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U.S. District Court judge blocks NH Medicaid work requirements
On July 29, 2019, U.S. District Court Judge James E. Boasberg, D.C., held that work requirements intended to go into effect in New Hampshire could not be implemented because of a failure to adequately consider the effect on Medicaid coverage. Judge Boasberg previously blocked work requirements sched...
/news-perspectives/us-district-court-judge-blocks-nh-medicaid-work-requirements/Federal district court judge upholds Trump administration rule expanding use of short-term health plans
On Friday, July 20, 2019, U.S. District Court Judge Richard J. Leon in Washington, D.C. ruled that the expansion of short-term health plans by the Trump administration caused “minimal” difficulty and found that their “benefits are undeniable.” The expansion permits short-term health insurance plans ...
/news-perspectives/federal-district-court-judge-upholds-trump-administration-rule-expanding-use-of-short-term-health-plans/Taking the initiative with PCG Cares in May
To keep up the great momentum so far this year, PCG Cares teams in Asheville, Albany, Princeton, and Harrisburg took action in their local communities by helping those in need this May. Read on for a selection of our volunteer involvement for the month. PCG Cares Asheville joined the American Red Cr...
/news-perspectives/taking-the-initiative-with-pcg-cares-in-may/PCGer appointed to National APSE Board of Directors
A member of PCG’s Human Services team, Maya Cox, has been appointed to the national 2019-2020 Board of Directors for the Association of People Supporting Employment First (APSE), the only national membership organization focused exclusively on integrated employment. Through advocacy and education, A...
/news-perspectives/pcger-appointed-to-national-apse-board-of-directors/U.S. Supreme Court agrees to hear case concerning risk corridors under the Affordable Care Act
On Monday, June 24, 2019, the U.S. Supreme Court agreed to hear the case involving risk corridors for insurance companies under the Affordable Care Act (ACA). A provision of the ACA established these so-called risk corridors, whereby the federal government would control gains and losses of insurance...
/news-perspectives/us-supreme-court-agrees-to-hear-case-concerning-risk-corridors-under-the-affordable-care-act/Reasonable Efforts – It’s Time to Review and Reconsider
“Reasonable efforts” is a term that has existed for decades in child protective services, though its interpretation has changed drastically over the years resulting in widely different and often contradictory conclusions. Factors such as the economic times, different organizational structures, budge...
/news-perspectives/reasonable-efforts-it-s-time-to-review-and-reconsider/Coding Training and Compliance Review Services
Coding and documentation requirements, along with compliance regulations, change all too frequently. To keep our clients abreast of changes in coding, documentation, and compliance, PCG has developed a series of training and compliance tools that can be tailored to meet your needs. Our team includes...
/health/for-state-health-medicaid-agencies/coding-training-and-compliance-review-services/Institutional Rate Setting and Support
Institutional Rate Setting Services and Support Services Institutional services, such as inpatient and outpatient hospital, skilled nursing facility, and nursing facility services are a significant spend and driver of healthcare costs. Medicaid and other state agencies need, and should adopt, paymen...
/health/for-state-health-medicaid-agencies/institutional-rate-setting-and-support/Physician Services Supplemental Payment Strategies
Physician Upper Payment Limit (UPL) Supplemental Payment Strategies Medicaid agencies across the country grapple with ensuring sufficient access to primary, specialty, and dental care services to the Medicaid population. By implementing a Physician Medicaid Supplemental Payment strategy, Medicaid ag...
/health/for-state-health-medicaid-agencies/physician-services-supplemental-payment-strategies/Third Party Administrator Services
Third Party Administrator (TPA) Services PCG serves as an expert and trusted third party administrator (TPA) providing end to end claims processing services and solutions on behalf of government agencies and health plans. Our team works with Medicare and Medicaid health plans, as well as other gover...
/health/for-state-health-medicaid-agencies/third-party-administrator-services/