Louisiana implements Medicaid expansion

On June 1, 2016, Louisiana became the 31st state to implement Medicaid expansion under the Affordable Care Act (ACA). Louisiana has obtained federal approval to use pre-existing data from its Supplemental Nutrition Assistance Program (SNAP) to adjudicate Medicaid eligibility in real time, both at initial Medicaid enrollment and upon re-enrollment; it is the first State to have won such approval via a Medicaid plan amendment rather than time-limited federal waivers. [More]

HHS finalizes ACA non-discrimination rules

On May 18, 2016, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), finalized rules in the Federal Register on non-discrimination under federally-funded health care programs and activities. The final rules implement section 1557 of the Affordable Care Act (ACA), which broadly prohibits discrimination based on race, color, national origin, sex, age, or disability, in order to advance health care equity and reduce health care disparities. The final rules reflect OCR’s evaluation of 24,875 public comments on proposed rules that were published on September 8, 2015. [More]

PCG provides program validation for innovative pay-for-success program aimed at reducing recidivism

In 2012, the Commonwealth of Massachusetts launched a pay-for-success program aimed at reducing recidivism among juvenile and adult offenders while improving the lives of hundreds of high-risk young men, saving taxpayer dollars, and strengthening communities. Referred to as the Massachusetts Juvenile Justice Pay for Success Project, this program was the third large-scale implementation of a pay-for-success model according to a Harvard Business School (HBS) case study entitled, “Massachusetts Pay for Success Contracts: Reducing Juvenile and Young Adult Recidivism.” [More]

Supreme Court returns ACA contraceptive cases to lower courts in hope of compromise resolution

In an opinion issued on May 16, 2016, the U.S. Supreme Court remanded to the lower courts challenges by a number of nonprofit religious organizations to the contraceptive coverage requirement contained in the Affordable Care Act (ACA).

Without expressing any “view on the merits of the case,” the Supreme Court vacated and sent back the cases to the Courts of Appeal indicating the possibility of the parties reaching a compromise, based upon supplemental briefs that were ordered to be submitted. The action was viewed as an attempt to avoid a 4-4 split decision by the Supreme Court, which would result in different outcomes in different states. [More]

SME moderates important child welfare panel

On May 17, American Enterprise Institute (AEI) hosted a conference, “Preventing harm to children through predictive analytics,” focused on examining predictive analytics in child welfare. PCG Subject Matter Expert (SME) Judge James Payne (Human Services – Indianapolis) moderated the first of two panels during AEI’s conference. [More]

U.S. District Court Judge rules in favor of the House against Administration’s funding of subsidies under the ACA

On May 12, 2016, Federal District Court Judge Rosemary M. Collyer of the District of Columbia District ruled in favor of the House of Representatives in its challenge against the Obama administration’s funding of subsidies under the Affordable Care Act (ACA). Judge Collyer ruled that Congress had not provided specific authority for the U.S. Department of Health and Human Services (HHS) to fund the subsidies provided under section 1402 of the ACA, which are intended to assist low-income individuals to pay for insurance premiums for coverage acquired under the exchanges. [More]

Final Medicaid managed care rules issued

Nearly a year after releasing its proposed overhaul of the regulations governing Medicaid and Children’s Health Insurance Program (CHIP) managed care, the Centers for Medicaid and Medicare Services (CMS) issued the final version of the regulations last week. In addition to their sweeping impact, these rules are particularly meaningful as the first major changes to the Medicaid and CHIP managed care rules since 2002. [More]