Category: Health Policy News

Health Policy News March 2017

The primary focus of this month’s edition of Health Policy News is the recently-introduced American Health Care Act. The bill has received much attention in D.C. and nationwide as it moves quickly through the U.S. House of Representatives. To help you understand what the bill would mean for private health insurance and Medicaid going forward, PCG ...

Health Policy News February 2017

PCG subject matter experts are working hard to keep up with the fast-moving action related to the Affordable Care Act (ACA), Medicaid, Medicare, prescription drug pricing, and other topics under debate at the federal level, as we are sure our readers are as well. Health Policy News seeks to be a source of reliable information ...

Health Policy News December 2016

With the end of 2016 and the change in administration fast approaching, it is no surprise we are seeing a flurry of activity and discussion across the health policy landscape. As state regulators and policy-makers, current and future Federal health care policy reforms directly affect your day to-day-operations and we hope to assist you by ...

Health Policy News September 2016

Today’s special edition of Health Policy News focuses on the Proposed Notice of Benefit and Payment Parameters (NBPP) for 2018 issued by the Centers for Medicare & Medicaid Services (CMS) on August 29th. PCG subject matter experts are hosting a webinar about the proposed regulations tomorrow, Thursday, September 15th at 3:00pm EST. See below for information ...

Health Policy News August 2016

As states across the country prepare for another year of open enrollment for the health insurance marketplace, they must assess the past three years of operation while adjusting to the changes brought on by evolving federal regulations. This issue of Health Policy News touches upon efforts being made at both the state and federal level ...

CMS releases report on Affordable Care Act (ACA) health insurers’ payment trends

The Centers for Medicare and Medicaid Services (CMS) released a report on August 11, 2016, entitled, “Changes in ACA Individual Market Costs from 2014 to 2015: Near-Zero Growth Suggests an Improving Risk Pool.” The report states that per member per month (PMPM) paid claims for health insurers in the individual market under the Affordable Care ...

Health Policy News June 2016

The Centers for Medicare and Medicaid Services (CMS) announced a new grant opportunity for states last week.  State insurance regulators across the country are eligible to apply for funding to support planning and implementation of health insurance market reform provisions of the Affordable Care Act (ACA). The first article in this edition of Health Policy ...

Alabama’s Regional Care Organization 1115 waiver approval

In May 2013, Act-2013-261, Ala. Code §§ 22-6-150 was passed, advancing the move from a fee-for-service (FFS) system to a managed care program. According to the Alabama Medicaid Advisory Board report issued in January 2013, based on 2011 data, 22 percent of Alabama’s population was Medicaid eligible for a portion of the year.  Additionally, Alabama’s ...

Innovative approaches to Medicaid expansion within the Medicaid managed care delivery system

Much attention has been paid to innovative approaches to coverage of the Medicaid expansion population that leverage the private commercial insurance market for coverage through “premium assistance” programs.  However, other states have turned to the Medicaid managed care delivery system as the vehicle for implementing innovative coverage designs for the newly eligible population.  As outlined ...