This message contains images. If you don't see images, click here to view.
Advertise in this news brief.




Text Version    RSS    Subscribe    Unsubscribe    Archive    Media Kit April 02, 2015

Home   About   Policy & Advocacy   Education & Resources   Events        

 



Study: Low income beneficiaries negatively impact star ratings
Inside Health Policy (Subscription required)
A new study finds Medicare Advantage plans serving low income beneficiaries may be providing higher quality care than their star ratings suggest. The study, done by Inovalon, a healthcare and technology analytics company, and the Special Needs Plan Alliance, found that "disadvantaged beneficiaries — such as dual eligible beneficiaries covered by both Medicare and Medicaid — have worse health outcomes that cannot be attributed to a health plan's quality of service," according to a release about the study.

The study particularly pinpoints dual eligible beneficiaries and their socioeconomic status as negatively impacting Medicare Advantage plans' ratings, something the authors say could lead to lower-quality care for the population in the future.
   Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE  




Supreme Court: Providers can't sue over low Medicaid rates
MedPage Today
Medicaid providers cannot sue the government seeking to raise their reimbursement rates, the Supreme Court ruled Tuesday. "Spending Clause legislation like Medicaid 'is much in the nature of a contract,'" wrote Justice Antonin Scalia, speaking for himself and Justices Stephen Breyer, Clarence Thomas, Samuel Alito, and Chief Justice John Roberts in the 5-4 decision.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


GOP senator: Medicare deal should be offset
The Hill
A freshman Republican senator is urging GOP Senate leadership to take a tougher stand on the House Medicare "doc fix" deal, highlighting a split within the party that could hold up the bill's passage.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


SPONSORED CONTENT


MHPA's Legislative Fly-In | May 11 | Washington, DC
MHPA
Join us for MHPA's Legislative Fly-In, scheduled May 11 and 12 at the Liaison Capitol Hill Hotel, to educate lawmakers on our industry and its key issues.

Click here for reservation information.

For details, please contact Nikida Levy via email or by phone at 202-857-5720.

Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Medicaid expansion plans rejected by multiple states
Washington Examiner
More Republicans tried to expand state Medicaid programs this year, but their colleagues haven't bitten. Legislators in Tennessee, Utah, Idaho and Wyoming have rejected alternative plans proposed by Republican governors, and some GOP legislators in Florida and Montana are struggling to advance alternate plans, as well.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


SHOWCASE
 
Your One Set of Data Gives You Access to Superpowers

Complex Clinical Reviews. Dependent Audits. And More.

Contact HMS today!
 


The red-state solution on Medicaid: Georgia's not part of it
The Atlanta Journal-Constitution via Kaiser Health News
A growing number of red states are intensely debating — and some actively pursuing — Republican-friendly ways to extend health insurance to their poorest citizens under the Affordable Care Act, a law they've long reviled. Georgia isn't one of those states. Indeed, the issue remains so politically toxic here that many Georgia Republicans are loath even to utter the phrase "Medicaid expansion" under the Gold Dome.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Missed an issue of MHPA's Industry NewsBrief? Click here to visit the brief's archive page.


Despite hundreds of supporters at Capitol, Insure Tennessee dies again
Chattanooga Times Free Press
VideoBrief Tennessee Republican Gov. Bill Haslam's proposed Insure Tennessee plan flopped for a second time Tuesday in a Senate committee and that's thrown the House effort into confusion with two top supporters disagreeing over whether to try to move it in a subcommittee there.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE




House, Senate advance budgets as Florida Medicaid scuffle looms
Orlando Sentinel
The House and Senate advanced competing budgets Wednesday, setting up what could be a weeks-long showdown between the two chambers over Florida Medicaid funding. The Senate's $80.4 billion spending plan is about $4.2 billion more than the House version. That's largely because the Senate includes a Medicaid expansion plan that draws $2.8 billion from the federal government and an alternative Low Income Pool program within Medicaid of $2.2 billion.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


House health committee passes Alaska governor's Medicaid expansion bill
Alaska Dispatch News
A Republican-controlled House committee Tuesday night easily moved forward Alaska Gov. Bill Walker's bill to expand the public Medicaid health program, but the measure still has many more stops in the legislature, including some in hostile territory.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


SPONSORED CONTENT


Missouri Senate votes to raise caps for some to get Medicaid
The Associated Press via The Kansas City Star
Missouri's Republican-controlled Senate has advanced a bill to expand eligibility for persons with disabilities to receive Medicaid. Senators advanced the bill in a voice vote Tuesday and will vote a second time before it moves to the House.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Lawsuit aims to stop Ohio from dropping people from Medicaid
The Associated Press via The Charlotte Observer
An Ohio group wants a federal judge to block state officials from ending the Medicaid health coverage of tens of thousands of low-income residents. The request comes as the state's Medicaid agency works to "redetermine" eligibility for recipients of the federal-state program, as required by the federal government.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Florida health officials propose Medicaid enrollment change
The Associated Press via The Baltimore Sun
Florida health officials want to remove Medicaid's 30-day wait period so people can automatically enroll for health insurance once they're deemed eligible. The proposed amendment would also get patients information more quickly about their plan options to encourage them to choose their own plan instead of being automatically enrolled in one.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


PRODUCT SHOWCASE
  Build Your Culture of Compliance

Reduce compliance risk by working with a partner that understands the industry’s complexities. We will work with you to improve your:

    • Policies, Procedures and Standards of Conduct
    • Compliance Program Oversight
    • Training and Education
    • Compliance Program Communication
    • Monitoring, Auditing and Identification of Compliance Risks
    • Compliance Investigations and Incident Management
Contact us
 


New Jersey doctors least willing to accept Medicaid
patients under Obamacare

NJ.com
The Affordable Care Act has provided a path for 420,500 low-income New Jersey residents to gain insurance through the Medicaid program, but a new study says the state ranks last in the nation in doctors willing to treat them.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Cleveland Clinic reports 40 percent drop in charity care after
Medicaid expansion

WCPN-FM via Kansas Health Institute
The Cleveland Clinic, one of the largest hospitals in the country, has cut its charity care spending — or the cost of free care provided to patients who can't afford to pay — to $101 million in 2014 compared with $171 million in 2013. Hospital officials credited the federal health law for the improvement.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


New York doctors allegedly offered free shoes in $7 million plot to
defraud Medicaid

The Hill
Nearly a dozen doctors in New York City are facing felony charges for allegedly baiting poor people to take unneeded tests with the promise of free shoes. A total of 23 defendants, including nine doctors, were charged with running a $7 million Medicaid scheme that preyed on people from homeless shelters, welfare offices and soup kitchens, according to the Brooklyn District Attorney's Office.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE




Did you miss Webinar Wednesday: 'Medication Monitoring & Pharmacogenetic Testing (PGT): Helping Clinicians to Individualize Safer Opioid Management' by Millennium Health?
MHPA
To request a copy of the presentation or for additional information, please contact Naissan Hussainzada, or visit www.millenniumhealth.com.

For copies of other past webinars,
visit here.

Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


April 15 Webinar Wednesday: 'The Role of Medicaid Managed Care Organizations in State Innovation Models'
Deloitte
The State Innovation Model grants are being widely used to develop and test multipayer payment and service delivery reform. These models can have a significant effect on Medicaid managed care organizations (MCOs). This webinar will explore the potential roles of Medicaid MCOs in a State Innovation Model (SIM) driven reform initiative.

Please join Director Randolph Gordon and Specialist Leader Jim Hardy for Deloitte Consulting LLP who will discuss challenges related to provider contracting, care management, information technology, market positioning and strategies for success.

Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Pay for success, social impact bonds: Request for proposals
Green & Healthy Homes Initiative
The Green & Healthy Homes Initiative released a request for proposals from asthma-related service providers to develop asthma social impact bond/pay for success projects. GHHI and its partner Calvert Foundation will provide technical assistance to five selected service providers in the catchment areas of the previously selected healthcare organizations:
  • Baystate Health (Springfield, MA)
  • Le Bonheur Children's Hospital (Memphis, TN)
  • Monroe Plan for Medical Care (Buffalo/Rochester, NY)
  • Spectrum Health (Grand Rapids, MI)
  • University of Utah Health Plans (Salt Lake, UT)
Please review the RFP; proposals are due Wednesday, April 8.

Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Medicaid Managed Care Congress: May 20-22 in Baltimore
Medicaid Managed Care Congress
At the Medicaid Managed Care Congress, government officials, health plan executives and other key players of the healthcare ecosystem come together to hear new case studies from industry peers and expert insights from state and federal regulatory bodies. This event will discuss the successes and challenges of implementation of major ACA provisions, delivery reform and payment reform and states pursuing better value. Use code XP2026MHPAB for a 15-percent discount.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE




Job opportunity: Clinical director, Homecare & Managed Care
First Quality
First Quality, a leading manufacturer of disposable home healthcare products, is seeking a clinical director for our Homecare & Managed Care Business. This candidate will provide leadership and have a focus on clinical education, utilization management protocols and programs and operational program development within homecare and managed care markets.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Job opportunity: Physician contract negotiator | Chicago
Aetna
Negotiates, re-negotiates and executes physician and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals. Medicaid and Medicare contracting experience strongly preferred. Enter Requisition #22158.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE

MHPA has more than 2,100 Twitter followers! Are you one of them? If not, start following
@mhpa for the latest in Medicaid and MHPA news.
 

Sponsored by ...

 

 

 

 

 

 

 

 

 

 


MHPA's Industry NewsBrief
Colby Horton, Vice President of Publishing, 469.420.2601
Download media kit

Damon Sayles, Senior Editor, 469.420.2662   
Contribute news

This edition of MHPA's Industry NewsBrief was sent to ##Email##. To unsubscribe, click here. Did someone forward this edition to you? Subscribe here -- it's free!
Recent issues
March 31, 2015
March 26, 2015
March 24, 2015
March 19, 2015



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