The U.S. Department of Health and Human Services (HHS) announced on Monday, August 16 that it is awarding $46 million in grants to 45 States and the District of Columbia to upgrade reviews of health insurance premium increases. This is the first installment in $250 million in Health Insurance Premium Review Grants over five years under the federal health care reform law. HHS awarded $1 million in round one to each grantee to support immediate priorities outlined by the grantee in response to a June 7 solicitation. Sixteen grantees will seek new or expanded state legislative authority to review premium increases, 22 grantees will expand the scope of their current reviews and financial analyses, 43 will provide more information to consumers/purchasers about the state review process and findings, all grantees will require health insurance companies to report more extensive financial information, and all grantees will develop or upgrade information technology supporting these activities. HHS noted that only 26 states currently have authority under state law to reject excessive increases, many states with such authority have limited resources and technology to perform the necessary financial analyses, and the competitive marketplace of state-operated health insurance purchasing exchanges will not be fully operational in all states until 2014.
About Tom Entrikin
A former policy specialist with the U.S. Health Care Financing Administration (now Centers for Medicare & Medicaid Services (CMS)), Tom Entrikin has vast experience providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; and Medicaid waiver programs. Since joining PCG in 1992, Tom has assisted in the design, development, and implementation of revenue projects for school-based health services; hospital-based and municipal projects for pregnant women, infants, and children; state services offered through youth services, child welfare, mental health, substance abuse, and public health agencies; and reimbursement systems for hospitals, long term care facilities, and community-based waiver programs. He has made presentations at national conferences on Medicaid waiver programs and participated in the development of a manual on self-determination under waiver programs for the Robert Wood Johnson Foundation.
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