range of topics, such as: medical research, development of drugs and medical devices, interoperability of electronic health record systems, and mental health/substance use disorder (MH/SUD) programs. [More]

Centers for Medicare and Medicaid Services issues new guidance

The Centers for Medicare and Medicaid Services (CMS) released a draft of its 2018 Letter to Issuers in the Federally-Facilitated Marketplaces (Letter) on November 10, 2016. The Letter – updated annually - provides operational and technical guidance for issuers seeking to offer Qualified Health Plans (QHPs) and Standalone Dental Plans (SADPs) on Federally-Facilitated Marketplaces (FFMs) and State-Based Marketplaces on the Federal Platform (SBM-FPs). [More]

PCG announces final “30 for 30” grants

To commemorate our 30th year of service, and to offer some very humble thanks to our clients and the communities that we serve, PCG pledged to donate $30,000 every other month, ($180,000), to selected charities during calendar year 2016.

December marks the final award in our yearlong campaign, and as such, we are pleased to announce that three “30 for 30” $10,000 grants, ($30,000), will go to organizations dedicated to supporting individuals with disabilities and their families: Parent to Parent USA, Self Advocates Becoming Empowered, and Sibling Leadership Network... [More]

PCG sponsors statewide Delivery System Reform Incentive Payment symposium

It seems entirely fitting that the historic Syracuse Marriott Downtown was the setting for New York’s second annual Statewide Delivery System Reform Incentive Payment (DSRIP) Learning Symposium from September 20 to September 22. The hotel’s renovation was completed just weeks before the event, with an eye toward preserving the workmanship of the past and melding it with 21st century upgrades and innovation. In many ways, that mission is mirrored by the New York State Department of Health in its devotion to time-honored quality of care and its dedication to modernizing the healthcare delivery system through the DSRIP project. [More]

Office of Inspector General releases 2017 Work Plan

The Office of Inspector General (OIG) within the U.S. Department of Health and Human Services (HHS) is charged with determining, on an annual basis, the use of federal funds across all HHS agencies and areas. These include the Centers for Medicare and Medicaid Services (CMS); Public Health (e.g., Centers for Disease Control and Prevention [CDC], Indian Health Services [HIS], Substance Abuse and Mental Health Administration [SAMHSA], Food and Drug Administration [FDA], etc.); and Human Services (i.e., Administration for Children and Families [ACF] and Administration for Community Living [ACL]). [More]