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Modern Healthcare
The CMS has sent a sweeping finalized rule that will overhaul the managed Medicaid program to the Office of Management and Budget for review. The 653-page proposed version of the rule suggested the biggest changes in Medicaid managed-care regulations in more than a decade. It would cap insurer profits, require states to more rigorously supervise the adequacy of plans' provider networks, encourage states to establish quality rating systems for plans, allow more behavioral healthcare in institutional settings and encourage the growth of managed long-term care.
The CMS rule also sets a medical-loss ratio (MLR) of 85 percent, meaning at least 85 cents of every premium dollar must be used for medical care. "The MLR is an arbitrary number that's both inappropriate and unnecessary given the requirement already in place that states set actuarially sound rates for Medicaid health plans," MHPA's Jeff Myers said.
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The Washington Post
House and Senate finance committees on Sunday unveiled dueling two-year budget proposals that reject Virginia Gov. Terry McAuliffe's vision for Medicaid expansion but pour big money into his top priorities: education and economic development. The spending plans take different approaches to giving schools greater flexibility in how they spend tax dollars and give lawmakers and businesspeople more authority to shape the state's approach to diversifying and growing the economy.
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Casper Star Tribune
The state Senate defeated a measure to expand Medicaid to 20,000 low-income Wyomingites on Friday afternoon, delivering the final blow to the Obamacare provision this legislative session. The amendment to the two-year state spending bill failed with 10 senators in favor of it and 20 opposed. No budget amendment appeared in the House, as lawmakers who supported Medicaid expansion said they didn't attempt it because the opposition was even stiffer.
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The Associated Press via Chicago Tribune
Championing a program he inherited under a federal health overhaul he opposes, Arkansas Gov. Asa Hutchinson has made his push to keep the state's hybrid Medicaid expansion the defining issue in several Republican primary contests next month. He's also turning the election into a referendum on his first two years in office, and an indicator of how the next two will go.
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Enterprising healthcare. Cost containment solutions.
How can we help you? Contact us today.
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Health News Florida
The Internet allows savvy consumers to comparison shop for big ticket items. Those items may soon include medical procedures. The Florida House is ready to consider a bill (H.B. 1175) that would enable consumers to see what hospitals around the state charge for similar surgeries and courses of treatment.
Under the bill, the Florida Agency for Health Care Administration would oversee a database that contains cost information from hospitals, surgical centers and insurance companies. But Rep. Lori Berman doesn't think a database is the best way to deal with soaring healthcare costs.
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Reuters
Premium increases for Medicaid, the government health program for the poor, may leave many U.S. children uninsured, a new review suggests. Higher premiums for the national Children's Health Insurance Program (CHIP), which also provides coverage to low-income kids, may have a similar result.
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Reuters
States that expand their Medicaid programs without covering non-emergency transportation for new enrollees could disadvantage the poorest patients, according to a report from the U.S. Government Accountability Office. The report, released Tuesday, looked at Indiana and Iowa, which have already expanded Medicaid without providing non-emergency transportation, and Arizona, which has sought permission from the Department of Health and Human Services to do so.
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With an emphasis on innovative initiatives and data-driven solutions, DentaQuest is partnering with health plans to fundamentally change the way oral health is delivered in America. Integrating preventive oral health programs not only offers members a wider portfolio of choice - it is also a proven driver of cost control.
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The New York Times
Alarmed at an epidemic of drug overdose deaths, the National Governors Association decided over the weekend to devise treatment protocols to reduce the use of opioid painkillers. The guidelines are likely to include numerical limits on prescriptions, or other restrictions, governors said.
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The Hill
City and state health directors are urging the Food and Drug Administration (FDA) to put warning labels on powerful painkillers that can be fatal when taken with other drugs. In a petition, a group of health directors led by Dr. Leana Wen, Baltimore's health commissioner, and Dr. Nicole Alexander-Scott, Rhode Island's health director, call for "black box warning" labels on opioids and benzodiazepines.
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Inside Health Policy
Introducing Medicaid Roundup, a new feature on Inside Health Policy offering news and analysis of major policies affecting Medicaid stakeholders. Our monthly roundup looks ahead at emerging issues and also provides an update on recent policy developments.
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MHPA
Last year, the Medicaid Health Plans of America (MHPA) and the Institute for Medicaid Innovation (IMI) received nearly 100 submissions for consideration in the annual best practices compendium. An electronic version of the compendium is now available at the Institute for Medicaid Innovation (IMI)'s landing page.
This year, we have two opportunities, as outlined below, for you to submit best practices.
CHildhood Obesity Prevent & Treatment (CHOPT) for Medicaid
The Institute, in partnership with MHPA and ACAP, was awarded an RWJF grant specific to childhood obesity prevention and treatment that we have named CHOPT for Medicaid. As part of the project, we are conducting an environmental scan (questionnaire for health plans) and soliciting examples of best practices.
The following is the timeline for participating in this project.
Feb. 22: Questionnaire DUE
March 21: Best Practices Submission Form DUE (NOTE: Submissions from MHPA members are automatically sent for review and inclusion in the annual compendium.)
Oct. 28: Childhood Obesity Summit (D.C.)
2016-2017 Medicaid Managed Care Best Practices Compendium
The categories for this year's compendium remain the same; women's and maternal health, child health, behavioral health, long-term care and transitions of care and expansion population. However, the deadlines for submission are earlier due to MHPA's annual conference occurring in September, instead of November as last year.
The following is the timeline for this year's submission cycle.
March 1: Best Practices Submission Form Emailed to Plans
April 30: Best Practices Submission Form DUE
Sept. 21: Release of Compendium and Announcement of Awards at MHPA Conference (D.C.)
Women's Reproductive Health Project
The Institute is also leading a women's reproductive health project that is funded by the Kaiser Family Foundation. We will be administering a questionnaire developed by your colleagues at Medicaid health plans that will include an opportunity to briefly identify innovative and promising best practices, develop an issue brief, and host a policy briefing with Kaiser. We encourage your participation in the following ways:
April 12: Questionnaire Emailed to Plans
May 16: Questionnaire DUE
TBD: Kaiser and Institute Joint Policy Briefing (D.C.)
Please send your submissions and any questions to Jennifer Moore.
MHPA
Thanks again to all who attended and who participated in this great recap of MHPA's annual conference. (download conference presentations here).
Next up: Save the date for mhpa2016 from Sept. 21-23!
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