Following UnitedHealthcare's move, other insurers also vow to keep some popular ACA pieces
United Healthcare's announcement that it would keep certain popular health reform provisions regardless of the Supreme Court's decision on the law's constitutionality quickly opened the floodgates for other large insurance companies to take action, with Humana and Aetna making similar announcements Monday (June 11), something that could partially ease Republicans' efforts to come up with an ACA replacement plan. More
As state revenues recover, health costs remain a burden
The Washington Post Share
State revenues are finally returning to pre-recession levels, but the growing cost of providing health care for the poor is leaving most governments in dire fiscal straits, according to a report to be released. States are finally seeing a bit of revenue growth in a turnaround from the economic downturn that devastated budgets in fiscal 2009 and 2010, according to a survey by the National Governors Association (NGA) and the National Association of State Budget Officers (NASBO). More
Health care reform rhetoric heating up as SCOTUS decision, election near
As the U.S. presidential campaign heats up, so is the rhetoric surrounding health care and President Obama's Affordable Care Act. The U.S. Supreme Court will rule before adjourning for the summer on whether the law, or at least part of it, is unconstitutional. In the meantime, right-leaning organizations are ramping up arguments against the individual mandate, which requires everyone who can afford to do so to buy coverage, and other aspects that require employers to provide coverage. And Republican lawmakers still are vowing to repeal the entire package. More
After Supreme Court, 'Plan B is nothing'
The Hill Share
The Obama administration apparently doesn't have much of a plan for moving forward if the Supreme Court strikes down all or part of its signature health care law. Although administration officials - including Health and Human Services Secretary Kathleen Sebelius - keep saying the White House will be "ready" for any ruling, they’ve declined to offer many specifics. More
Only 7 states, D.C. expand Medicaid ahead of 2014
American Medical News Share
Most states have taken advantage of new health system reform law provisions to upgrade or improve care within their Medicaid programs, but only seven and the District of Columbia so far have sought an option to cover more adults before the 2014 expansion of the program, according to a recent Kaiser Commission on Medicaid and the Uninsured policy brief. More
Tom Scully: Even if health law survives court challenge, Congress could delay timetable
Kaiser Health News Share
Thomas Scully, who ran Medicare and Medicaid under President George W. Bush (2001-2003), believes that the 2014 implementation of the Affordable Care Act will have to be delayed, even if the Supreme Court upholds it. Next year, Congress will have to negotiate a major deficit reduction deal, and could find savings by postponing the law. Scully, an attorney, is now a health care consultant. More
California decision not to support nursing home demo signals states' heavy reliance on duals demo
California is blocking organizations in that state from participating in a Medicare demonstration that aims to curb hospitalizations from nursing homes because California officials believe the nursing-home demo overlaps too much with another CMS demonstration on dually eligible beneficiaries, according to a CMS email obtained by Inside Health Policy. More
California copay proposal for some drugs, emergency visits
California Healthline Share
The Senate Committee on Budget and Fiscal Review approved a significantly scaled-down version of a copay proposal for Medi-Cal beneficiaries. The Legislature last year passed a more extensive copay proposal that was projected to save $511 million in general fund dollars for the state. It called for $5 per physician visit and $50 for an emergency department visit. In February federal health care officials nixed that plan. More
Nebraska Medicaid clients urged to enroll in health plans
Pharmacy Choice Share
Medicaid clients in 83 Nebraska counties have until June 26 to enroll in one of two expanded Medicaid Managed Care health plans and choose their primary care provider. More providers are being added to the Arbor Health and Coventry Care health plan networks every day. Medicaid clients are urged to see if their medical provider is listed and then select one of the health plans. More
Connecticut, first to expand Medicaid under ACA, sees unexpected enrollment swell
Connecticut's decision to be an "early expansion" state to cover some low-income adults without dependent children under Medicaid is something the state's Medicaid director recently described as a "self-inflicted wound" because of the unexpected influx of individuals into the program. The experience highlights the difficulty states could face in 2014 because of the current lack of data on childless adults that will soon be able to get Medicaid coverage as a result of the health reform law, sources say. More
Brisk cut-off for parents on Illinois Medicaid
The Associated Press via The Times of Northwest Indiana Share
More than 25,000 working parents in Illinois stand to lose their state-provided health coverage on July 1 - and most of them don't know it yet. State officials will eliminate their coverage in just three weeks as part of the $2.7 billion package of cuts and taxes the Legislature passed in May in an effort to save Illinois' Medicaid program from possible collapse. But with the clock ticking, the state has just sent out notices to the Medicaid families who will be affected once Gov. Pat Quinn signs the bill, as he has promised to do. More
17 states put creating health care exchanges on hold
The Boston Globe Share
Illinois might seem the least likely place for the health care law to get sidelined. It's a state with a Democratic governor and solid Democratic majorities in both houses of the Legislature. It's also the political base of President Obama, who championed the legislation in the face of furious opposition. More
CMS eyes Medicaid audit overhaul as lawmakers slam agency's anti-fraud efforts
CMS Deputy Administrator for Program Integrity Peter Budetti said CMS is "looking at the restructuring of our entire [Medicaid] audit program so that we can use those resources in a much more effective way," as House members slammed CMS over the handling of its contractor-run audit programs in hearings by two committees Thursday (June 7) and Friday (June 8). More
Prosecution is key to fraud prevention
When it comes to fraud prevention and detection, Health Care Services Corp. (HCSC) takes a hard line against criminals. "Our goal is to prosecute fraudsters," Sharon Green, senior manager of special investigations for HCSC-owned Blue Cross Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas, told FierceHealthPayer. "Stealing health care is the same as stealing any other assets," she said, and criminals should be punished accordingly. More
Reducing readmissions and length of stay | Thursday, June 14 at 1 pm ET
A free webinar by VITAS Innovative Hospice Care
The Hospital Readmission Reduction Program is intended to reduce hospital readmissions by aligning them with payment incentives. Hospice and palliative care programs can help providers reduce hospital readmissions by providing comprehensive care to patients. They improve discharge planning and increase coordination of care while being cost effective. This results in improved quality patient care and increased patient/family satisfaction.
Register for this free webinar
Dual Eligible Strategies for Managed Medicaid | Monday, June 25 at 11 am ET
An Insights Webinar by Truven Health (formerly Thomson Reuters)
While a small handful of states have used managed care purchasing strategies for long-term services and supports for a number of years, the shift to managed LTSS has grown rapidly, and is expected to grow even more rapidly in 2012. Since LTSS represent a large percentage of total Medicaid spending, this shift represents a major new opportunity for Medicaid Managed Care plans to grow their businesses by effectively addressing the unique needs of these recipients.
This webinar will provide an overview of the projected growth in managed LTSS, and highlight selected strategies for how plans can successfully compete in this marketplace.
Registration now open for MHPA's 2012 Annual Meeting | October 24-26
The MHPA 2012 Annual Meeting at the Hyatt Regency Washington on Capitol Hill in Washington, D.C., again will be the country's largest gathering of top-level executives in the Medicaid health plan industry. This year's meeting, "A Pivotal Time for Medicaid Health Plans," kicks-off just one week before Americans cast their ballots in a presidential election in which health care is one of the foremost issues. As you've come to expect, the MHPA Annual Meeting will provide the perfect opportunity to participate in thought-provoking sessions and hear from compelling speakers, including Charlie Cook, political analyst and publisher of The Cook Report; Donna Brazile, political strategist and commentator; and Robert Brownstein, political director for Atlantic Media Corp.
For more info and to register online, visit http://www.mhpa.org/Events/2012_Annual_Meeting/.
2nd Annual Leadership Summit on Medicaid | July 24-25, Arlington, Va.
The World Congress Share
With the Supreme Court Ruling to determine the future of Medicaid Expansion in June, the 2nd Annual Leadership Summit on Medicaid will be the first national platform for all stakeholders to come together to discuss the implications and next steps. Hear Thomas Johnson, president and CEO of MHPA, participate on a keynote panel with other industry leaders to address the Supreme Court Ruling on Medicaid expansion and health reform. MHPA members, receive a $200 discount when you register online or at 800.767.9499 with promo code MHPA200. More
Dual Eligibles Best Practices Summit | July 30-31 | Orlando, Fla.
Healthcare Education Associates Share
Learn how to execute a well-run dual eligibles plan, from outreach campaigns to managed long term care and everything in between. Members of MHPA are entitled to a 15 percent discount. Mention HMP122 during registration to enjoy this offer. For more information, click here or contact Theresa Powers at 704.341.2437 or firstname.lastname@example.org.
Banner advertising available with MHPA NewsBriefs
Now you can ensure that your message gets out to the Medicaid managed care industry. For rate information, contact James Debois for opportunities 469.420.2618 or email at email@example.com.
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