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FierceHealthcare
Insurers voiced their support Monday for a Centers for Medicare & Medicaid Services proposal that would allow states more flexibility in determining the network adequacy of their Medicaid managed care providers.
But they raised concerns about changes in that proposal that would make technical changes in federal rate setting standards they said could be inconsistent with actuarial soundness requirements and ultimately result in Medicaid managed care plans having inadequate resources.
Medicaid Health Plans of America (MHPA) pointed to a change that would require rate ranges must conform to a number of parameters including an upper bound rate range that does not exceed the lower bound by 5 percent. MHPA suggests this range should be narrower. "We are concerned that without further guardrails this proposal could lead to rate levels that are actuarially unsound when used in competitive bidding situations," MHPA officials wrote in their comments.
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Politico
The Trump administration is quietly devising a plan bypassing Congress to give block grants to states for Medicaid, achieving a longstanding conservative dream of reining in spending on the healthcare safety net for the poor.
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The Hill
The House Oversight and Reform Committee is launching a sweeping investigation into the prescription drug industry's pricing practices, a major priority of new Chairman Elijah Cummings (D-Maryland).
Cummings sent letters to a dozen different companies seeking detailed information and documents about how the companies price their medications. He is billing it as one of the broadest drug pricing investigations in decades.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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The Washington Post
Louisiana officials announced Thursday that their state would become the first to move forward with a new way to pay for expensive hepatitis C treatments, which could dramatically increase the number of people who can be cured of the liver-damaging disease and provide a model for others struggling to afford the medications.
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Iowa Public Radio
Starting this month more hepatitis C patients can qualify for care under Iowa Medicaid. But some doctors and advocates argue the remaining restrictions are immoral and illegal.
Iowa is considered one of the most restrictive states when it comes to treatment of the blood-borne hepatitis C Virus, or HCV, under state Medicaid programs. The state received a D grade in a nationwide analysis conducted by the Center for Health Law and Policy Innovation of Harvard Law School and the National Viral Hepatitis Roundtable.
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ZeOmega
Watch how Kern Health Systems, a large Medicaid organization in California, uses Jiva—the industry’s leading PHM platform—to achieve seamless integration and single sign-on while also streamlining workflows, lowering costs, and improving overall health outcomes for its members.
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Detroit Free Press
Thousands of low-income Michiganders who are already working or otherwise trying to find work could see their health insurance seized under a program approved by the Trump administration and set to be implemented in the state, a public policy group said Thursday.
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Richmond Times-Dispatch
The Department of Social Services has asked the Senate Finance Committee to approve $17.2 million in budget amendments over the next two years, with more than half of that to pay for the costs to implement work requirements, as well as employment and housing services, that were a condition of the legislature approving Medicaid expansion.
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The Salt Lake Tribune
An expanded Medicaid program in Utah is set to launch in April after 53 percent of the state’s voters approved Proposition 3 in November.
But that launch date could be moved back, with health care benefits ultimately available to fewer individuals, under proposed legislation sponsored by Sen. Allen Christensen, R-North Ogden.
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Limiting opioids will not solve our nation’s pain problem- 56% of Americans will still experience pain in any three-month period, contributing to the $300 billion cost of chronic pain.
Our capabilities improve pain care across a network to ensure members receive appropriate cost, high quality care for their pain conditions.
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Clarion Ledger
Mississippi is one of 14 states that have refused to expand Medicaid coverage, but that could change in 2019.
On Monday, the director of the Mississippi Division of Medicaid spoke to the House Appropriations Committee about expanding insurance coverage in the state.
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Kern Health Systems (Kern) is overcoming numerous care management challenges using Jiva, the industry’s leading PHM platform. Learn how the powerful end-to-end platform is helping Kern consolidate data, streamline workflow, manage compliance, create holistic assessments, improve overall health outcomes, and plan for future expansion into new lines of business.
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The Associated Press via San Francisco Chronicle
California Gov. Gavin Newsom released a state budget proposal Thursday that seemingly does it all — boosts spending toward his ambitious campaign promises and sets aside significant contributions toward debts and savings.
It appears he can have his cake and eat it too because he's projecting a massive $21.5 billion surplus — far beyond anything the state has seen in nearly 20 years — as California collects more in taxes than predicted and growth slows for Medi-Cal, which provides health care for low-income people.
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