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Most doctors still reject Medicaid as program expansion nears
McClatchy
Doctors in several states have refused to operate on patients covered by Medicaid, the state-federal health insurance program for poor people and those with disabilities. Because of the program's history of low payments, fewer than half of U.S. doctors and other health care professionals accept Medicaid patients, according to a recent study.
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White House won't ding Medicaid expansion holdouts
Politico
The Obama administration has proposed delaying a potentially painful decision on whether to penalize states that refuse to expand Medicaid coverage for low-income populations under Obamacare. The national healthcare law calls for a gradual reduction in special federal payments — known as Disproportionate Share Hospital, or DSH payments — to hospitals that take care of large numbers of uninsured patients.
Colorado Gov. Hickenlooper signs Medicaid expansion
KDVR-TV
The last of the 11 bills Colorado Gov. John Hickenlooper signing into law is by far the most significant and controversial of the bunch — a major expansion of Medicaid that will provide coverage for a 160,000 uninsured Coloradans.
MHPA welcomes MTM as newest partner company, MHPA 2013 sponsor
MHPA
MHPA proudly welcomes MTM, a medical and transportation management company, as its newest corporate partner and sponsor of MHPA 2013, MHPA's annual conference. MTM's mission is to improve the overall health and well-being of individuals by removing barriers to healthcare and promoting independence. MTM provides transportation management, home and community-based services, call center services, ambulance claims management, functional assessments and travel training to state and county governments, Medicaid and Medicare managed care organizations (MCO), third-party administrators and healthcare providers.
By providing careful assessments, comprehensive care management, and responsible network development and oversight, MTM is able to improve member outcomes while helping clients align incentives, reduce costs, and increase customer satisfaction. For more on MTM, visit here, or call 1-888-561-8747. For a complete list of MHPA partners, visit here.
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Arizona House Speaker Tobin takes on Medicaid standoff
The Arizona Republic
Arizona House Speaker Andy Tobin has emerged as the key player in getting Gov. Jan Brewer's Medicaid expansion plan through the legislature, and momentum may be shifting in the nearly dormant Capitol as he appears ready to negotiate. Tobin who opposes the Brewer plan as drafted, said he is working on an alternative that could include putting a time limit on the broadened eligibility and the hospital tax that helps fund it, stronger legislative oversight of the state's Medicaid program and audits of hospital finances.
Beshear: State of Kentucky will expand Medicaid
CNHI News Service via The Morehead News
Kentucky Gov. Steve Beshear recently announced the state will go along with an expansion of Medicaid to deliver healthcare coverage to 308,000 presently uninsured citizens through provisions of the Affordable Care Act — or Obamacare as it's sometimes called.
Michigan Medicaid expansion: Snyder concerned, Democrats critical of 4-year cap in House GOP plan
Michigan Live
Michigan House Republicans recently laid out a unique and far-reaching proposal that would initially expand Medicaid eligibility in Michigan but place a four-year cap on coverage for able-bodied adults.
Ohio Senate President Faber signals hope for Medicaid 'reform' but not
Kasich-style expansion
The Plain Dealer
Ohio Senate President Keith Faber told a City Club of Cleveland crowd that he expects state legislators to tackle Medicaid "reform" by the end of the year. But the Republican is not optimistic that a deal will reached before the June 30 deadline to pass the state's two-year budget. He also doubts the final product will resemble the Medicaid "expansion" Gov. John Kasich favors.
Texas Medicaid providers make a last push for higher rates
The Texas Tribune
In the waning days of budget negotiations, medical providers are sounding their biennial battle cry to raise Medicaid reimbursement rates. Despite their refrain that increasing reimbursement rates could shore up the program's provider network, the rates probably won't budge much, as that is traditionally one of few variables that the legislature relies on to contain Medicaid costs.
Budget rider could lay out terms for Texas Medicaid reform
The Texas Tribune
The fate of Medicaid reform in Texas could rest solely on an up-or-down vote on the 2014-15 budget. State Rep. John Zerwas, a member of the conference committee that is hashing out the differences between the House and Senate budget plans, said he's relatively confident that a rider stipulating the legislature's preferred Medicaid reform terms — like cost containment measures and private market reforms — for any deal with the federal government is "sticking" to the 2014-15 budget.
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White House gives nod to Utah's dual exchange
Politico
Utah will be the only state in the country next year to run its own Small Business Health Options Program exchange — under a modified set of Obamacare rules — and let the federal government set up the exchange for the individual market. Republican Gov. Gary Herbert announced that Utah had received a crucial nod from the White House that will allow the state to bend Obamacare's exchange rules to accommodate the state's small-business exchange.
DC nears decision on health insurance exchange
The Washington Post
The D.C. Council could decide soon whether to require small-business owners to purchase their employee health insurance through a city-run exchange, highlighting a special implication of the federal healthcare overhaul that has been strongly opposed by some business interests. Councilmember Yvette M. Alexander said she planned to introduce emergency legislation to be taken up at a May 22 meeting authorizing key policy aspects of the city's health insurance exchange, which is set to open Oct. 1.
ACOs complain of problems with payer data, but some say they expect too much
AISHealth
As more provider organizations seek out accountable care partnerships with insurers, those nascent ACOs say they are bumping up against a sometimes unexpected but very real problem: The data the payers are able to provide them with isn’t always high enough quality to be usable. This has led to struggles as the ACOs attempt to reconcile their internal data with the data provided by insurers. Subscription required
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To find out how to feature your company in the MHPA eNewsletter and other advertising opportunities, Contact James DeBois at 469-420-2618.
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Novo Nordisk's US Diabetes Barometer initiatives influencing policy
Novo Nordisk
Novo Nordisk's U.S. Diabetes Barometer is a framework for measuring the progress in the fight against diabetes. DiabetesBarometer-US.com is a comprehensive online resource that highlights important research about the current state of diabetes in the United States, including state-level diabetes cost and prevalence projections out to 2025. To learn how the U.S. Diabetes Barometer initiatives are influencing policy click here. To access the new U.S. Diabetes Barometer and understand how your state compares with others, please visit here.
MHPA job opportunity: Director of membership and development in
Washington, DC
MHPA
The director will assist MHPA in recruiting new members and managing membership accounts. Applicants will be accepted through May 17.
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Aetna acquires Coventry Health Care
Aetna
Aetna acquired Coventry Health Care, Inc., on May 7. As a combined company, Aetna is now the third largest healthcare benefits company in America based on membership. Aetna now serves an estimated 22 million medical members in the U.S. and around the world.
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Obamacare repeal vote coming in House
The Hill
In a nod to the right, House Republican leaders will once again seek to repeal President Barack Obama's healthcare law. The decision, announced by House Majority Leader Eric Cantor, represents a shift by top Republicans in the lower chamber.
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Navigant job opportunities in DC, Chicago areas
Navigant
Navigant is a specialized, global expert services firm dedicated to assisting clients in creating and protecting value in the face of critical business risks and opportunities. Navigant's Healthcare Practice strives to be the premier independent management consulting practice assisting senior level healthcare executives deal with their core business challenges.
Aetna job opportunity: Director of medical management for
Delaware Physicians Care
Aetna
Aetna is looking for a new director of medical management for Delaware Physicians Care. The position oversees the implementation and on-going execution of the strategic and operational business plan for the business segment's clinical operations, inbound/outbound call queue, implementation and/or plan sponsor operations. The position also coordinates business segment policies and procedures in support of financial, operational and service requirements.
Recent webinar presentations from Deloitte, Reckitt Benckiser, ProgenyHealth available free on MHPA's website
MHPA
View PDFs or listen to audio for "Blurring Boundaries: Considering the Role of Medicaid-oriented Health Plans in 2014 and Beyond", by Deloitte Consulting, "Opioid Dependence — A Chronic Relapsing Brain Disease" by Reckitt Benckiser, "NICU Costs, Trends, and Effective Management Solutions" by ProgenyHealth and more.
Missed our previous issues? See which articles your colleagues read most.
2012-2013 Best Practices Compendium on sale now
MHPA
MHPA's 2012-2013 Best Practices Compendium is the sixth edition of our annual publication that contains Medicaid health plans' best practices, as well as helpful resource information. Get yours today ($25 for members, $30 for nonmembers). To order, call 202-857-5720, or email us.
MHPA on Twitter, LinkedIn and Facebook
MHPA
Follow us on Twitter, LinkedIn and Facebook to get industry-related news and the latest MHPA announcements.
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