This message contains images. If you don't see images, click here to view.
Click here to advertise in this news brief.
  Mobile version   RSS   Subscribe   Unsubscribe
Home   About   Policy & Advocacy   Education & Resources   Events   Contact Us Mar. 6, 2012


Managed care plans 'encouraged' by Grassley probe into state compliance with actuarial soundness policy    Share   Share on FacebookTwitterShare on LinkedinE-mail article
An association representing Medicaid managed care plans is pleased that Sen. Charles Grassley, R-Iowa, has initiated a probe into whether states have been complying with Medicaid's actuarial soundness requirement when setting rates for plans.

Altegra Health, First 'Third-Party Submitter'

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.

Important information for CoventryCares of Kentucky members and health care providers affected by the recent tornadoes
Business Wire via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In response to the tragic weather events that have impacted communities in the Commonwealth, CoventryCares of Kentucky wants to make sure that our members and health care providers know where to turn for answers to questions about their health and health care coverage to ensure our members get the care and medicines they need. More

Former governors mixed on Medicaid block grants    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A group of former governors recently expressed varying opinions on the cost-saving potential of transforming Medicaid into a block grant program, a proposal House Budget Committee Chair Paul Ryan included in his budget plan last year and which could reappear in his fiscal 2013 budget plan. More

Providers warn that block grants would hinder state Medicaid budgets
McKnight's Long Term Care News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A prominent long-term care group is joining several Republican governors in saying that that block grants wouldn't work for their state Medicaid budgets. "Governors are beginning to realize what we have known for years — any viable blueprint for Medicaid reform does not include block grants," said American Health Care Association President and CEO Mark Parkinson. More

Fraud's #1 Enemy!

HMS has the only comprehensive pre-payment claim solution on the market:

• Forensic editing
• Predictive modeling
• Ongoing monitoring of State-specific regulations

CMS seeks to fix Medicaid integrity data gap as OIG, lawmakers watch closely    Share    Share on FacebookTwitterShare on LinkedinE-mail article
CMS is taking steps to fill in gaps in Medicaid data that have made it difficult for its Review Medicaid Integrity Contractors to accurately review Medicaid claims to identify potential over-payments and fraud, responding to an Office of Inspector General report blasting the Review MIC program and to health reform law mandates. More

Will health care ever hurt Romney?
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
With Mitt Romney poised for several big wins on Super Tuesday, the political world is one again asking why his health care record hasn't been a bigger liability. More

Does California ruling help handicap ACA in high court?
California Healthline    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Supreme Court's consideration of back-to-back health care issues with potentially significant ramifications for California makes it tempting to look for connections. More

Oregon Gov. Kitzhaber signs health care overhaul bill; promises to improve care, reduce costs
The Associated Press via The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
If Oregon's Democratic governor is right, the bill he recently signed will improve health care and reduce costs so significantly that it could help fix the federal budget. More


• Comprehensive InSight™ risk analysis
• Direct access to pricing actuaries
• Partnership solutions for health care reform
• Medical management programs and services
• Capital management

Kansas legislators to propose KanCare delay
Kansas Health Institute    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Several legislators are expected to introduce a resolution sometime this week urging Kansas Gov. Sam Brownback to delay by six months the start of his Medicaid reform plan. More

Half of all Mississippi kids could soon be on Medicaid or CHIP
Mississippi Public Radio    Share    Share on FacebookTwitterShare on LinkedinE-mail article
New research shows that the recent health care overhaul could mean a growing number of Mississippi kids will get their health insurance through the government. MPB's Jeffrey Hess reports child welfare advocates see the expansion as good news for the health of Mississippi's youngest residents. More

New Jersey denied $107 million for Medicaid; works to adjust
Asbury Park Press via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Although New Jersey was refused an anticipated $107 million Medicaid reimbursement from the federal government, there will not be Draconian cuts to services in that program, a state official said recently. More

Improving Lives. Reducing Costs.
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.

Feds approve Illinois Medicaid fraud check
The Associated Press via Quad Cities Online    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The federal government has approved plans by Illinois to check the addresses of Medicaid recipients against driver's license records to ensure they live in the state. More

New Hampshire Medicaid grant money to help home based services
New Hampshire News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
New Hampshire will be the first state in the country to receive new Medicaid grant money to help seniors and people with disabilities remain in their homes. More

Florida budget negotiators strike deal on health cuts
The News-Press    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Budget negotiators agreed to a $303.9 million rate cut for hospitals under Medicaid but went with a relatively modest reduction to substance abuse and mental health programs as the House and Senate moved toward a final deal on a spending plan for next year. More

MHPA Center for Best Practices Insights Webinar Series: First webinar on Monday March 12
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
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.

Register today for the MHPA Center for Best Practices 2012 Awards Forum April 30 Washington, DC
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The MHPA Center for Best Practices Second Annual Awards Forum will be from 8 a.m.-1:30 p.m. at the U.S. Chamber of Commerce, 1615 H St., NW, Washington, D.C. This event of industry CEOs, CMOs and other key personnel will honor health plans for implementing innovative and effective best practices that have improved the health of Medicaid enrollees. Award categories include innovation, technology, outreach, children's health and cultural competency. Keynote Presentation from Ken Thorpe, executive director of The Partnership to Fight Chronic Disease. Also presenting is Joel Menges, executive vice president and chief operating officer of Special Needs Consulting Services who will discuss "Getting off the FFS Bus: Aren't We There Yet?" For more information and to register, click here. More

MHPA's new Keeping You Healthy video: Chopper Check
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
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, drector 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 You Tube. More

20th Annual Medicaid Managed Care Congress
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
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.
• 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 The hotel block expires on March 30, so be sure to book early.

Banner advertising available with MHPA NewsBriefs
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
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

MHPA on Twitter, Facebook and LinkedIn
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Follow us on Twitter, and Facebook and LinkedIn to get industry-related news and the latest MHPA announcements.
More connections mean higher capitation rates.
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

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.
VITAS Innovative Hospice Care®, a pioneer and leader in the hospice movement since 1978, provides a special form of care for people with life-limiting illnesses.


















MHPA's Industry NewsBrief
Colby Horton, Vice President of Publications, 469.420.2601   Download media kit
Ralph Ayyad, Content Editor, 469.420.2638   Contribute news
This edition of the MHPA's Industry NewsBrief was sent to %%emailaddr%%. To unsubscribe, click here. Did someone forward this edition to you? Subscribe here -- it's free!
Recent issues
March 6, 2012
March 1, 2012
Feb. 28, 2012
Feb. 23, 2012

7701 Las Colinas Ridge, Ste. 800, Irving, TX 75063