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The Hill
Washington's leading drug lobbying group says that it favors a proposal from Hillary Clinton to cap out-of-pocket costs on drugs, a rare area of agreement between Clinton and pharmaceutical companies. Importantly for PhRMA, the proposal does not affect the full price of the drug, it just means that the insurance company will pay a larger share, as opposed to the patient. Insurance companies oppose the proposal precisely because it simply shifts more costs onto them without addressing the overall price of the drug.
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The Hill
The Obama administration's aggressive move to rein in the cost of prescription drugs in Medicare has triggered a backlash, with some advocates warning the plan goes too far. The administration is pursuing a pilot program that could squeeze the margins for doctors that prescribe high-cost drugs, potentially saving the government billions of dollars in the process. It's the first step of a model from the Centers for Medicare and Medicaid Services that could be finalized as early as next month. The stark shift in doctor payments is slated to go into effect in some parts of the country this summer.
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Inside Health Policy
Introducing Medicaid Roundup, a new feature on Inside Health Policy offering news and analysis of major policies affecting Medicaid stakeholders. The monthly roundup looks ahead at emerging issues and also provides an update on recent policy developments. You can read the latest Medicaid Roundup featuring MHPA's comments on North Carolina's $835 million in Medicaid overpayments to doctors and hospitals when you click here to set up your no-obligation, one-month-free trial to Inside Health Policy.
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Modern Healthcare
The John Kasich administration wants to transition to a more conservative Medicaid expansion that would allow Ohio to drop adult beneficiaries who don't pay into a health savings account, regardless of their income. In his 2015 budget proposal, Kasich, who is running for the Republican presidential nomination, suggested assessing premiums for adults above 100 percent of poverty. GOP state lawmakers last summer passed a bill to have it apply to all program beneficiaries.
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The Columbus Dispatch
Ohio Gov. John Kasich's administration projects tens of thousands of poor Ohioans will lose Medicaid coverage while taxpayers save nearly $1 billion under a plan to charge new fees for the government health coverage and impose penalties on those who miss payments. The proposal, subject to federal approval, would require those being treated for breast and cervical cancer, teens coming out of foster care and other working-age, nondisabled adults on Medicaid to make monthly payments into a health-savings account to help cover their expenses beginning Jan. 1, 2018.
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The Kansas City Star
For weeks, Senate Appropriations chairman Kurt Schaefer seemed determined to make major changes to Missouri's Medicaid program. In the end, the federal health insurance program for the state's poorest citizens emerged largely unscathed. Leading up to the Missouri Senate's vote Thursday to approve its version of the state's $27 billion budget, Schaefer repeatedly railed against projected Medicaid cost increases.
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The Associated Press via KTVI-TV
Missouri state senators have trimmed about $28 million of Medicaid spending from a mid-year increase to Missouri's budget. The Senate appropriations committee on Tuesday lowered the planned funding boosts for Medicaid's hospital care, medicine and physician services. Most of the nearly $500 million supplemental budget would still go to healthcare for people with low incomes.
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The Courier-Journal
Two Kentucky House bills meant to save kynect and the state's current Medicaid expansion died in a Senate committee Monday after an unusual move to pass the bills "with no expression" failed. The vote prompted objections from Democrats on the Senate Health and Welfare Committee, who called the attempt to move the bills along without actually voting in favor of them a political stunt to spare Republicans from having to vote in support of Obamacare.
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The Times-Picayune
Legislative support appears to be crumbling for plans to charge Louisiana Medicaid recipients copays for receiving healthcare services. Gov. John Bel Edwards threw his support behind copays after Republicans pushed for the measure as part of Medicaid expansion. But two legislators recently interviewed said there are serious doubts about whether there is enough support to get the plan out of committee after healthcare providers began lobbying against the bill. The House Health and Welfare Committee is scheduled to hear Medicaid copay bills Thursday.
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The Times-Picayune
Louisiana House Speaker Taylor Barras has filed legislation that will allow hospitals across the state to be charged a first-of-its-kind fee that will help the state pay for the cost of Medicaid expansion. The bill is the result of several years of legislative work that began under former Gov. Bobby Jindal, a vocal opponent of Medicaid expansion.
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New Hampshire Union Leader
The day New Hampshire Gov. Maggie Hassan signed the bill extending Medicaid expansion for two years, the federal Health and Human Services secretary rejected the state of Arkansas' work requirement, a key element in New Hampshire's bill. The biggest debate among lawmakers over reauthorizing the New Hampshire Health Protection Program was the 30-hour work requirement for more than 48,000 low-income adults.
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The Associated Press via Modern Healthcare
Utah's governor and lawmakers have agreed on a pared-down plan to expand Medicaid after wrestling with the issue for years, but the law still needs approval from federal officials. The plan, which Gov. Gary Herbert approved in late March, is estimated to insure about 16,000 people, mostly childless adults who are homeless or in treatment and offender programs.
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The Associated Press via KTHV-TV
Arkansas House leaders say a host of state programs including public schools, prisons and colleges would face cuts if lawmakers don't fund the state's hybrid Medicaid expansion. Arkansas House Speaker Jeremy Gillam on Monday released an alternate budget detailing the cuts needed if legislation funding the expanded coverage isn't approved. The Legislature last week approved Gov. Asa Hutchinson's plan to keep and rework the expansion, which uses federal funds to purchase private insurance for the poor.
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Montgomery Advertiser
Alabama Gov. Robert Bentley and Medicaid Commissioner Stephanie Azar on Wednesday laid out a stark picture of the impact of the Medicaid budget approved by the legislature, including the elimination of many services, cuts to physician reimbursements and elimination of drug coverage for adults.
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Argus Leader
A coalition working to expand Medicaid in South Dakota is racing to complete its work before a new president moves into the White House. The state has negotiated for years with the Obama administration to reach agreement on re-interpret federal policy on funding Medicaid-eligible American Indians. And in February, the governor's office learned that the federal government would accept the terms of a compromise if the state would expand Medicaid.
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MHPA and Institute for Medicaid Innovation
Last year, MHPA and the Institute for Medicaid Innovation (IMI) received nearly 100 submissions for consideration in the annual best practices compendium.
2016-2017 Medicaid Managed Care Best Practices Compendium
The categories for this year's compendium remain the same; women's and maternal health, child health, behavioral health, long-term care and transitions of care and expansion population. However, the deadlines for submission are earlier due to MHPA's annual conference occurring in September, instead of November as last year.
The following is the timeline for this year's submission cycle.
April 30: Best Practices Submission Form DUE
Sept. 21: Release of Compendium and Announcement of Awards at MHPA Conference (D.C.)
Women's Reproductive Health Project
The IMI is also leading a women's reproductive health project that is funded by the Kaiser Family Foundation. We will be administering a questionnaire developed by your colleagues at Medicaid health plans that will include an opportunity to briefly identify innovative and promising best practices, develop an issue brief and host a policy briefing with Kaiser. We encourage your participation in the following ways:
April 12: Questionnaire emailed to plans
May 16: Questionnaire DUE
TBD: Kaiser and Institute Joint Policy Briefing (D.C.)
Please send your submissions and any questions to Jennifer Moore.
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