This message contains images. If you don't see images, click here to view.
Advertise in this news brief.
|
|
| |
Expensive hepatitis C drug presents Medicaid payment quandary for
South Carolina
The State
A new drug that's extremely effective in treating hepatitis C costs $84,000 per patient, but it can prevent much more costly medical expenses down the road. The challenge facing state Medicaid program managers is how to balance Sovaldi's up-front cost while also considering the health of hepatitis C patients.
$1,000 hepatitis C pill a tough miracle to swallow
San Francisco Chronicle
Three decades ago, Scott Barnes needed luck to survive the bullets and bombs of the Vietnam War. Today, his life depends on a beige, $1,000 pill. Hailed as a breakthrough treatment for hepatitis C, Sovaldi could help more than 130 million people across the globe who suffer from the disease.
SHOWCASE
 |
|
How much can our customized solutions save you? Contact HMS today.
|
|
Who should get pricey hepatitis C drugs?
Kaiser Health News and The Washington Post
Simple math illustrates the challenge facing U.S. taxpayers, consumers and insurers following the launch late last year of two expensive new drugs to treat hepatitis C. If all 3 million people estimated to be infected with the virus in America are treated at an average cost of $100,000 each, the amount the U.S. spends on prescription drugs would double, from about $300 billion in one year to more than $600 billion.
Growing pains for Medicaid managed care expansions
Healthcare Payer News
Although they're not expanding Medicaid under the Affordable Care Act, Texas, Florida and other states are expanding managed care, bringing insurers opportunities as well as challenges, including competition from provider-based health plans.
May 7 Webinar Wednesday: 'Emerging Regulatory Issues and Risk Exposures Impacting Medicaid Managed Care Plans' by Deloitte
Deloitte Consulting
As Medicaid coverage expands under the ACA, states — along with Medicaid health plans — are faced with the challenges of enrolling newly eligible beneficiaries through Health Insurance Exchanges, providing coverage to these individuals and coordinating delivery of care and benefits with other entities. The ACA has set forth regulatory guidelines for expansion which Medicaid health plans must follow.
As plans navigate this regulatory landscape, failure to comply with such regulations may have financial ramifications in addition to federal fines. This webinar will explore the emerging regulatory environment of Medicaid managed care plans and implications as they comply with state and federal compliance, security and privacy regulations.
Medicaid & CHIP: March 2014 monthly applications, eligibility
determinations and enrollment report
Centers for Medicare & Medicaid Services via Medicaid.gov
This report is the sixth in a series of monthly reports on state Medicaid and Children's Health Insurance Program data, and represents state Medicaid and CHIP agencies' eligibility activity for March 2014.
Burwell, ahead of confirmation hearings, talks Obamacare menu regs
The Hill
President Barack Obama's nominee to be the next secretary of Health and Human Services took time recently to discuss with concerned lawmakers a contentious Obamacare regulation requiring calorie counts on restaurant menus. The meetings with senators, revealed in administration records, come as the Senate considers White House budget director Sylvia Mathews Burwell's nomination to replace Secretary Kathleen Sebelius.
Pew poll: Opposition to Obamacare at new high
The Hill
A recently released poll found that 55 percent of people in the United States disapprove of Obamacare despite the surge in enrollments this year. The survey from Pew Research Center and USA Today found 41 percent support the health law. In September, before the launch of Healthcare.gov, 53 percent said they disapproved of Obamacare, with 42 percent registering approval.
|
| FEATURED ARTICLE
|
TRENDING ARTICLE
|
MOST POPULAR ARTICLE
|
Illinois Medicaid moves to managed care
Chicago Tribune via
Kaiser Health News
Sherry Loveless can see the promise of managed care right through her bedroom door. Saddled with multiple disabilities, Loveless, 61, has been stuck in her Rockford, Ill., bedroom for months because the doorway is too narrow for her wheelchair to squeeze through. Thanks to a restructuring in Illinois' Medicaid program, a renovation project is scheduled to widen the door and build a ramp that will allow her access to the outside.
|
|
State of Pennsylvania waiting for Medicaid expansion ruling
The Associated Press via
The Washington Post
While awaiting a federal decision on his request to link a work requirement to benefits under the Medicaid expansion, Pennsylvania Gov. Tom Corbett has softened his rhetoric. It's an issue that has flared up in his hotly contested re-election campaign.
|
|
States enroll former foster youth in Medicaid
The Pew Charitable Trusts
One of the Affordable Care Act's successes is a provision that allows young people up to 26 years old to remain on their parents' health insurance. Under a similar-but-less-known provision, young adults who have been recently released from foster care can also get Medicaid coverage, regardless of their incomes. An estimated 180,000 foster care alumni became eligible on Jan. 1.
|
|
Virginia Senate Democrats urge GOP to offer health proposal
Richmond Times-Dispatch
Virginia Senate Democrats called on House Republicans to produce the alternative healthcare proposal they promised months ago to close the coverage gap.
Democrats say Kansas Medicaid expansion won't be debated after
GOP maneuvers
Kansas Health Institute
Kansas House Democrats said recent discussion of Medicaid expansion was essentially over for this legislative session after procedural moves by Republicans to avoid floor debate on the topic in the lower chamber.
California state officials prioritized insurance exchange over enrollment system for the poor
California Health Report
As they scrambled to open the insurance gates to millions of Californians under the federal health law, state officials prioritized the open-marketplace enrollment system over one for low-income residents, according to California state documents and officials. That decision significantly contributed to the backlog of about 900,000 applications to Medi-Cal, the state's low-income health program.
Arkansas Medicaid director stepping down from position
The Associated Press via Arkansas Business
Andy Allison, the director of Arkansas' Medicaid office, is stepping down from the position, according to the Department of Human Services. Allison, who led implementation of the private option, has been state Medicaid director since 2011 and will leave the position as of June 1 to pursue other opportunities.
MHPA adds new member in Harbor Health Plan
MHPA
Medicaid Health Plans of America is proud to welcome Harbor Health Plan as its newest member. Harbor Health Plan (formerly ProCare Health Plan) is owned by Tenet Healthcare Corporation and affiliated with the Detroit Medical Center.
Harbor Health Plan has deep roots in caring for the Wayne County population. Harbor was certified as a Clinic Plan in 1996, a Qualified Health Plan in 1998, and a licensed HMO in December 2000. Their MHPA board member is Carrie Harris-Muller, Harbor's president and CEO.
Visit Harbor here. Visit here for a full list of MHPA member health plans.
Share this article:
 |
Did you miss Webinar Wednesday's 'Prediction and Prevention of Preterm Birth' by CerviLenz? Download slides, other webinar presentations free
MHPA
View PDFs or listen to audio for the following webinars:
View additional webinars here.
|
Share this article:
|
173 days until mhpa2014: Registration set to open June 2014; hotel, airfare discounts now available
MHPA
"Making It Personal: Focusing on the Enrollee in the Tangled Era of Health Reform," MHPA's 2014 conference on Oct. 26-28 at the new Marriott Marquis/Walter E. Washington Convention Center in downtown Washington, D.C., will put the spotlight back on the Medicaid beneficiary. Registration will open in June, but hotel and flight discounts are available now. Click here for details.
If you're interested in sponsoring or exhibiting at mhpa2014, please check out our sponsor page.
Missed our previous issues? See which articles your colleagues read most.
May 14 Webinar Wednesday: 'Effective Administration of
Dual Eligibles' by TriZetto
TriZetto
The dual-eligible market is growing rapidly with projected membership expected to increase by 400 percent by 2020. This market represents a significant opportunity for health plans who are able manage this complex population efficiently and effectively. Join TriZetto's Becky Erbe, vice president of government programs, and Norah Brennan, associate vice president, as they discuss roadblocks to managing duals and solutions to serve this vulnerable population.
May 21 Webinar Wednesday: 'Transitioning to Managed Care for Individuals Receiving Long Term Services Support' by Deloitte
Deloitte Consulting
The Long Term Services Support population is undergoing a dramatic change as states and plans transition home and community-based services and nursing home services from a fee-for-service system to a managed care system. Jim Hardy and Jim Jones, both specialist leaders at Deloitte Consulting LLP, will focus on some of the key capabilities organizations should develop to overcome challenges in the areas of provider contracting, risk management and targeted care models.
MHPA launches health insurance tax website MedicaidTaxHurts.org
MHPA
Visit MedicaidTaxHurts.org for everything you need to know about the health insurance tax, including its effect on the Medicaid program and how it hits individual states.
MHPA CEO Jeff Myers to speak at Medicaid Managed Care Congress 2014, scheduled May 19-21 in Baltimore
MHPA
The Medicaid Managed Care Congress is where government officials, health plan executives and other key players of the healthcare ecosystem come together to learn from one another. Not only will you have exclusive access to industry leaders who will guide you through the 2014 healthcare evolution, you will also have unique networking opportunities to learn from case studies that will drive your business strategy forward.
Highlights include: CMS Keynote speakers, ABC News Chief White House Correspondent, Jeff Myers, MHPA's president and CEO, Jonathan Karl, 18+ health plan case studies from MajestaCare, Molina Healthcare, Cigna-Health Spring and more, eight intimate round table discussions with government officials and 12 never-before-heard presentations across three unique tracks.
Save 20 percent with your MHPA code: XP1926MHPA. Visit here to register today!
|
Share this article:
|
MHPA on Twitter, LinkedIn and Facebook
MHPA
Follow us on Twitter, LinkedIn and Facebook to get industry-related news and the latest MHPA announcements.
|
Share this article:
|
|
|
|
|
Sponsored by ...
|
7701 Las Colinas Ridge, Ste. 800, Irving, TX 75063
|
