Tuesday, July 31, 2012
Monday, July 30, 2012
Friday, July 27, 2012
Thursday, July 26, 2012
Wednesday, July 25, 2012
Tuesday, July 24, 2012
Monday, July 23, 2012
Friday, July 20, 2012
Thursday, July 19, 2012
Wednesday, July 18, 2012
Tuesday, July 17, 2012
What's A Governor To Do With The Health Care Law? GPB
Sun., July 15, 2012 6:15am (EDT)
What's
A Governor To Do With The Health Care Law?
By Julie Rovner GPB
As governors from around the country meet this weekend in
Williamsburg , Va.
Republican governors in particular said they were genuinely surprised by the Supreme Court ruling. The justices declared the health law in general constitutional, but gave states the option of whether or not to dramatically expand their Medicaid programs. They'll now get to choose whether to put most people who earn more than about $15,000 a year on the program or not.
"I think a lot of us, certainly on the Republican side, believed it would be found unconstitutional. So I think it's just added more confusion to the issue rather than settling the issue," said Utah Gov. Gary Herbert, "and probably more impetus on the November election to really find out and sort out what the implications are going to be going forward."
Indeed, the meeting's host, Virginia Gov. Bob McDonnell, said he wasn't planning to say yet whether his state would expand its Medicaid program, even with the federal government picking up the vast majority of the costs.
"Honestly, I don't think it's responsible fully for my state to make a decision now because there's still more information we need," he said.
Many Democratic governors see things differently, however, includingDelaware
"This is not political. This is a financial analysis of what does it mean to cover, in our case, an additional 30,000 people," he said, "and my view and we're clarifying that we're understanding it all properly ... is that this is absolutely a good deal forDelaware
Unlike Republicans, who say the Supreme Court decision confused matters, Democrats likeMaryland
"I think most governors understand that the Supreme Court's decision was a final and clear ruling," he said.
Other Democrats were less charitable.Vermont
"Have a spine. The American people are sick and tired of spineless politicians. [Either] say, 'I believe the Affordable Care Act is the wrong thing, so I will not take the loot,' or say, 'I believe the Affordable Care Act will help my state cover uninsured Americans, grow jobs, economic opportunities, and I'm taking the loot,' " Shumlin said. "But to say, 'I'm gonna criticize the plan, but I won't tell you whether I'm taking the loot or not until after the election,' that's what breeds cynicism among the American people."
O'Malley ofMaryland
"Once the posturing of the election is past, I think that a lot of these governors are going to have a hard time going home to their doctors, nurses, hospitals and explaining to them why they are passing up an opportunity to transform these dollars into better economic uses for job creation in their states," he said.
But for many Republican governors, likeNebraska
"They all say it's free federal money. No, it's not. That's our tax dollars," he says. "It's costing every one of us."
Behind the scenes at the meeting, however, governors did seem to agree on one thing. There are still lots of questions they want the federal government to answer about how they will all work together as the health law's implementation proceeds.
Republican governors in particular said they were genuinely surprised by the Supreme Court ruling. The justices declared the health law in general constitutional, but gave states the option of whether or not to dramatically expand their Medicaid programs. They'll now get to choose whether to put most people who earn more than about $15,000 a year on the program or not.
"I think a lot of us, certainly on the Republican side, believed it would be found unconstitutional. So I think it's just added more confusion to the issue rather than settling the issue," said Utah Gov. Gary Herbert, "and probably more impetus on the November election to really find out and sort out what the implications are going to be going forward."
Indeed, the meeting's host, Virginia Gov. Bob McDonnell, said he wasn't planning to say yet whether his state would expand its Medicaid program, even with the federal government picking up the vast majority of the costs.
"Honestly, I don't think it's responsible fully for my state to make a decision now because there's still more information we need," he said.
Many Democratic governors see things differently, however, including
"This is not political. This is a financial analysis of what does it mean to cover, in our case, an additional 30,000 people," he said, "and my view and we're clarifying that we're understanding it all properly ... is that this is absolutely a good deal for
Unlike Republicans, who say the Supreme Court decision confused matters, Democrats like
"I think most governors understand that the Supreme Court's decision was a final and clear ruling," he said.
Other Democrats were less charitable.
"Have a spine. The American people are sick and tired of spineless politicians. [Either] say, 'I believe the Affordable Care Act is the wrong thing, so I will not take the loot,' or say, 'I believe the Affordable Care Act will help my state cover uninsured Americans, grow jobs, economic opportunities, and I'm taking the loot,' " Shumlin said. "But to say, 'I'm gonna criticize the plan, but I won't tell you whether I'm taking the loot or not until after the election,' that's what breeds cynicism among the American people."
O'Malley of
"Once the posturing of the election is past, I think that a lot of these governors are going to have a hard time going home to their doctors, nurses, hospitals and explaining to them why they are passing up an opportunity to transform these dollars into better economic uses for job creation in their states," he said.
But for many Republican governors, like
"They all say it's free federal money. No, it's not. That's our tax dollars," he says. "It's costing every one of us."
Behind the scenes at the meeting, however, governors did seem to agree on one thing. There are still lots of questions they want the federal government to answer about how they will all work together as the health law's implementation proceeds.
CMS: No Deadline for States to Launch Medicaid Expansion
CMS: No Deadline for States to Launch Medicaid Expansion
By Jane Norman, CQ HealthBeat Associate
Editor
There’s no deadline for a state to tell the federal government whether or
not it plans to expand its Medicaid rolls under the health care law, Centers
for Medicare and Medicaid Services Acting Administrator Marilyn Tavenner wrote
state governors on Friday.
Tavenner also said a state can receive extra funding to help pay for
Medicaid Information Technology and exchange implementation even if it has not
yet decided whether it will expand Medicaid eligibility or run a state-based
exchange. “And if a state ultimately decides not to do so, it will not have to
pay those resources back,” Tavenner said in the letter to the chairmen of the
National Governors Association, Republican Governors Association and Democratic
Governors Association. The NGA begins a meeting today in Williamsburg , Va.
Administration officials had said on background earlier that there wouldn’t
be a deadline for states to inform the Department of Health and Human Services
of their intentions. But the letter from Tavenner represents the first official
statement.
The letter from Tavenner begins to answer some of the many questions that
states, the health care industry and policy experts have been raising since the
June 28 Supreme Court decision that upheld the health care law but said states
could opt out of the Medicaid expansion. Under the law, states will receive
federal funding to expand their programs to adults earning under 138 percent of
the federal poverty level.
About a half-dozen Republican governors have said they are opposed to the
Medicaid expansion, and others have hinted they are considering opting out.
Some Democratic governors have not yet stated a position.
Tavenner, in her letter, said that as states study their options, “they
will recognize this is a good deal” because the costs of the expansion will be
funded 100 percent by the federal government for the first three years, then
gradually phased down to a minimum of 90 percent in 2020 and thereafter.
“The hospitals will get paid for what would otherwise be uncompensated care
provided to uninsured patients,” she added. “Their local economies will benefit
and jobs will be created when their hospitals remain viable and their workers
remain healthy.”
She added: “We hope states will not turn down the resources and flexibility
offered in the Affordable Care Act and will put aside old political battles to
move forward with implementation.”
Deal: June revenue up 2.6 percent
Deal: June revenue up 2.6 percent
|
Friday,
July 13, 2012
|
|
Gov.
Nathan Deal reported today that the State of Georgia
Despite
softer than expected revenue collections at the end of the fiscal year,
positive year-over-year growth continued for the eighth consecutive quarter;
net revenues topped out at $4.3 billion for the fourth quarter compared to $4.1
billion last year.
The
following changes within the various tax categories led to the overall net
revenue increase in June:
Individual Income Tax: Individual Income Tax collections for June 2012 totaled $780.75 million, down from $782.5 million in June 2011— a decrease of ($1.75 million) or -0.2 percent.
Individual Income Tax: Individual Income Tax collections for June 2012 totaled $780.75 million, down from $782.5 million in June 2011— a decrease of ($1.75 million) or -0.2 percent.
The
following notable components within Individual Income Tax account for the
decrease:
• Individual Tax Return payments were up $14 million, or 77.5 percent
• Individual Tax Return payments were up $14 million, or 77.5 percent
•
Individual Income Tax refunds issued (net of
voided checks) were down ($9.5 million), or -16.4 percent
• All other Individual categories including Withholding payments were down a combined ($25.3 million)
• All other Individual categories including Withholding payments were down a combined ($25.3 million)
Sales
and Use Tax: Net Sales and Use Tax collections for June 2012 totaled $429
million, down from $439 million in June 2011— a decrease of nearly ($10
million), or -2.2 percent. The monthly Sales Tax Distribution to local
governments totaled $401.5 million, which was an increase of $35 million, or
9.6 percent, compared to last year.
Corporate
Income Tax: Corporate Income Tax collections for June 2012 rose by $43
million, or 38.7 percent, up from $111 million in June 2011 to $154 million in
FY2012.
The
following notable components within Corporate Income Tax make up the increase:
• Corporate Tax refunds issued (net of voided checks) were down ($31.5 million), or -70.5 percent
• Corporate Tax refunds issued (net of voided checks) were down ($31.5 million), or -70.5 percent
•
Corporate Tax Return payments were up $10.75
million, or 26.2 percent
•
All other Corporate Tax categories combined for
an increase of $0.75 million, or 0.75 percent
Department of Community Health Medicaid and CHIP Redesign Moves Forward
Department of Community Health Medicaid and CHIP Redesign
Moves Forward
|
Friday,
July 13, 2012
|
Contact:
Pamela A. Keene
|
“I
am very proud of the process we have used during this redesign initiative,”
said David A. Cook, commissioner of the Georgia Department of Community Health.
“As a result of our efforts, we will implement numerous initiatives to improve
services in a cost-effective manner. Even though increasing uncertainty in Washington
The
department will continue using a Care Management Organization (CMO) to service
the Low-Income Medicaid and PeachCare for Kids® populations in a full
risk-based managed care environment. The department will work to improve the
current program and incorporate many of the excellent ideas received from
stakeholders.
DCH
will also transition foster children to a single-designated CMO to achieve
greater continuity of care for this special population.
“This
is an opportunity that will greatly enhance our service to this vulnerable
population through better care coordination that simply does not exist today,”
Cook said.
In
addition to this initiative, the department will continue to utilize
information it gains from the redesign process. For example, the department
plans to improve Medicaid care by encouraging movement toward Patient-centered
Medical Homes.
Also,
DCH will utilize a value-based purchasing model. Value-based purchasing will
allow DCH to continuously improve the quality of care for members while
containing costs.
Another
initiative will create a centralized web portal that will reduce administrative
burdens and make it easier for providers to serve their patients. Specifically
the portal will give health care providers more comprehensive, accurate and
up-to-date information about their members and their medical history,
streamline their credentialing process, present key performance metrics, and
align the metrics with areas of improvement.
A
final initiative will create a Common Pharmacy Preferred Drug List that will
simplify the program and reduce administrative burdens on providers.
DCH
will continue moving forward with its Home- and Community-based Services
Rebalancing initiatives. This rebalancing will encourage the delivery of
patient care to home- and community-based settings rather than skilled nursing
facilities. The result will be improved care in the least restrictive setting
at a cost that is less than or equal to the cost of placing a patient in a
skilled nursing facility.
“The
redesign process has been a great benefit for the department,” Cook added. “It
has allowed us to start a meaningful dialogue with the health care community,
take a comprehensive look at options, receive recommendations on improvements,
and solicit feedback on numerous ideas. We will continue the process as we look
at more ways to improve Georgia
After
several months of in-depth analysis, the department concluded that the current
health care environment is so volatile that acting now with a full redesign
would not serve the best interests of all Georgians.
The
fallout from the recent U.S. Supreme Court’s decision on the Affordable Care
Act as well as the potential impact of the November elections contributed to
the uncertainty. There is also a great deal of unpredictability about
Medicaid funding as a result of federal budget talks scheduled to take place
later this year.
Moreover,
substantial uncertainty exists about how states might replace the loss of
federal Upper Payment Limit funding if they moved toward greater managed care.
While waivers to offset the loss of that funding are possible, it takes nearly
a year to get through the federal waiver process and by then the current waiver
system could prove unnecessary.
In
addition, an increasing number of influential national leaders are proposing to
give every state a waiver from the Affordable Care Act. These leaders have
expressed support for a block grant system of funding, which would eliminate
the cumbersome waiver system currently in place.
“Although
we are not moving forward with a full redesign at this time, this process has
been invaluable and it will continue,” Cook concluded.
DCH scraps plans to restructure Medicaid because of ‘uncertainty’
DCH scraps plans to
restructure Medicaid because of ‘uncertainty’
By Tom Crawford | Published: July 13, 2012
The Department of Community Health (DCH) announced Friday it
is dropping its plans to restructure the Medicaid and PeachCare health
insurance programs that serve low-income Georgians.
DCH Commissioner David Cook cited the “uncertainty”
overhanging the Medicaid program as a result of the June 28 Supreme Court
decision that upheld the constitutionality of the federal Affordable Care Act
(ACA).
In a statement released Friday morning, DCH said:
The fallout from the recent U.S. Supreme Court’s decision on
the Affordable Care Act as well as the potential impact of the November
elections contributed to the uncertainty. There is also a great deal of
unpredictability about Medicaid funding as a result of federal budget talks
scheduled to take place later this year.
Moreover, substantial uncertainty exists about how states
might replace the loss of federal Upper Payment Limit funding if they moved
toward greater managed care. While waivers to offset the loss of that funding
are possible, it takes nearly a year to get through the federal waiver process
and by then the current waiver system could prove unnecessary.
DCH committed more than $3 million for consulting services
and has been working for nearly a year on a comprehensive restructuring of the
Medicaid program.
The Navigant consulting firm recommended that DCH retain the
current managed care model that includes the majority of Medicaid patients but
expand it to include the aged, blind and disabled population. Navigant also
said the department should move some Medicaid participants into a “commercial”
model of health insurance coverage.
DCH said it will continue to use the current system in which
three care management organization (CMOs) contract with the agency to
administer Medicaid and PeachCare to a large portion of the programs’
participants.
“As a result of our efforts, we will implement numerous
initiatives to improve services in a cost-effective manner,” Cook said. “Even
though increasing uncertainty in Washington
would make a full Medicaid redesign imprudent at this time, it is important
that we focus on what we can do to provide better service.”
In voting to uphold the Affordable Care Act, the Supreme
Court also ruled that states have the option as to whether they will expand
Medicaid coverage to persons making up to 133 percent of the federal poverty
level. That would add an estimated 650,000 persons to Georgia ’s
Medicaid rolls.
Under the provisions of ACA, the federal government will pay
100 percent of the costs of Medicaid expansion for the first three years and 90
percent of the costs thereafter.
Gov. Nathan Deal opposes the Affordable Care Act and
contends the state cannot afford to expand Medicaid coverage to an additional
650,000 people.
Shortly after the Supreme Court decision was handed down,
Deal said he will wait to see if voters elect a Republican president and
Republican-controlled Congress in November that would repeal the healthcare act
and make Medicaid expansion a moot point.
Thursday, July 12, 2012
Tuesday, July 10, 2012
Monday, July 9, 2012
Sunday, July 8, 2012
5010 Enforcement Begins on July 1, 2012 - DCH Newsletter
5010 Enforcement Begins on July 1, 2012
After a series of CMS-ordered postponements, enforcement of the use of Version 5010 electronic standards for all HIPAA-covered entities will begin on July 1, 2012. As of that date, electronic claims must be filed in the 5010 version.
“Georgia Medicaid has been processing claims using 5010 since the original compliance date of January 1, 2012,” said Sonny Munter, chief information officer for the Georgia Department of Community Health. “At this point, there are very few providers who are not compliant. And as a bonus we’re able to process claims more quickly with the new system.”
Some of the changes that may affect claims processing are:
• ZIP Code + plus 4
• Service location cannot be a P.O. Box
• Billing address cannot be a P.O. Box
For more information, contact the HP Enterprise Services’
Customer Service Call
Center
Thursday, July 5, 2012
Monday, July 2, 2012
Subscribe to:
Posts (Atom)