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Insurers to actuaries: Factor new drugs, devices into Medicaid capitation rates; MHPA's Myers comments
Inside Health Policy
Actuaries should consider the impact of potential breakthrough drugs or devices on spending when establishing the capitation rates for Medicaid managed care plans, health insurance stakeholders tell the trade group representing the nation's actuaries. The insurers' concerns come as managed care plans urge states to reimburse them for spending on the high-cost hepatitis C drug Sovaldi, which entered the market after states and plans had already negotiated 2014 rates.
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Sesame Street asks: Can you tell me how to get to North Carolina?
Morning Consult
"One of these things is not like the other; one of these things doesn't belong. Can you tell which thing is not like the other before I finish my song?" This catchy, little ditty from the beloved show Sesame Street teaches children how to spot differences in everyday objects. According to MHPA President and CEO Jeff Myers, it also brilliantly demonstrates what's wrong with North Carolina Medicaid and offers guidance on the path state legislators should take.
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North Carolina Senate challenges Medicaid spending plans
The Associated Press via News & Observer
Senators from the state of North Carolina were not persuaded to accept Medicaid spending numbers for the coming year from Gov. Pat McCrory's administration after hearing a two-hour presentation led by State Budget Director Art Pope.
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CMOs, clinical staff can earn CE credits at mhpa2014
MHPA
Attend the National Committee for Quality Assurance (NCQA) sessions "Using the PCMH Model to Improve Patient Care Coordination" and/or "Expanding Managed Care: Integrating Medical Care and Supportive Services" at MHPA's annual conference, and claim continuing education credits (includes medical, nursing and pharmacy) free of charge. We hope you take advantage of this opportunity to learn how to improve care for your members while earning state-required CE credits.

Registration and additional information can be found here.

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Horizon NJ Health to launch MLTSS program
PRWeb
Horizon NJ Health, the state's largest managed Medicaid health plan and an Horizon Blue Cross Blue Shield of New Jersey company, announced that it will launch a Managed Long-Term Services and Supports program beginning July 1. Horizon NJ Health's MLTSS program will be statewide.
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Medicaid managed care arriving in South Florida
Miami Herald
Beginning July 1, more than a half-million South Floridians, mostly children and women, will begin receiving their government-subsidized healthcare through private insurers, part of an effort to move about 3.6 million Floridians on Medicaid to a managed care model that lawmakers believe will cut costs.
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Illinois moving on with Medicaid managed care plan
The Associated Press via Pantagraph.com
Facing a Jan. 1 deadline, Illinois' top Medicaid official, Department of Healthcare and Family Services Director Julie Hamos, announced a timetable for moving hundreds of thousands of low-income patients into managed care health plans.
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'A uniquely New Hampshire approach' to Medicaid expansion
Kaiser Health News
New Hampshire recently became the 26th state to embrace the federal health law's expanded Medicaid program, with as many as 50,000 low-income residents expected to begin signing up. Coverage for those who enroll in July will take effect Aug. 15. Initially, most New Hampshire enrollees will join one of two Medicaid managed care plans in the state. That's the way most other states expanded Medicaid earlier this year.
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Where KanCare meets Obamacare
Kansas Health Institute
Kansas Gov. Sam Brownback once called Obamacare "an abomination," and with the federal health reform law now four years on the books bad-mouthing it has become a conservative Republican ritual.
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Nursing homes in arrears may lose Medicaid in Georgia
Georgia Health News
Nursing homes and other medical providers that owe money to a state health agency now face a repayment timetable that could lead to their being cut off from the government Medicaid program. The new policy on collections, which goes into effect July 1, defines a series of steps on how delinquent providers can be suspended and then terminated from the Medicaid and PeachCare programs.
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No money set aside for Medicaid shift in Massachusetts
The Boston Globe
The stopgap program that enrolled tens of thousands of people in temporary Medicaid coverage after the failure of the Massachusetts health insurance website is not going to have a big effect on the state budget, at least not by the legislature's reckoning.
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The ACA and America's cities: Fewer uninsured and more federal dollars
Urban Institute
This report estimated the effect of the Affordable Care Act on 14 large and diverse cities: Los Angeles, Chicago, Houston, Philadelphia, Phoenix, Indianapolis, Columbus, Charlotte, Detroit, Memphis, Seattle, Denver, Atlanta and Miami. For each city, changes are estimated in health coverage under the ACA, particularly the resulting decline in the uninsured.

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Health insurers pressing down on drug prices
The New York Times
In dealing with health plans, drug companies are facing a new imperative — bargain or be banned. Determined to slow the rapid rise in drug prices, more health plans are refusing to cover certain drugs unless the companies charge less for them. The strategy appears to be getting pharmaceutical makers to compete on price.

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New health chief Burwell revamps HealthCare.gov
The Associated Press via
Yahoo News

Moving to prevent more insurance chaos this fall, Health and Human Services Secretary Sylvia Burwell revamped the management of HealthCare.gov. Burwell appointed a new high-level operations manager to closely supervise the online portal to coverage under President Barack Obama's healthcare law.

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Visualizing Health Policy: Understanding the effect of Medicaid expansion decisions in the south
The Henry J. Kaiser Family Foundation
This Visualizing Health Policy infographic examines the effect of decisions by states in the south to implement or forgo the Affordable Care Act Medicaid expansion. It shows that southerners are more likely than people living in other parts of the United States to be uninsured. It also shows that most Southern states have poverty rates above the national average.
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Olmstead's role in community integration for people with disabilities under Medicaid: 15 years after the Supreme Court's decision
The Henry J. Kaiser Family Foundation
June 2014 marks the 15th anniversary of the United States Supreme Court's landmark civil rights decision in Olmstead v. L.C., finding that the unjustified institutionalization of people with disabilities is illegal discrimination. While many cases are resolved without involving the courts, during the last 15 years, the lower courts have had the opportunity to apply the case in a number of contexts, resulting in decisions furthering community integration for people with disabilities.
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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    North Carolina House, Senate still at odds over Medicaid reform, funding (North Carolina Health News)
Ohio seeks better managed-care, lower costs (The Columbus Dispatch)
Some patient groups refuse to participate in NCHC's drug-price campaign (Inside Health Policy)
Pennsylvania governor nets 9 insurers for Medicaid alternative (The Associated Press via Modern Healthcare)
Pence picks new social services chief to push Medicaid alternative after sudden exit by Minott (The Columbus Republic)

Don't be left behind. Click here to see what else you missed.


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MHPA
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