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The Wall Street Journal (Subscription required)
Seema Verma, head of one of the most powerful federal healthcare agencies, granted Republican states the authority to require that Medicaid recipients work to be eligible. Now, after November midterm elections that saw Democrats flip seven governorships and retake the House of Representatives, Democratic-run states are poised to ask for approval to expand coverage, including statewide single-payer or public health options. Verma has said her goal is to give states more authority over their own healthcare markets. Some health analysts say the question now is whether that push for deregulation will also mean her agency approves bolder Democratic plans.
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Insider Louisville
Changes to Kentucky's Medicaid program, including the implementation of a work and community engagement requirement, redistribution of money and a proposal to reduce the number of managed care organizations will backfire, said Dr. Andrey Ostrovsky, the chief medical officer for U.S. Center for Medicaid and CHIP Services in 2016 and 2017, and senior vice president of behavioral health for Phoenix-based healthcare startup Solera Health.
Ostrovsky told Insider that such efforts are "misguided. ... Ultimately, (they) will increase costs."
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The Hill
Utah's governor on Monday signed legislation into law a limited Medicaid expansion plan, defying voters who approved a full expansion in November.
The bill signed by Gov. Gary Herbert would cover far fewer people, and cost taxpayers more money, than the plan voters approved in November.
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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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Idaho Statesman
Legislation to make Medicaid expansion in Idaho null and void if the federal government changes the percentage it pays for the program in Idaho will get a hearing.
The Senate Health and Welfare Committee on Monday voted 5-4 to hold the hearing on the bill sponsored by Republican Sen. Mary Souza of Coeur d'Alene that also authorizes an optional workforce training program.
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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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The Atlanta Journal-Constitution
Georgia Gov. Brian Kemp will ask the Georgia Legislature and the federal government for flexibility to improve access to government-funded health insurance for the state's poor and middle class.
His administration told The Atlanta Journal-Constitution on Thursday that it will back a measure that seeks two separate federal "waivers" to Medicaid and the Affordable Care Act to tailor new programs to Georgia's needs.
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The Atlanta Journal-Constitution
What to do about Georgia's thousands of poor adults without health coverage sparked a wave of debate Friday, one day after Gov. Brian Kemp was quoted in The Atlanta Journal-Constitution embarking on plans to address it.
Democrats decried Kemp's plan to spend $1 million on researching and developing a more conservative Georgia plan for Medicaid.
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Modern Healthcare
Over the past two years, despite strong objections from hospitals and other provider groups, the CMS has granted waivers of 90-day retrospective eligibility to Arizona, Arkansas, Florida, Iowa and Kentucky. Some were part of broader Medicaid Section 1115 demonstrations of work requirements. Maine also received a waiver but its new Democratic governor announced she won't implement it. The CMS is considering similar waiver requests from Ohio and other states.
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For patients with opioid use disorder, a diagnosis can be the difference between addiction and recovery. For health benefits providers, it can represent a more than $2,200 PMPM cost reduction. Connect with us to learn how we leverage patient-level intelligence to identify and alert providers to patients at risk for OUD.
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Kaiser Health News
Last year, Medicaid enrollment there declined far faster than in other states, and most of those losing coverage are children, according to state data. State health officials say several factors, including the improved economy, are behind last year's drop of 7 percent in Missouri and 9 percent in Tennessee.
But advocates for the poor think the states' efforts to weed out residents who are improperly enrolled, or the difficulty of re-enrolling, has led to people being forced off the rolls. For example, Tennessee sent packets to enrollees that could be as long as 47 pages to verify their re-enrollment. In Missouri, people faced hours-long waits on the state’s phone lines to get help in enrolling.
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A commercial Medicaid plan in Nevada leveraged MCG solutions in its community health program and reduced ER visits by 20% and hospital readmissions by 30%. Click here to learn more about how MCG can support improved member outcomes and cost control.
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The Associated Press via The State
Missouri could save up to $1 billion a year within the next four years if it overhauls the state's Medicaid health insurance program, according to a study from a consulting team.
A draft of the report obtained by the St. Louis Post-Dispatch does not recommend tightening eligibility rules for Medicaid. State lawmakers are separately considering a plan to require healthy Medicaid recipients to work.
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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 Boston Globe
A federal judge sharply rebuked the state for failing to provide prompt mental health services to low-income children, saying that constant delays can lead to violent physical outbursts, removal from homes, and traumatizing and unnecessary hospital stays.
Massachusetts has repeatedly violated its own standard of providing certain mental health treatment to seriously ill children on Medicaid within 14 calendar days, with thousands of children having waited weeks, putting them at risk for "devastating setbacks," U.S. District Court Judge Michael Ponsor found.
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