CMS proposes changes to Medicare ACO rules

On February 3, 2016, the Centers for Medicare and Medicaid Services (CMS) proposed regulations in the Federal Register on Medicare payments to accountable care organizations (ACOs) under the Medicare “shared savings” program (MSSP), which currently includes 434 ACOs, serving 7.7 million Medicare beneficiaries nationwide. Under the MSSP, Medicare Part A and Part B fiscal intermediaries and carriers pay ACOs on a traditional, fee-for-service basis. An ACO may qualify for a “shared savings” bonus if the ACO achieves CMS-specified Medicare savings targets while meeting CMS-specified quality of care performance metrics. [More]

Workforce expert: Healthcare jobs will change but the field remains 'hands on'

RALEIGH, N.C. — Healthcare workers are hardly immune from the threat of a jobless future as being explored in this week's Emerging Issues Forum "Future Work" conference. But as one of the speakers explains opportunities will remain available for humans in healthcare.

Ahead of the Institute for Emerging Issues event, WRAL TechWire sought analysis about how technology continues to disrupt the healthcare industry and what workers today and tomorrow can do to better prepare themselves for future jobs.

Reg Javier is associate manager of Boston-based Public Consulting Group. He will be speaking on Tuesday.

"Automated records have made file clerk jobs all but disappear," Javier explained. "All across the professional continuum, healthcare now requires tech competency. [More]

Supreme Court rules mandatory life sentences for juveniles unconstitutional

Last week, advocates for youth involved with state juvenile justice systems celebrated when the United States Supreme Court ruled it unconstitutional for people to serve mandatory life sentences in prison for crimes of murder committed as children. The high court made retroactive a 2012 ruling that banned mandatory life sentences without parole for juveniles. Justice Anthony Kennedy stressed that “the decision to impose life without parole should never be invoked.” Youth should be able to contemplate the possibility of a life on the outside again. The issue was brought forth by the Juvenile Law Center in Philadelphia. [More]

CMS finalizes new Medicaid drug reimbursement rules

On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published final regulations in the Federal Register on Medicaid upper payment limits (UPLs) for covered outpatient drugs, as well as rebates that drug manufacturers must provide to states. State Medicaid agencies must take into account “average manufacturers’ prices” (AMPs) and other factors in calculating state Medicaid payments for covered outpatient drugs and dispensing fees to pharmacies that purchase medications, usually from wholesalers. Based on data in reports generated by state Medicaid agencies, drug manufacturers must calculate rebates to states under methods specified in the rule. [More]

States risk penalties for failing to meet data reporting requirements

PCG has an opportunity to counsel state Health and Human Services departments on how to reduce the financial risks of failing to meet extensive reporting requirements of the National Youth in Transition Database (NYTD).

Following the establishment of the John H. Chafee Foster Care Independence Program (CFCIP) at section 477 of the Social Security Act (SSA), the Administration for Children and Families (ACF) established requirements for allowing states to issue for the benefit of qualified youth a Chafee Foster Care Independent Living grant. [More]

Massachusetts Health Policy Commission issues 2015 Cost Trends Report

On January 20, 2016, the Massachusetts Health Policy Commission issued its “2015 Cost Trends Report,” pursuant to Chapter 224 of the Acts of 2012. The report contains comprehensive data on the Commonwealth’s health care spending across all private and public payers, detailed analyses of multi-year spending trends, and key insights about the strengths and weaknesses of the health care delivery system across Massachusetts’ communities. [More]

CMS and ONC update health IT goals

On January 19, 2016, the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) released a joint statement which defines guiding principles on promoting “meaningful use” of electronic health records (EHRs) for purposes of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). [More]

California child well-being report card released

On January 7, 2016, Children Now, a nonprofit children’s advocacy group, published a report card outlining the well-being and health of California’s 9 million children, 12 percent of the nation’s entire child population. Focusing on three areas of child well-being (education, health, and child welfare), the “2016 California Children’s Report Card” revealed mix results, from an ‘A-‘ for “health insurance” to a ‘D-‘ for “childhood trauma and resiliency.” [More]

Draft 2017 letter to issuers in the Federally-facilitated marketplaces

On December 23, 2015, the Center for Consumer Information and Insurance Oversight (CCIIO) and the Centers for Medicare & Medicaid Services (CMS) released the draft 2017 Letter to Issuers in the Federally-facilitated Marketplaces to provide issuers seeking to offer qualified health plans in the Federally-facilitated Marketplaces or the Federally-facilitated Small Business Health Options Programs with operational and technical guidance to help them successfully participate in those Marketplaces. [More]