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Iowa to hire private firms to help run Medicaid
Des Moines Register
Iowa Gov. Terry Branstad plans to hire a private managed-care company or companies to help run the state's Medicaid program, legislators and administration officials said. Details are scarce on how the plan would work, but Branstad projects it would save $51.3 million from January through June 2016, its first six months.
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With federal policy change, more money for school-based health services; MHPA weighs in
The Pew Charitable Trusts
A recent federal policy reversal, long-sought by states and health care advocates, could enable schools to take a lead role in managing chronic childhood diseases and result in the hiring of many more school nurses. The change, announced quietly and unexpectedly last month by the Centers for Medicare and Medicaid Services, will allow public schools to receive Medicaid money for health services they provide to eligible students for the first time since 1997.
Doctors seek administrative ways to renew Medicaid primary care bump
Inside Health Policy (Subscription required)
Doctor lobbyists are quietly exploring ways CMS could administratively increase Medicaid pay for primary care services because of concerns it is increasingly unlikely Congress will renew a newly expired ACA measure that temporarily paid Medicaid doctors at the higher Medicare primary care rates, sources tell Inside Health Policy.
High court considers if providers can sue states for higher Medicaid pay
Kaiser Health News
The U.S. Supreme Court heard arguments in a case that could block hospitals, doctors — or anyone else — from suing states over inadequate payment rates for providers who participate in the Medicaid program for low-income Americans.
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Politico Pro: Study finds Medicaid 'bump' increased primary care access
Politico (Subscription required)
The Medicaid bump made it easier for beneficiaries to get appointments, according to a study released three weeks after the payment boost expired.
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Medicaid expansion absent from SOTU
President Barack Obama made no plea for Medicaid expansion in his address, omitting a healthcare policy that he has described as a crucial way to reducing the nation's uninsured rate. The government's low-income healthcare program received just one brief mention in this year's State of the Union address as a social safety net to "protect ourselves from the harshest adversity."
Millions of children could soon lose their health insurance if Congress doesn't act
The Washington Post
For all the handwringing about what the new Republican-controlled Congress could to do Obamacare, another health insurance program could be dropped entirely if lawmakers don't take action this year — the Children's Health Insurance Program.
Merck will no longer sell its Victrelis hepatitis C drug in the US
The Wall Street Journal
Rival hepatitis C drugs from Merck and Vertex Pharmaceuticals made a big splash when they debuted in 2011, marking an advance in treatment of the liver disease and a lucrative new market segment. But now the Class of 2011 has almost sunk to the bottom, made obsolete by a newer wave of drugs, a sign of how rapidly the hepatitis C market is changing. Merck this week notified the FDA that it will stop selling its Victrelis medicine in the U.S. by the end of this year, although the drug will remain available in other countries. The move comes three months after Vertex Pharmaceuticals discontinued U.S. sales of its own Incivek hepatitis C drug.
Arkansas governor to talk about Medicaid plan's future
The Associated Press via KATV-TV
Arkansas Gov. Asa Hutchinson is addressing the future of the state's compromise Medicaid expansion in a speech about healthcare.
Hutchinson planned Thursday to announce whether he'll back reauthorizing the state's "private option" program, which uses federal funds to purchase private insurance for the poor. The program was crafted two years ago as an alternative to expanding Medicaid under the federal health law.
5 keys in the Arkansas private option debate
The Arkansas legislature is once again ready to debate the private option — the state's unique version of Medicaid expansion, which uses funds available via the Affordable Care Act to purchase private health insurance for low-income Arkansans. Gov. Asa Hutchinson will take a long-awaited position on the policy in a speech at UAMS tomorrow morning. Then it will be up to the legislature. Health insurance for more than 200,000 Arkansans is at stake. Here are some keys to remember as the debate unfolds.
Republican Wyoming governor touts Medicaid expansion in
State of the State
Wyoming Gov. Matt Mead told state lawmakers that Wyoming can no longer afford to wait to pass a Medicaid expansion bill. "We have fought the fight against the (Affordable Care Act)," he said. "We've done our best to find a fit for Wyoming. We are out of timeouts, and we need to address Medicaid expansion this session."
Texas' new governor echoes the plans of Perry
The New York Times
Greg Abbott, the first new governor of Texas in more than a decade, was sworn in Jan. 20, as he prepared to lead the state at a time of economic anxiety, partisan divisions and shifting demographics, and he appeared poised to continue the policies of his predecessor, Rick Perry.
Missouri senator pushing Medicaid expansion for veterans
The Kansas City Star
With Republican legislative leaders declaring Medicaid expansion dead on arrival this year, Sen. Ryan Silvey is hopeful Missouri will at least be able to expand coverage for veterans. The Kansas City Republican plans push for legislation allowing veterans and their families to qualify for Medicaid if they make less than 138 percent of the federal poverty level. Currently, to be eligible for Medicaid in Missouri, a non-elderly adult must have a dependent child and can earn no more than 19 percent of the poverty level, or roughly $3,700 for a single mother with two children.
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.
MHPA's Myers joins keynote health plan panel at Medicaid Managed Care Leadership Summit | Feb. 24-25 | Alexandria, VA
World Congress and MHPA
Hear from CMS, national health plans and seven state offices. Topics include expansion, long term care, dual eligibles and more!
MHPA members: Save $300 with promo code MHPA400. Register here, or call 800-767-9499. For more info, visit the website here.
MHPA's Myers to chair WHCC 4th Annual Medicaid and Medicare Reform Summit | March 2015 | Washington, DC
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.
Feb. 4 Webinar Wednesday: 'Engage Moms on Mobile Devices: How Smartphone-Based Programs Can Improve Maternal Health'
Think your Medicaid moms don't have smartphones? Think again. Research shows that nearly 80 percent of women in the Medicaid pregnancy demographic have smartphones, and the number is just going up. In this webinar, learn how native smartphone applications customized to your plan and state can help you improve engagement of pregnant women, identification of high-risk pregnancies and compliance with maternal health quality measures.
NDEP Webinar: 'Population Health Management: Improving Health Where We Live, Work, and Play' | Feb. 24 | noon-1 p.m. ET
National Diabetes Education Program
Healthcare costs continue to soar, outpacing inflation and taking up increasingly larger portions of business, government and consumer budgets. But while costs are rising, overall health and well-being are declining. A population health management approach considers health quality and costs beyond the clinical setting to integrate health information, management and support into people's daily lives. Join the CDC's National Diabetes Education Program in this webinar that will show you a different way to think about health and wellness on the job and in the community.
Feb. 25 Webinar Wednesday: 'Health Plans Leave Money on the Table When They Fail to Effectively Audit, Track Rx Drug Claims'
The total cost of overpayments and fraud, waste and abuse (FWA) in the prescription drug claims arena can be significant. Discuss techniques that health plans and pharmacy benefit management companies can consider to root out FWA and audit for claims processing inefficiencies.
Job opportunity: Physician contract negotiator | Chicago
Negotiates, re-negotiates and executes physician and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals. Medicaid and Medicare contracting experience strongly preferred.
Job opportunity: Clinical director, Homecare & Managed Care
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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