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. 15, 2012


Do 'medical home' programs save money?
Stateline    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The aim of the"medical home" concept is simple — improve primary care so fewer people need to go to the hospital. States experimenting with this nationwide movement say that when practiced by doctors serving Medicaid patients, it improves overall health conditions and saves billions of dollars in the long run. More

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.

Scott & White Health Plan awards Payment Integrity Services contract to HMS
Business Wire via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
HMS, a wholly owned subsidiary of HMS Holdings Corp. announced that it has been awarded a contract by Scott & White Health Plan to provide a variety of payment integrity services on behalf of the plan's Medicaid members, including coordination of benefits; overpayment recovery; subrogation; and fraud, waste and abuse. More

Congressional Budget Office: Health law could cause as many as 20 million to lose coverage
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As many as 20 million Americans could lose their employer-provided coverage because of President Barack Obama's health care reform law, the nonpartisan Congressional Budget Office said in a new report. More

Congressional Budget Office: Obama's health law to cost less, cover fewer people than first thought
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
President Barack Obama's health care reform law coverage provisions will cost less but cover fewer people than first thought, the nonpartisan Congressional Budget Office recently said. 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

Supreme Court seen influenced by politics in health care ruling
Bloomberg    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Three-quarters of Americans say the U.S. Supreme Court will be influenced by politics when it rules on the constitutionality of a health care law signed by President Barack Obama two years ago. More

CBO projects fewer people to receive exchange coverage as more shift to Medicaid, CHIP    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Fewer people than earlier projected are expected to receive health insurance coverage in the health reform law's exchanges or from their employers and more are expected to obtain coverage from Medicaid and the Children's Health Insurance Program, according to CBO's updated estimates for the insurance coverage provisions of the health reform law. More

Medicaid patients struggle to get primary care, visit ERs more
PRNewswire via MarketWatch    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Twice as many people insured by Medicaid as by private insurance report barriers to primary care and Medicaid patients are twice as likely to visit the emergency department as their privately insured counterparts, according to a study published online in Annals of Emergency Medicine. More


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

Florida Medicaid shift could take longer than expected
The News-Press    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Florida's overhaul of the Medicaid system likely will take longer than expected, with some beneficiaries not enrolled in HMOs or other types of managed-care plans until 2015, according to a revised state timeline. More

Clock ticking for governor to sign controversial Florida Medicaid legislation
The Miami Herald    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A controversial measure that would shift $300 million in disputed Medicaid bills to counties has been received by Florida Gov. Rick Scott's office, triggering the 15-day window for him to either sign or veto the legislation. More

California to receive funds for Medicaid Mental Health pilot program
California Healthline    Share    Share on FacebookTwitterShare on LinkedinE-mail article
CMS awarded $75 million in funding to California and 10 other states, as well as the District of Columbia, for a demonstration program that will expand access to emergency psychiatric care, The Hill's "Healthwatch" reports. More

Minnesota bill to change HMO Medicaid requirements advances
Twin Cities Pioneer Press    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A state House committee advanced a bill that would eliminate a requirement for nonprofit health plans to participate in the state's Medicaid program. More

Senators take first crack at state Medicaid overhaul
The Times-Picayune    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Unlike his approach to the slate of education proposals that will dominate the 2012 legislative session, Louisiana Gov. Bobby Jindal did not mount much of a public campaign before he decided to shift more than $2 billion of state Medicaid business to private insurers during his first term. More

Wisconsin lawmakers approve Medicaid cuts
The Journal Sentinel    Share    Share on FacebookTwitterShare on LinkedinE-mail article
An estimated 22,800 people would leave or be turned away from the state's health programs for the poor, under a cost-cutting proposal revised by a legislative committee. 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.

Virginia officials deliberately moving slowly on health care exchange
The Connection    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Virginia has eight months to create a certification plan for how it plans to create a health care exchange, a legal requirement of President Barack Obama's Patient Protection and Affordable Care Act. But Virginia is lagging far behind other states, which have made more progress toward creating the new exchanges, state-run insurance markets designed to operate online. More

Study: Medicaid is a vital insurance source in rural areas
Public News Service    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Small towns are increasingly becoming reliant on Medicaid. A new study from the Center for Rural Affairs calls Medicaid a "vital insurance source" in rural Montana — and there are several reasons why, according to study author Jon Bailey, the center's director of research and analysis. More

Save money on MHPA's Insights Webinars: Register now for the 2012 Best Practices Awards Forum
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Register for the MHPA Center for Best Practices Second Annual Awards Forum (8 a.m.-1:30 p.m. at the U.S. Chamber of Commerce, Washington, D.C.) and receive 15 percent off MHPA's Insights Webinars (20-webinar series package) or 25 percent off an Insights individual webinar. Contact Suzanne Austin at 202.857.5720 or to take advantage of this special deal. More

New Webinar from Dual Eligibles: State Initiatives and Growth Opportunities for Health Plans
AIS Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the past year, the federal and state governments have developed huge new initiatives to expand integrated care delivery for Medicare-Medicaid dual eligibles and, in the process, created big near-term growth opportunities for health plans. During this April 12 Webinar from, hear Thomas Johnson, from Medicaid Health Plans of America, and Gary Jacobs, from Universal American Corporation, detail how states' dual initiatives will transform both what they do and how they do it. You'll also hear directly from California's top duals consultant, Peter Harbage, of Harbage Consulting, about the state's process and intentions. 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 15, 2012
March 13, 2012
March 8, 2012
March 6, 2012

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