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Gilead strikes back in HCV price war
BioCentury
Gilead Sciences Inc. has fired back in the HCV price war. CVS Health Corp. recently announced that it would give exclusive formulary status to Gilead's HCV drugs Harvoni ledipasvir/sofosbuvir and Sovaldi sofosbuvir, effective Jan. 7. The deal covers all HCV genotype 1 patients across a broad range of formularies serviced by the pharmacy benefits manager, including its CVS/Caremark Standard Commercial formulary as well as its state marketplace exchange, Medicare Part D and Medicaid formularies.
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Medicare, Medicaid to loom large in 2015 on Capitol Hill and in many states
Inside Health Policy (Subscription required)
Medicare and Medicaid reform issues are expected to loom large this year on Capitol Hill and in many states. Congress' short-term Medicare physician payment patch ends after March, and funding for the Children's Health Insurance Program runs out Oct. 1. Legislation to avoid those pitfalls, especially physician payment cuts driven by the Sustainable Growth Rate formula, could be vehicles for other Medicare and Medicaid reforms, including bills on hospital reimbursement, anti-fraud reforms and funding for graduate medical education. New House Ways & Means Chair Paul Ryan had a history of pushing major Medicare and Medicaid reforms in his former position of Budget Committee chair, and now he is better placed to achieve those goals, likely within budget reconciliation.
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Cantor: GOP focus on Obamacare would be 'disservice'
The Hill
Former House Majority Leader Eric Cantor said that a GOP focus on highly politicized issues like Obamacare and immigration in 2015 would be a "disservice to the American people." Cantor, who fell from power this summer after a shocking primary defeat, said Republicans needed to stop playing politics and instead focus on growing the economy if they wanted to keep the White House within reach in 2016.
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GOP legislators thwart bids to expand Medicaid
The Associated Press via Yahoo News
Governors across the political spectrum are hitting a roadblock in their bids to expand Medicaid with federal funds: Republican legislators who adamantly oppose Obamacare. While some of these governors themselves have criticized the president's healthcare law in general, they've come to see one component — Medicaid expansion — as too generous to reject. But they're battling conservative lawmakers who say it's better to turn down billions of federal dollars than to expand Medicaid under the 2010 law.
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Republicans in state governments plan juggernaut of
conservative legislation

The Washington Post
Legislators in the 24 states where Republicans now hold total control plan to push a series of aggressive policy initiatives in the coming year aimed at limiting the power of the federal government and rekindling the culture wars.
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As Medicaid rolls swell, cuts in payments to doctors threaten access to care; MHPA comments
The New York Times
Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care.
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Medicaid's western push hits Montana
Kaiser Health News
The Affordable Care Act is on the move in western states, with the governors of Utah, Wyoming and Montana all working to hammer out deals with the Obama administration to expand Medicaid in ways tailored to each state. But getting the federal stamp of approval is just the first hurdle; the governors also have to sell it to their legislatures who have their own ideas of how expansion should go.
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Arizona governor dealt legal blow over Medicaid expansion plan
Los Angeles Times
Arizona Gov. Jan Brewer was dealt a significant legal defeat Wednesday when the Arizona Supreme Court ruled that a lawsuit challenging her controversial Medicaid expansion plan could move forward.
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Could Texas win block Medicaid grant from feds?
The Associated Press via San Antonio Express-News
The White House's signature health care law is loathed by Texas' political leadership, and the idea of expanding Medicaid likely remains a non-starter when the Legislature reconvenes this month. But Gov.-elect Greg Abbott and many top conservatives support working with Washington to devise a federal block grant that would allow the state to remake Medicaid, a joint state-federal program that provides health care for the poor and disabled. Such an agreement could also earn Texas much of the up to $10 billion in annual subsidies that would have otherwise come via Medicaid expansion.
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Obamacare slaps states with $15 billion in new costs
Forbes
Thirty-six states that rely on private managed care programs to provide medical services to all or some of their Medicaid recipients are facing an added Obamacare tax. According to a report by Milliman consulting actuaries, states that contract with Medicaid managed care plans face up to $15 billion in added costs over 10 years for their share of the law's tax on private health insurance.
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How Obamacare is affecting health insurance enrollment
Modern Healthcare
Obamacare has expanded health insurance to millions of Americans, and the latest enrollment data show that the individual and managed Medicaid markets have ballooned the most over the past year.
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Jan. 14 Webinar Wednesday: 'Integrated Health Care: Physical and Behavioral Care Delivery Models' | 3 p.m. ET
Deloitte Consulting LLP
More state Medicaid agencies are continuing to move towards integration of physical health/behavioral health medical services. This move typically involves complete integration via a carve-in program or partial integration/stronger coordination in a carve-out program. Increasingly, health plans need to adapt to physical health/behavioral health integration state requirements in order to continue to contract with the state.
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MHPA's Myers to chair WHCC 4th Annual Medicaid and Medicare Reform Summit | March 2015 | Washington, DC
World Congress
MHPA President and CEO Jeff Myers will chair the WHCC 4th Annual Medicaid and Medicare Reform Summit, a meeting that convenes executives from health plans, hospital systems and policy organizations to share, learn and discuss approaches to improve the quality of government programs and achieve payment and delivery reform. For conference details, agenda and registration, please visit here.
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MHPA's Myers to speak at 6th Annual Medicaid Innovations 2015 Forum | Feb. 3-5, 2015 | Orlando
Medicaid Innovations Forum
Join MHPA President and CEO Jeff Myers at the Sixth Annual Medicaid Innovations 2015 Forum in February 2015. This meeting offers a unique combination of forward-thinking perspectives including first-hand case studies and examples of true innovation from both Medicaid managed care plans and state government agencies. The forum, which gathers hundreds of representatives from states, health plans and solution providers in one room, goes beyond policy to explore the specific strategies these organizations are leveraging to improve quality of care, reduce costs and position themselves for success in serving the rapidly expanding Medicaid population. Use Discount Code MHPA200 to receive $200 off the current rate.
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Job opportunity: Clinical director, Homecare & Managed Care
First Quality
First Quality, a leading manufacturer of disposable home health care products, is seeking a clinical director for our Homecare & Managed Care Business. This candidate will provide leadership and have a focus on clinical education, utilization management protocols and programs and operational program development within home care and managed care markets.
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