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Scully: Medicaid managed care offers program integrity
benefit for states

InsideHealthPolicy.com
As states move toward a Medicaid managed care model, one benefit for states is that plans, not states, are at risk for fraud, according to former CMS Administrator Thomas Scully. Plus, Medicaid managed care plans currently don't face the medical loss ratio requirements imposed by the health law on other private plans and which sources say could impede those plans' program integrity efforts by pegging many anti-fraud activities as administrative costs.
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MHPA pens 2 endorsement letters to Congress on insurer fee repeal legislation
MHPA
Joe Moser, MHPA's interim executive director, wrote letters to both Sen. John Barrasso of Wyoming and Rep. Charles Boustany of Louisiana endorsing legislation they introduced separately to fully repeal the insurer fee.
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MHPA supports National Minority Health Month 2013
MHPA
MHPA and its member companies recognize the importance of the HHS Office of Minority Health's National Minority Health Month this April and their work to eliminate disparities in the health of minorities compared to the rest of the U.S. The theme for 2013, "Advance Health Equity Now: Uniting Our Communities to Bring Health Care Coverage to All," aims to rally Americans to work towards improving the health of our communities and increasing access to quality healthcare.
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Study: Medicaid expansion will help lower out-of-pocket costs
The Hill
Expanding Medicaid is the healthcare law's single-best tool for reducing out-of-pocket healthcare costs, the Robert Wood Johnson Foundation said in a research paper. The study said other provisions of the Affordable Care Act will have an "uneven impact" on healthcare costs for low-income families, because of state-by-state variations in cost.
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Confirmation hearing set for top healthcare nominee
The Hill
The Senate Finance Committee will hold a hearing on April 9 on Marilyn Tavenner's nomination to lead the Centers Medicare and Medicaid Services. Tavenner has broad bipartisan support in Congress. Even House Majority Leader Eric Cantor of Virginia has endorsed her nomination, saying he worked well with Tavenner when she led Virginia's Medicaid agency.
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McCrory plan would open North Carolina's Medicaid business to
private companies

The News & Observer
North Carolina Gov. Pat McCrory wants to overhaul the state's Medicaid program by having managed care companies offer healthcare plans for poor, elderly and disabled people. The overhaul, recently unveiled by administration officials, would diminish the role of a nationally recognized nonprofit agency while opening the state's Medicaid business to private companies that now provide such services in more than half the states in the country.
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Public involvement in managed care licensing in California?
California Healthline
Thirteen bills came before the Assembly Committee on Health, and all 13 were approved — but not all them got a red-carpet reception. One of the bills that stirred up opposition from health plans was a proposal by Assembly member Roger Dickinson to open the managed care licensing process to public scrutiny and input.
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Corbett says he may accept Medicaid plan to finance private
coverage in Pennsylvania

The Philadelphia Inquirer
Pennsylvania Gov. Tom Corbett, under pressure to accept a federal expansion of Medicaid, said he was looking at ways to use that money to fund private coverage for hundreds of thousands of uninsured Pennsylvanians. Corbett has resisted opting into the Medicaid expansion envisioned under President Barack Obama's healthcare overhaul, saying he is concerned it would be too costly for the state down the road.
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House Speaker Weatherford: 'Never say never' to federal money for
Medicaid alternatives in Florida

Tampa Bay Times
As the legislature weighs options for insuring the low-income residents in Florida, House Speaker Will Weatherford, for the first time, indicated he might be open to accepting federal money. "You never say never in this business, I've learned that," Weatherford replied when asked about his willingness to accept some federal aid as part of a House alternative to Medicaid expansion.
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Nixon and Republicans inching toward possible Missouri Medicaid expansion
The Kansas City Star
Missouri Gov. Jay Nixon hopscotched across the state for months trying to line up public support for adding 300,000 uninsured Missourians to Medicaid. Yet each time the issue has come before lawmakers, the Republican supermajority rejected it.
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Haslam insists Medicaid pursuit no 'fool's errand' in Tennessee
The Associated Press via The Daily News Journal
Tennessee Gov. Bill Haslam said that his ongoing pursuit of a special deal for Medicaid expansion in Tennessee is no "fool's errand" and that an arrangement could still be struck at any time. The Republican governor said he remains in negotiations with the federal government over his proposal to use $1.4 billion in Medicaid money available under the federal health care overhaul to pay for private coverage for uninsured Tennesseans.
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Zerwas: Texas House Medicaid bill will include Williams' plan
The Texas Tribune
Texas Rep. John Zerwas confirmed that he will incorporate into his own Medicaid reform bill a proposal by Sen. Tommy Williams to use premium tax revenue to subsidize private health policies for the uninsured.
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MHPA welcomes new supporting member Healthcare Financial, Inc.
MHPA and Healthcare Financial, Inc.
Healthcare Financial, Inc. is a privately owned, for-profit company specializing in connecting low income and disabled individuals, families, children and elderly with public health insurance benefits. They specialize in advocating for the socially and/or medically complex applicant. Their clients include hospitals, managed care plans, community health centers, nursing homes and the people they serve.
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'NICU Costs, Trends, Effective Management Solutions': A free webinar by Progeny Health | April 10 at 3 p.m. EST
MHPA
Medical costs for a baby born in the neonatal intensive care unit are considerably higher than they are for a healthy newborn. With preterm deliveries on the rise and issues with overutilization, the high costs associated with babies in the NICU are impacting payers more than ever. "NICU Costs, Trends and Effective Management Solutions" focuses on managing the care of this medically complex population. Ellen Stang, M.D., the president and CEO of ProgenyHealth, will discuss a collaborative approach to NICU care management that delivers quality outcomes and reduces costs.
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FEATURED ARTICLE
TRENDING ARTICLE
MOST POPULAR ARTICLE
Scully: Medicaid managed care offers program integrity benefit for states
InsideHealthPolicy.com
As states move toward a Medicaid managed care model, one benefit for states is that plans, not states, are at risk for fraud, according to former CMS Administrator Thomas Scully.

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Republicans' 'no' on Medicaid expansion possibly shifting
The Associated Press via
The Washington Post

Given the choice of whether to expand Medicaid under President Barack Obama's healthcare law, many Republican governors and lawmakers initially responded with an emphatic "no." Now they are increasingly hedging their objections.

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3 firms picked for DC Medicaid contracts
The Washington Post
City officials in Washington, D.C. have chosen three firms to receive some of the city's largest contracts in an effort to provide healthcare to low-income D.C. residents enrolled in Medicaid and other government health programs.

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'Opioid Dependence: A Chronic Relapsing Brain Disease,' a free webinar by Reckitt Benckiser | April 17 | 3 p.m. EST
MHPA
Joe Volpicelli, M.D., executive director at the Institute of Addiction Medicine and staff physician at Chestnut Hill Hospital, will help payers, patients and their communities better understand the chronic nature of opioid dependence.
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'Blurring Boundaries: Considering the Role of Medicaid-oriented Health Plans in 2014 and Beyond,' a free webinar by Deloitte Consulting | April 24 | 3 p.m. EST
MHPA
As 2014 nears, many states are grappling with their approaches to Medicaid expansion, the expanded use of managed care to cover new categories of Medicaid beneficiaries and coverage of subsidized individuals through their exchanges. At the same time, HHS is providing greater flexibility to states to help maximize the scope of coverage expansion and help minimize churn between Medicaid and subsidized exchange programs. As Medicaid health plans navigate this uncertainty, they should consider the impact of the expanding scope of subsidized coverage and the evolution of traditional Medicaid norms and boundaries.

This presentation will explore the strategic and operational implications for health plans as they address major changes ahead, including: the evolving subsidized coverage landscape for managed care in Medicaid and exchanges; exchanges as a potential future channel for Medicaid enrollment and plan selection; the possible convergence of the Medicaid and subsidized individual exchange markets in some states, including Medicaid bridge plan and premium assistance approaches.

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Recent webinar presentations from Deloitte, PwC, AmeriHealth Mercy available free on MHPA's website
MHPA
View PDFs or listen to audio for "The Duals Dilemma — Identifying Effective Care Management Approaches to Support Meaningful Improvement" by Deloitte Consulting, "The Race to 2014: Health Reform and the 30 Million Newly Insured" by PwC, "Optimizing Pharmaceutical Care in a Drug Therapy Management Program" by The AmeriHealth Mercy Family of Companies and more.
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2012-2013 Best Practices Compendium on sale now
MHPA
MHPA's 2012-2013 Best Practices Compendium is the sixth edition of our annual publication that contains Medicaid health plans' best practices, as well as helpful resource information. Get yours today ($25 for members, $30 for non-members). To order, call 202-857-5720, or email us.
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TRENDING ARTICLES
Missed last week's issue? See which articles your colleagues read most.

    Republicans' firm 'no' on Medicaid expansion shifting (The Associated Press via The Washington Post)
Health Partners outpaces other area plans in provider satisfaction (Health Partners)
3 firms picked for DC Medicaid contracts (The Washington Post)
California duals demo smaller than proposed, yet size concerns remain (InsideHealthPolicy.com)
Alabama legislature to take on revamp of Medicaid (The Associated Press via WBNS-TV)


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MHPA on Twitter, LinkedIn and Facebook
MHPA
Follow us on Twitter, LinkedIn and Facebook to get industry-related news and the latest MHPA announcements.
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