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MHPA
Read the statement from Medicaid Health Plans of America (MHPA) President and CEO Jeff M. Myers on the sweeping final rule that modernizes Medicaid managed care regulations for the benefit of Medicaid health plans, states, and Medicaid recipients.
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Morning Consult
The Medicaid Health Plans of America, a trade association representing the health insurers that sell Medicaid plans, says the recently-released Medicaid managed care rule reflect the shift away from a fee-for-service system. "With the vast majority of beneficiaries being served by Medicaid managed care organizations (MCOs) using a risk-based capitated model, the final regulations released on April 25, reflect the changes that have occurred in Medicaid since 2002 as states shift from a fragmented fee-for-service system to coordinated, comprehensive care for our nation’s underserved," Jeff Myers, the group’s president and CEO said according to a press release released Friday.
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HealthExec
New standards for the private insurance plans that cover most Medicaid beneficiaries include an 85 percent medical-loss ratio (MLR). "Every single state contract has a medical-loss ratio in it. That is a substantive part of the contract and the states take very seriously money used by the plans to spend on the medical portion of the benefit," MHPA president and CEO Jeff Myers said. "So our view was that having the feds set an arbitrary number is unnecessary and possibly disruptive."
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Modern Healthcare
The key word defining the first significant federal changes to Medicaid managed care in 14 years is "flexibility" – for states, that is.
The CMS laid the responsibility of ensuring that some of the country's poorest residents receive timely, high-quality care to the 39 states and the District of Columbia that contract with private managed-care plans to provide Medicaid services.
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MHPA
During this webinar, asthma compliance and asthma control will be the main topics of discussion. Basic information on the current state of asthma compliance and some of the real-world limitations will be introduced. Data results will be provided on a pilot study that was completed within the Medicaid population that utilized remote in-home patient monitoring to improve asthma medication compliance. Other areas of potential impact to improve asthmatic control using new and updated technology will be discussed. This program serves to increase the awareness and consideration of alternatives to the standard mode of treatment to improve asthma control.
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Kaiser Health News
Every day, headlines detail the casualties of the nation's surge in heroin and prescription painkiller abuse: The funerals, the broken families and the patients cycling in and out of treatment. Now, a new study sheds light on another repercussion – how this public health problem is adding to the nation's ballooning healthcare costs and who's shouldering that burden.
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Morning Consult
Momentum on most major legislation is stalled, from a response to the Zika virus to the Puerto Rico debt. But lawmakers have had no trouble advancing a legislative response to the growing opioid addiction problem. Three House Committees voted to advance more than a dozen opioid bills to the House floor on this week. The legislation has broad support. Members of the Energy and Commerce Committee, the Judiciary Committee and the Education and the Workforce Committee approved most bills by voice vote, with little debate on many of them.
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TMG Health has the experience and expertise you need to administer your Medicaid plan efficiently and effectively. Our technology-enabled solutions can help you attain the highest achievable performance while OPTIMIZING COSTS and ENSURING COMPLIANCE. Contact us to learn how outsourcing with TMG Health can improve your plan performance.
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USA Today
Most inmates in halfway houses after release from prison will be eligible for Medicaid benefits under a new federal policy announced Thursday, April 28.
The change, part of a larger push by the Obama administration to help former inmates or reduce sentences, means nearly 100,000 people in halfway houses in states where they would be eligible for Medicaid should soon have access to health care, mental health and substance abuse treatment.
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The New York Times
New York's governor is seeking federal approval to extend Medicaid coverage to inmates who face serious health challenges immediately before they're released from prison.
Andrew Cuomo's office announced that the state is the first in the nation to make such a request.
The Democratic governor says that too many inmates leave prison with serious mental health and addiction challenges and that helping them get the care they need improves their chances of successfully re-entering society.
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NOLA.com
Gov. John Bel Edwards debuted a new website and name for Louisiana's Medicaid program on Monday, May 2, saying "Healthy Louisiana" will replace Bayou Health as a program aimed at making people across Louisiana healthier.
The new name is expected to be printed on all new materials being distributed as part of Medicaid expansion, Department of Health and Hospitals Secretary Rebekah Gee said Healthy Louisiana will only be printed on new materials.
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The Hill
The Obama administration and Texas have reached an agreement to extend a temporary program that helps the state's poor access healthcare, postponing a contentious debate over ObamaCare's Medicaid expansion. The deal between the federal Centers for Medicare and Medicaid Services (CMS) and Texas continues for another 15 months an "uncompensated care" program that gives billions of dollars in federal funding to help hospitals in the state care for the uninsured.
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Yahoo
An additional 15,000 children and pregnant women grappling with Flint's lead-contaminated water crisis should become eligible for government health insurance starting next week, once the funding receives final legislative approval, Gov. Rick Snyder said Monday, May 2. The expanded health coverage will apply to people under 21 who used Flint's water system from April 2014, when the city switched its water source, until the time it is deemed safe again.
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The Hill
A group of 242 lawmakers is calling on the Obama administration to scrap a proposal aimed at fighting high drug prices. The proposal to change how Medicare pays for certain drugs has been controversial, drawing concern from both sides of the aisle in Congress. However, only four House Democrats joined the letter on Monday calling for a complete end to the program.
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USA Today
The drug company previously headed by Martin Shkreli was sued Monday for allegedly breaching a contract that let it sell Daraprim, the medication whose price the company marked up 5,000 percent, sparking nationwide criticism. New York City-based Turing Pharmaceuticals neglected to provide and certify accurate pricing data for the drug and failed to assume responsibility for Medicaid rebate liability linked to the medication's sales, the federal lawsuit filed in New York by Impax Laboratories (IPXL) charged.
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MHPA and Institute for Medicaid Innovation
Women's Reproductive Health Project The IMI is 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:
- 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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