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MHPA flexes its policy chops, hires Medicaid expert Ashley Gray
Ashley Gray joins Medicaid Health Plans of America (MHPA) as the national trade association's new director of federal policy. In this role, Gray will serve as the organization's lead for all policy and regulatory issues that affect the Medicaid managed care industry.
Gray comes to MHPA from Avalere Health, a Washington, D.C.-based healthcare consulting firm. There she provided strategic health reform implementation support to life sciences and health plans, with a particular focus on state and federal Medicaid policy issues.
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April 15 Webinar Wednesday: 'The Role of Medicaid Managed Care Organizations in State Innovation Models'
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.
Discounted hotel rooms for MHPA's DC Legislative Fly-In expires
Friday, April 17
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. Special guest speaker is Pennsylvania Sen. Pat Toomey. Book by Friday, April 17, to get the room discount.
Click here for reservation information.
For details, please contact Nikida Levy via email or by phone at 202-857-5720.
Senate to consider 6 'doc fix' amendments, including CHIP extension
The Senate is expected to consider six amendments on a $200 billion Medicare reform package that is slated for a vote Tuesday afternoon, according to a source familiar with the negotiations. Under current plans, senators will consider three proposals from Democrats and three from Republicans to amend the House's "doc fix" legislation.
Specialty med cost up 27 percent in 1 year to $124 billion
Los Angeles Times
Driven by innovative but pricey new drugs for hepatitis C, U.S. spending on prescription drugs jumped 13 percent last year to a record $374 billion, according to an industry report.
The new hepatitis C drugs accounted for more than $11 billion of the spending, according to a report by IMS Institute for Healthcare Informatics, an industry research firm. Its annual report analyzes pharmaceutical sales, top-selling drugs and trends in the industry.
The influx of millions of people newly insured under the Affordable Care Act was less of a factor than expected — about $1 billion of the spending growth, it said.
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Specialty, generic drug costs drive Missouri Medicaid costs up
The Associated Press via The Baltimore Sun
The high cost of a drug used to treat Medicaid patients with hepatitis C drew scrutiny from lawmakers earlier this year, but other drugs are also driving up the state of Missouri's costs and likely will continue to do so for several years, government data reveals.
State of Kentucky aims to improve Medicaid managed care
In a step intended to address concerns of patients and providers, the state has decided to seek bids for new standardized contracts to manage the massive Kentucky Medicaid program. The Kentucky Health and Family Services Cabinet announced Monday it is advertising for new bids rather than exercising its option to extend for a year current contracts with five managed-care organizations that will expire June 30.
Montana lawmakers endorse Medicaid expansion
The Montana Legislature has backed expansion of the state's Medicaid program under Obamacare, a startling turnaround after supporters' repeated setbacks during the current session. The action provides the Obama administration a much-needed boost given how efforts have foundered in other states such as Tennessee, Wyoming, Utah and Florida. The House's final passage of the measure on Saturday marks the first time this year a Republican-dominated legislature has agreed to expand coverage under the healthcare law.
Alaska governor: Medicaid reform without expansion unacceptable
The Associated Press via The Charlotte Observer
Alaska Gov. Bill Walker said Monday that he could not support Medicaid reform legislation without Medicaid expansion. Walker in an interview said reform and expansion go hand-in-hand. To have reform and not expansion, he said, would be unacceptable.
South Carolina senators renew push for Medicaid expansion debate
The Post and Courier
A bipartisan group of senators plans to push for South Carolina lawmakers to accept federal health care money that Gov. Nikki Haley and other Republicans have previously rejected. A state budget amendment would allow more of South Carolina's poorest residents access to healthcare through new money from the federal government.
Missed an issue of MHPA's Industry NewsBrief? Click here to visit the brief's archive page.
Medicaid expansion in Florida faces long odds in final weeks of session
The Florida Senate is advancing a plan that would let the state use federal Medicaid expansion money to subsidize a new state-run marketplace for private insurance. It would be available to low-income Floridians who work and pay small monthly premiums. The proposal has the support of influential business organizations, hospitals and grassroots consumer advocacy groups. But for both political and logistical reasons, it is a long shot in the final weeks of Florida's legislative session.
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States expanding Medicaid see significant budget savings and
Robert Wood Johnson Foundation
States that expanded the number of people eligible for Medicaid are seeing big budgetary savings without reducing services. Data from eight states show $1.8 billion in budget savings and revenue gains by the end of 2015 as a result of Medicaid expansion.
Uninsurance among young adults continues to decline, particularly in Medicaid expansion states
The Affordable Care Act provision allowing young adults to remain on a parent's private insurance plan until age 26 disproportionately reduced uninsurance among higher-income young adults, while the 2014 coverage provisions were associated with substantial reductions for those with low and moderate incomes, particularly in Medicaid expansion states. About 20 percent of young adults remained uninsured in early 2014.
April 29 Webinar Wednesday: 'One Member, One Community, One Day at a Time: Guiding Principles for Person-Centered Care'
Focus on implementing organizational and individual change from a strength-based perspective with a focus on the concepts of "One Member, One Community, One Day at a Time." Join Luke Crabtree, chief executive officer at Project Transition, who will provide concepts and tools that support professionals working directly with persons with serious mental illness and co-occurring disorders, including the identification of strengths in the change implementation process and data use to show positive outcomes in behavioral health.
Did you miss Webinar Wednesday: 'Medication Monitoring & Pharmacogenetic Testing (PGT): Helping Clinicians to Individualize Safer Opioid Management' by Millennium Health?
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.
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.
Job opportunity: RN, manager, prior authorization | Detroit
Aetna seeks experienced RN with managed care, leadership and prior authorization expertise. Reinforces clinical philosophy, programs, policies and procedures. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes. Visit here and search for requisition #24937BR to learn more and apply.
Job opportunity: Clinical director, Homecare & Managed Care
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.
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