CMS Releases Final ACO Rules

The Centers for Medicare and Medicaid Services (CMS) issued final rules on October 20 on accountable care organizations (ACOs), the centerpiece of the Medicare “shared savings” program to be launched next year under section 3022 of the Affordable Care Act (ACA). CMS estimates that as many as 270 ACOs could be formed over the next three years, replicating models pioneered by distinguished medical organizations such as the Mayo Clinic (Minnesota), the Cleveland Clinic (Ohio), Intermountain Healthcare (Utah and Idaho), and the Geisinger Health System (Pennsylvania). [More]

Applicants Vie for Awards in the Second Round of the i3 Competition

According to U.S. Department of Education (ED) data, 587 applicants are vying for awards in the second round of the Investing in Innovation (i3) competitive grant program. Under the 2009 American Recovery and Reinvestment Act (ARRA), $650 million was allocated for i3 awards in 2010 and, in the fiscal 2011 budget, Congress appropriated an additional $150 million for second round of i3 awards in 2011. ED’s website states that the purpose of the i3 program is to provide competitive grants to applicants with a record of improving student achievement and attainment in order to expand the implementation of, and investment in, innovative practices that are demonstrated to have an impact on improving student achievement or growth, closing achievement gaps, decreasing dropout rates, increasing high school graduation rates, or increasing college enrollment and completion rates. [More]

HHS Suspends CLASS Implementation

The U.S. Department of Health and Human Services (HHS) notified Congress on October 14 that it does not plan to implement the Community Living Assistance Services and Supports (CLASS) program under Title VIII of the Affordable Care Act (ACA). CLASS was to be financed entirely through employees’ payroll deductions on a voluntary basis (automatic enrollment with an opt-out) scheduled to begin in 2012. After a minimum five-year vesting period, individuals who had paid CLASS enrollment premiums could qualify for cash benefits to help them purchase non-medical services and supports that they might need in the future to remain in their own homes (versus confinement in nursing homes) following the onset of functional limitations due to illness, disability, or old age. [More]

Legislation for Improving Educational Outcomes for Foster Care Children

This week the Senate Health, Education, Labor and Pensions (HELP) Committee will commence the long-awaited overhaul of the Elementary and Secondary Education Act (ESEA), otherwise known as No Child Left Behind. In the ESEA, there is an amendment that is critically important to students in foster care. This group of students is significantly impacted by its status as foster children. The majority of foster children – 67 percent – are of school age. Research related to foster children’s education demonstrates that academic performance is significantly impacted by effects of abuse and neglect, detachment and abandonment issues, placement disruptions, as well as many of other factors. [More]

The Senate’s Proposed Overhaul of NCLB Sparks Controversy over Accountability

In an October 17, 2011 press release, U.S. Senate Democrat and Republican leaders announced their agreement to move forward with comprehensive bipartisan legislation to overhaul the No Child Left Behind Act (NCLB), also known as the Elementary and Secondary Education Act (ESEA). The proposed legislation would eliminate measuring accountability through adequate yearly progress (AYP), allow more flexibility in student testing, and call for strong federally-mandated interventions in only the 5% lowest-performing schools and the 5% of schools with persistent achievement gaps. According to some advocacy groups, the changes in accountability would be detrimental to the education of students with disabilities, English language learners, and economically disadvantaged students. [More]

OIG Releases FY 2012 Audit Work Plan

The Office of the Inspection General (OIG) of the U.S. Department of Health and Human Services released its FY 2012 audit work plan on October 5. New audit priorities for FY 2012 under the Medicaid program include reasonableness of payment rates for state-operated facilities, supplemental payments to public providers, provider taxes, overpayment reporting and collection, completeness and accuracy of managed care organizations’ encounter data, and states’ implementation of quality of care safeguards under home and community-based services waivers. [More]

States Demonstrate Strong Interest in New Pilot Programs for Medicare/Medicaid Dual Eligibles

The Centers for Medicare and Medicaid Services (CMS) announced on October 11 that 37 states and the District of Columbia have submitted letters of intent to participate in pilot programs to test new payment and service delivery models designed to coordinate care for Medicare/Medicaid “dual eligibles.” CMS asked state Medicaid directors on July 8 to provide letters of intent by October 1. CMS will test a new capitation model, using a three-way contract among states, CMS, and health plans to offer integrated Medicare-Medicaid benefits to such individuals. [More]

Institute of Medicine Releases Report on Benefits Design under Health Care Reform

The Institute of Medicine (IOM) released a report on October 6 offering recommendations to the U.S. Department of Health and Human Services (HHS) on developing the definitions of “essential health benefits” that qualified health plans will offer through Exchanges under section 1302 of the Affordable Care Act (ACA). The ACA requires such plans to cover at least ten categories of diagnostic, preventive, and therapeutic services. HHS must further define each of those ten categories and periodically update its definitions. [More]

National Event Highlights High Schools’ Need for Postsecondary Education Data

On October 5, 2011 College Summit and the Data Quality Campaign co-hosted a Washington, D.C. event highlighting the need for more postsecondary education data and the progress states have made in meeting that need. According to an October 6th article in Education Week online, congressional representatives from both sides of the aisle, educators, and non-profit leaders participated in the event and discussed the importance of using data to support the college- and career-ready component of the education reform agenda. [More]

House and Senate Introduce Versions of Stop Child Abuse in Residential Programs

The Government Accountability Office (GAO) did a review of thousands of allegations of child abuse and neglect at residential programs housing mostly teenagers since the early 1990s. Tragically, in a number of cases, this abuse/neglect resulted in the death of a child. To address this issue, the “Stop Child Abuse in Residential Programs for Teens Act of 2011” was introduced. Thousands of children and youth are housed in private and public residential programs, including boarding schools, wilderness camps, boot camps, and behavior modification facilities aimed at addressing behavioral, emotional, mental health, and substance abuse issues. [More]