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MHPA
MHPA president and CEO Jeff Myers contributes to this story on Blue Cross Blue Shield of New Mexico using EMTs to keep Medicaid beneficiaries out of emergency rooms. Significantly higher use of emergency services is consistent with what other Medicaid managed care plans have reported in states that expanded Medicaid, Myers said.
"In the short period after [Medicaid] expansion, there were some who showed up very sick in the ER because they never had access to quality medical care until Medicaid," Myers said. "The remainder showed up for less serious conditions that can be treated in other settings, but think that the ER is their only or easiest option."
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The Hill
Rep. Bob Dold (R-Illinois) said Saturday the fight against the opioid epidemic must continue as both Congress and the White House put forward initiatives to address the growing issue.
"This type of abuse spans every demographic, financial situation and community," Dold said in the weekly Republican address. "It can literally happen to anyone. That's why the opioid epidemic demands a national response. We can't let politics get in the way of giving people a second chance at recovery."
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Kaiser Health News
At Richard Logan's pharmacy in Charleston, Missouri, prescription opioid painkillers are locked away in a cabinet. Missouri law requires pharmacies to keep schedule II controlled substances — drugs like oxycodone and fentanyl with a high addiction potential — locked up at all times. Logan goes further than the law requires. He’s been a pharmacist for 40 years. For the last 20, he has also been a reserve deputy with two local sheriff's departments, investigating prescription drug abuse. That puts him on edge in his day job.
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Nashville Public Radio
Tennessee House Speaker Beth Harwell is putting together a task force that will study ways to improve Medicaid in Tennessee, more than a year after lawmakers rejected Gov. Bill Haslam's plan to expand the program. Harwell announced the task force of four Republican lawmakers Tuesday. They're to report back in June with some ideas to improve Medicaid, known in the state as TennCare.
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The Associated Press via Albuquerque Journal
A spot survey by New Mexico analysts found low-income Medicaid patients in the state are waiting on average from three weeks to nearly two months to get an appointment with a doctor, prompting new concerns about barriers to health care access for the poor and disabled. Staff at the Legislative Finance Committee on Wednesday released results of a "secret shopper" survey that they devised after struggling to find any other meaningful measure of wait times in multiple Medicaid contract evaluations for managed care organizations.
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Southwest Times Record
A bill to appropriate funding for the state Medicaid program, including the governor's plan for Medicaid expansion, advanced out of committee on Wednesday, the first day of the Arkansas Legislature's fiscal session. The bill cleared the Joint Budget Committee in a voice vote and is expected to be voted on Thursday in the Senate. Legislators on both sides of the debate over Medicaid expansion said the bill was unlikely to pass in the Senate.
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KOCO-TV
Many nursing homes across rural Oklahoma, including Fairview Fellowship Home, may have to stop serving Medicaid patients if the proposed cuts are approved. The Oklahoma Health Care Authority has proposed cutting provider reimbursement rates for Medicaid by 25 percent. Fairview Fellowship Home is the only five-star nursing home within a 50-mile radius in Major County.
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Portland Press Herald
The Maine House voted to approve an expansion of Medicaid on Wednesday, but still fell well short of the margin needed to overcome an inevitable veto from Gov. Paul LePage. The 85-64 vote was largely along party lines and came one day after the Republican-controlled Senate narrowly endorsed using federal funds to purchase coverage for more low-income Mainers. The measure, however, appears headed for a sixth-straight defeat by LePage, who has argued expansion would cost the state more money down the line.
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Rapid City Journal
Although nothing is certain yet about South Dakota's proposed expansion of Medicaid coverage, a member of Gov. Dennis Daugaard's cabinet on Monday said preparations for adding 50,000 Medicaid recipients are moving "full speed ahead." Daugaard would call a special session of the Legislature on expanding Medicaid eligibility, and a decision on whether to do that probably will come by summer.
But Social Services Secretary Lynne Valenti said five teams of tribal, state and federal government officials are working with health care providers on the operational plans. She provided an update to members of the state Board of Social Services.
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The Henry J. Kaiser Family Foundation
Medicaid provided health coverage for over 70 million individuals during the 2013 fiscal year. A number of studies have demonstrated that Medicaid coverage helps to improve receipt of preventive healthcare, access to care, and out-of-pocket spending burdens and other financial outcomes.
However, given ongoing concerns about federal and state budgets, the costs of the Medicaid program are likely to be again at the forefront of state and federal policy discussions. As federal policy makers consider proposals to reform Medicaid financing, this issue brief examines evidence from over 40 methodologically rigorous studies related to Medicaid program spending.
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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.
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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