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Obama's upcoming budget to spare Medicaid from deep cuts
The Associated Press via Fox News
 President Barack Obama's budget next week will steer clear of major cuts to Medicaid, including tens of billions in reductions to the health care plan for the poor that the administration had proposed only last year.
Big cuts in the federal-state program wouldn't go over too well at a time that Health and Human Services Secretary Kathleen Sebelius is wooing financially skittish Republican governors to expand Medicaid coverage to millions who now are uninsured. That expansion in the states is critical to the success of Obama's health overhaul, which is rolling out this fall and early next year.
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Top healthcare nominee garners bipartisan praise
The Hill
Republicans lavished praise on President Barack Obama's nominee for a key healthcare post. Marilyn Tavenner found broad bipartisan support as the Senate Fiance Committee considered her nomination to lead the Centers for Medicaid Services — a post that includes overseeing both entitlement programs as well as implementation of the Affordable Care Act.
Study: Shift to managed Medicaid shows some effects on patient care, but overall effect unclear
Drug Store News
A growing number of patients on Medicaid are filling their prescriptions through managed Medicaid plans instead of the fee-for-service model as states switch them over in an effort to improve patient care and cut healthcare costs, but the effects remain unclear, according to a new study.
Tens of thousands could be kicked off Medicaid in historically generous states
The Washington Post
At a time when most states are preparing to expand their Medicaid programs in line with the new healthcare law, tens of thousands of people in states with historically generous Medicaid coverage could soon be kicked off the rolls.
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This week's Webinar Wednesday: '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.
Ohio House to drop Medicaid expansion
The Associated Press via Zanesville Times Recorder
A Republican-controlled legislative panel will drop Ohio Gov. John Kasich's proposal to expand the Medicaid program from the state's two-year budget plan, as advocates for extending the healthcare coverage to thousands more low-income Ohioans prepared to rally against the move.
Missouri senators to Nixon: No deal on Medicaid expansion this session
St. Louis Beacon
One week after discussing Medicaid expansion with House Republicans, Missouri Gov. Jay Nixon will sit down with Republican members of the Missouri Senate to talk about the issue. But the meeting may not go too smoothly, as the top Republican in the Missouri Senate indicated that Medicaid expansion may be dead for the session.
Texas House backtracks on Medicaid amendment
The Texas Tribune
Hours after approving the measure, the Texas House backpedaled on an amendment to the 2013-14 budget that would have opened the door to negotiations on expanding Medicaid, a key provision of federal healthcare reform.
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Chartered Health Plan will become AmeriHealth District of Columbia on May 1
The Washington Post
It appears one of the best-known names in Washington D.C. healthcare has less than a month to live. AmeriHealth Mercy Family of Cos. will assume operations of D.C. Chartered Health Plan on May 1. The plan, serving low-income residents eligible for Medicaid and other government health programs, will be doing business as "AmeriHealth District of Columbia," according to a company spokesperson.
ValueOptions names Jason Feuerman public sector division president
ValueOptions
ValueOptions, a health improvement company specializing in mental and emotional wellbeing and recovery, has announced that Jason Feuerman has joined the company as senior vice president and public sector division president.
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Obama's upcoming budget to spare Medicaid from deep cuts
The Associated Press via Fox News
President Barack Obama's budget next week will steer clear of major cuts to Medicaid, including tens of billions in reductions to the health care plan for the poor that the administration had proposed only last year.
Big cuts in the federal-state program wouldn't go over too well at a time that Health and Human Services Secretary Kathleen Sebelius is wooing financially skittish Republican governors to expand Medicaid coverage to millions who now are uninsured.
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Florida implements CMS' requirements; MCOs concerned about MLR
InsideHealthPolicy.com
Insurers are expressing concern that CMS' medical loss ratio requirements for Florida's Medicaid managed care waiver, which went into effect April 1 for the demonstration, indicate HHS could create a federal MLR requirement for managed care organizations, despite stakeholders' arguments that existing federal requirements render MLR requirements unnecessary for Medicaid plans.
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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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'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.
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.
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.
Missed last week's issue? See which articles your colleagues read most.
Annual Medicaid Managed Care Congress | May 20-22 | Baltimore Marriott Inner Harbor Hotel | Baltimore
Institute for International Research
Collaborate and drive innovation to move the Medicaid industry forward. Implement the ACA, increase quality, grow membership and strengthen financials. Register with code XP1826MHPA, and save 25 percent.
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