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Provider Management and Program Integrity
Each year, hundreds of millions of Medicaid dollars go to personal care services, home health, community behavioral health, hospice, non-emergency transportation, and other in-home care services. Managing these services – and their providers – requires a unique and innovative approach that is not tr...
/health/for-state-health-medicaid-agencies/provider-management-and-program-integrity/Provider Screening and Onsite Visits
Did You Know? Did you know your site visit program could be managed externally and fully funded at no cost to the state? Keeping a pulse on providers is vital, yet challenging for many states . A lack of time, personnel, and adequate resources are common barriers in the development of a comprehensiv...
/health/for-state-health-medicaid-agencies/provider-management-and-program-integrity/provider-screening-and-onsite-visits/Delivery System Reform, Performance Management, And Quality Improvement
PCG provides Medicaid departments expertise in reducing cost and improving program quality across several major Medicaid reform efforts enabled through Section 1115 Waiver authority. Learn more about our current program work in New Jersey, Massachusetts, and New York below. New Jersey Beyond managin...
/health/for-state-health-medicaid-agencies/delivery-system-reform-performance-management-and-quality-improvement/Delivery System Reform, Performance Management, And Quality Improvement
PCG provides Medicaid departments expertise in reducing cost and improving program quality across several major Medicaid reform efforts enabled through Section 1115 Waiver authority. Learn more about our current program work in New Jersey, Massachusetts, and New York below. New Jersey Beyond managin...
/health/for-provider-organizations/delivery-system-reform-performance-management-and-quality-improvement/Recently proposed JOBS Act could signal coming TANF reforms
Momentum has been building for several years to reform the Temporary Assistance for Needy Families (TANF) program, and many consider the recently proposed Jobs and Opportunity with Benefits and Services for Success (JOBS) Act to be an indicator of coming reforms. The House Ways and Means committee r...
/news-perspectives/recently-proposed-jobs-act-could-signal-coming-tanf-reforms/CMS Releases Final Exchange Guidance
On April 9, 2018, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited final Exchange guidance for the 2019 plan year – the final Notice of Benefit and Payment Parameters for 2019 (NBPP) and the final Letter to Issuers in the Federally-facilitated Exchanges (Letter). Toge...
/news-perspectives/cms-releases-final-exchange-guidance/A look back at major developments in health policy during 2017, and a preview of 2018
In the following roundup, PCG health policy subject matter experts reflect upon major policy shifts and changes that have occurred in 2017, as well as preview policy developments expected in 2018. With major announcements that will affect 2018 just within the past couple of months, our subject matte...
/news-perspectives/a-look-back-at-major-developments-in-health-policy-during-2017-and-a-preview-of-2018/The latest news from D.C.
Following the failure in the Senate to pass various legislative proposals – the Better Care Reconciliation Act (the Senate version of repeal and replace), the straight repeal option , or the “skinny repeal” bill – last week, Senate leadership has continued to say that they are moving on to other age...
/news-perspectives/the-latest-news-from-dc/Developments in Section 1332 State Innovation Waivers
Progress has continued on state efforts to secure Section 1332 State Innovation Waivers. Oregon submitted a waiver application at the end of August, seeking support for a state-based reinsurance program, and that application has since been determined complete. Iowa submitted two recent updates to it...
/news-perspectives/developments-in-section-1332-state-innovation-waivers/Balance billing – a new report on recent efforts by state
PCG subject matter experts recently completed a survey report entitled “Balance Billing: Report of Recent Efforts to Protect Consumers . ” The practice of balance billing is historically commonplace, but increased scrutiny on rising out of pocket health care costs is driving efforts to provide great...
/news-perspectives/balance-billing-a-new-report-on-recent-efforts-by-state/