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CMS' final rule on Medicaid waivers extends transparency requirements to dual-eligible demos
InsideHealthPolicy.com
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CMS' long-awaited Medicaid waiver rule not only increases transparency in the process used by CMS and states to negotiate Medicaid demonstration projects but also extends the new requirements to dual eligible financial arrangements being tested by the agency's Medicare-Medicaid coordination shop.
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Centene wins Missouri Medicaid contract
St. Louis Post-Dispatch
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Centene Corp. has won a major contract to manage health care for Medicaid beneficiaries across Missouri, the Clayton-based company recently announced. The firm will share the business with two other companies, Missouri Care Inc., a subsidiary of Aetna Inc., and Health Care USA, a subsidiary of Maryland-based Coventry Healthcare Inc., state officials said.
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Court action could prolong health care fight
USA Today
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Next month's challenge to the Obama-sponsored health care law could affect the care available to most Americans, alter the balance of power between Washington and the states and remain a flash point through this presidential campaign.
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SCOTUS punts on California Medicaid lawsuit
Politico
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The Supreme Court is punting on a key question about when Medicaid providers and beneficiaries have the right to sue over cuts to the federal-state health care program. That was the major question at the heart of Douglas v. Independent Living Center, in which provider and consumer groups claimed that California violated federal law by cutting Medicaid provider payment rates.
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Altegra Health is the first ‘Third-Party Submitter’ to receive certification in Encounter Data Front End Testing from the Centers for Medicare and Medicaid Services (CMS). This certification reflects our expertise in encounter reporting, risk adjustment analytics, and data management. Altegra Health continues to be a health care services leader.
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New Mexico proposes to overhaul Medicaid program
The Associated Press via San Francisco Chronicle
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New Mexico Gov. Susana Martinez's administration is proposing to overhaul a program that provides health care to a fourth of the state's population, and the changes could require some needy New Mexicans to dig into their pockets to pay a fee if they go to an emergency room for medical care that's not considered an emergency.
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Illinois's 'toughest' budget may cut $2.7 billion from Medicaid
Bloomberg
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Illinois Governor Pat Quinn will propose a $33.8 billion spending plan that would cut $2.7 billion from the Medicaid program, which provides health care for the poor. It's the "toughest budget," Jack Lavin, Quinn's chief of staff, told reporters in Springfield, Ill., capital of the fifth-most-populous U.S. state. The plan, an increase from the current $33 billion, would close two prisons and four mental-health facilities, he said. The state faces a backlog of $9 billion in unpaid bills.
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Illinois to tighten Medicaid eligibility
Pharmacy Choice
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New enrollment restrictions for Medicaid in Illinois, effective March 1, include electronic cross-checks on residency and income data, officials said. State officials developed the new rules after a year of talks with federal health counterparts to try to determine whether the 2010 health care law's "maintenance of effort" requirement that bars states from doing anything that would reduce the number of people who qualify for Medicaid would include any measure that would reduce the pool of Medicaid recipients through more vigorous checking, Stateline.org reported.
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HMS has the only comprehensive pre-payment claim solution on the market:
• Forensic editing
• Predictive modeling
• SIU
• Ongoing monitoring of State-specific regulations
www.hms.com |
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Major Medi-Cal changes raise questions
California Watch
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Sweeping changes for the state's medical program for the needy are taking shape, even as legislative advisers and advocates raise major questions. Changes include more seniors being routed to managed care programs, a reinvention of how hospitals are paid and the collapse of two state agencies that currently serve beneficiaries.
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Maine Medicaid costs above average
The Associated Press via Houston Chronicle
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In his relentless demands for steep Medicaid cuts, Gov. Paul LePage has said Maine spends far more per capita than other states on Medicaid and is high above the national average.
Whether you support or oppose LePage's cost-cutting proposals, he's right.
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Georgia drug-testing bill would break new ground
Georgia Health News
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Georgia could become the first state to require drug testing of Medicaid applicants, if a Senate bill becomes law. That's according to a Department of Community Health official, who was asked by a state senator at a legislative hearing whether other states have such a requirement.
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• Comprehensive InSight™ risk analysis
• Direct access to pricing actuaries
• Partnership solutions for health care reform
• Medical management programs and services
• Capital management MORE |
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UnitedHealth Group and Fort Bend Independent School District launch "JOIN for ME" program to fight childhood obesity
Business Wire via Green Technology World
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UnitedHealth Group is collaborating with Fort Bend Independent School District on a 12-month program designed to help kids who struggle with extra weight reach healthier weights and reduce the risk of many related health concerns.
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Cognosante showcases new product at HIMSS12
Business Wire via Pharmacy Choice
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Cognosante, a leading provider of IT services to health care organizations is showcasing a new health care transformation solution while exhibiting at the 2012 Annual HIMSS Conference and Exhibition, Feb. 20-24, at the Venetian Sands Expo Center in Las Vegas.
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Health Integrated, the leading innovation partner for health plans, provides evidence- based solutions to achieve health management goals for clinical outcomes, quality measures and cost containment.
Our expertise with vulnerable populations and 360-degree view of the impact of bio-psycho-social risk factors on health makes us the perfect partner for Medicaid and Medicare plans.
www.healthintegrated.com
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Introducing the MHPA Center for Best Practices Insights Webinar Series
MHPA
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In keeping with its mission of educating Medicaid health plans, the MHPA Center for Best Practices brings you the 2012 Insights Webinar Series, a course of 20 online presentations on emerging trends and important issues facing the Medicaid managed care industry. Geared specifically for Medicaid health plans, these expert-led webinars provide subscribers with the tools they need to improve their operations while maintaining high quality care for enrollees.
From March 12 — Dec. 17, you'll have the opportunity to sit in on up to 20 one-hour presentations on the following issues:
- Hot Trends and Topics
- Improve Your Operations
- Risk Adjustment
- Clinical Best Practices
- Compliance Issues
- Dual Eligibles
For details, including a complete list of webinar titles and subscription rates, click here.
MHPA's new Keeping You Healthy video: Chopper Check
MHPA
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Tooth decay is a significant problem in young children. The situation is made worse for those kids on Medicaid by barriers that keep them from getting dental care. This problem hits home for MHPA member Health Partners of Philadelphia, where about half of their enrollees are children. Watch Carol Smolij, Vice President of Clinical and Regulatory Operations at Health Partners of Philadelphia and Judy Gelinas, Director of Community Oral Health Initiatives at St. Christopher's Foundation for Children, discuss the Chopper Check program on MHPA's Center for Best Practices new Keeping You Healthy video on Youtube.
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Population Health and Care Coordination Colloquium
Population Health Colloquium
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North Carolina Medicaid medical homes: The numbers don't add up, period.
Sunday Feb. 26, 2012
A hybrid Conference and Internet event
ONSITE
Philadelphia Marriott Downtown
Philadelphia
ONLINE
In your own office or home live via the Internet with 24/7 access for six months
For more information click here.
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The World Congress 5th Annual Leadership Summit on Medicaid Managed Care
World Congress
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Feb. 28 - March 1, 2012
Sheraton Reston, Reston, Va.
Network with over 100 Health Plan and Pharmaceutical industry executives and State Medicaid Directors at the 5th Annual Leadership Summit on Medicaid Managed Care.
Featured Speakers Include: Thomas L. Johnson, president and Chief Executive Officer, Medicaid Health Plans of America Henry Waxman, D-CA, U.S. HOUSE OF REPRESENTATIVES Jennifer Coleman, Senior Advisor, Federal Coordinated Health Care Office, Centers for Medicare and Medicaid Services (tentative) Karen Brodsky, Director, New Jersey Department of Human Services
30 Sessions, 12 Keynotes, 15 Track Sessions
In-Depth Examinations and Discussions on issues such as:
•Medicaid Expansion
•Early Innovator Grants
•Health Insurance Exchanges
•MMIS & HIT
•Care Management/Quality Improvement and more.
MHPA health plan members can attend the conference for just $695 (a $900* savings!) when using Promo Code SEZ526 to register by Jan. 13.
To register, call us at 800.647.7600 or visit the World Congress website.
* Discount does not apply to the Government Rate.
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| NCQA briefing on new HEDIS Schizophrenia measures for Medicaid - public comments due March 14 |
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| Tuesday, March 06, 3:00 p.m. — 4:00 p.m.
Conference Dial-in Number: 760.569.0100 Participant Access Code: 510735#
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Registration open for Second Annual Awards Forum
MHPA
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The MHPA Center for Best Practices Second Annual Awards Forum will be held on April 30, 2012, from 8 a.m.-2 p.m. at the U.S. Chamber of Commerce, 1615 H St., NW, Washington, D.C. This event of industry CEOs, CFOs, CMOs and other key personnel will honor health plans for implementing innovative and effective best practices that have improved the health of Medicaid enrollees. For more information and to register, click here.
20th Annual Medicaid Managed Care Congress
MHPA
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Join MHPA as we partner with IIR's 20th Annual Medicaid Managed Care Congress, May 1-May 2 at the Hilton Baltimore. MHPA's president & CEO, Thomas Johnson and over 350 State Officials, Health Plan executives and CMS will share insights on how to improve quality, achieve better health outcomes and control costs. Don't miss Thomas's sessions on the Opportunities for the New Basic Health Plan option and as part of the closing panel discussion.
Highlights:
• State Snapshots providing insight into states that are making moves in the Medicaid managed care space. Hear from Pennsylvania, New Jersey, Texas and Washington, D.C.
• Realigned Track Sessions based on in-depth analysis of our audience to better meet your needs.
• Full Day Summits on Medicaid Managed Care 101 and Dual Eligibles to go deeper into these hot topics.
• Political commentary from speaker Paul Begala from CNN and Newsweek, as he presents potential outcomes for the upcoming presidential elections and the future of Medicaid managed care.
Download the Brochure to learn more about the 40 speakers, 35 sessions, 4 pre-conference workshops, and numerous networking opportunities. Because of our partnership, MHPA members can receive 25 percent off the standard registration rate. Just mention priority code XP1726MHPA when registering. Register online, by calling 888.670.8200, or emailing register@iirusa.com. The hotel block expires on March 30, so be sure to book early.
Banner advertising available with MHPA NewsBriefs
MHPA
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Now you can ensure that your message gets out to the Medicaid managed care industry. For rate information, contact James Debois for opportunities 469.420.2618 or email at jdebois@multiview.com.
MHPA on Twitter, Facebook and LinkedIn
MHPA
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Follow us on Twitter, and Facebook and LinkedIn to get industry-related news and the latest MHPA announcements.
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Firstsource’s advanced IVR technology helps achieve a 34% live connect rate, up from 14 to 18% with traditional dialers. As a result, we dramatically improve member contacts and results for disability transfers, member retention/recertification, SSI benefits and member wellness programs and initiatives. For a better, faster way to connect, contact Firstsource at 877-926-7370. MORE
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Epstein Becker Green is uncompromising in its pursuit of legal excellence and client service in its areas of practice: Health Care and Life Sciences, Labor and Employment, Litigation, Corporate Services, and Employee Benefits. The Firm was founded to serve the health care industry and has been at the forefront of health care legal developments since 1973.
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