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Rep. Pingree presses HHS to block Medicaid cuts in wake of Supreme Court ruling
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Supreme Court's landmark healthcare decision has touched off a fiercely partisan debate not just over whether to expand Medicaid, but also whether governors can cut their programs immediately. Maine Gov. Paul LePage was the first GOP governor who announced plans to cut the existing Medicaid program in addition to opting out of its expansion in 2014. U.S. Rep. Chellie Pingree, D-Maine, urged the Obama administration Tuesday to block LePage's efforts, and healthcare advocates say the high court's decision doesn't allow immediate cuts. More

Medicaid expansion poses a familiar face-off
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Texas Gov. Rick Perry declared Monday that his state would not participate in the healthcare law's Medicaid expansion, becoming the sixth Republican governor to do so. If they follow through, those six states alone could shrink the insurance expansion by nearly 4 million people. Although the stakes are high for the White House, the territory is by no means uncharted. Washington has twice faced off with states over federal healthcare expansions, when Medicaid was created in 1965 and with the Children's Health Insurance Program in 1997. Both times, all 50 states ultimately signed on — but not without some wrangling. More

The state of the Medicaid expansion in 1 map
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Texas Gov. Rick Perry became the sixth Republican governor to opt out of the Medicaid expansion. Six governors may not seem like a lot, but consider this: A full quarter of the 15.8 million Americans expected to gain Medicaid under the Affordable Care Act live in these states. These six governors, if they follow through on their pledges, can singlehandedly shrink the Medicaid expansion by 3.89 million people. More

Texas governor tells Washington his state won't expand Medicaid
The Associated Press via Yahoo News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Rick Perry said Monday that Texas won't establish an online marketplace for patients to shop for insurance or expand Medicaid, two key elements of the federal healthcare overhaul. In a letter sent to U.S. Health and Human Services Secretary Kathleen Sebelius, the Republican governor and former presidential candidate said both elements "represent brazen intrusions into the sovereignty of our state." "I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government," Perry said in a statement. Texas has the highest uninsured rate in the nation, with about 6.2 million residents — a quarter of the state's population — lacking health insurance. More

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State Medicaid directors ask CMS to clarify key policy issues left unclear by ACA ruling    Share    Share on FacebookTwitterShare on LinkedinE-mail article
State Medicaid directors have sent a barrage of questions to CMS in a quest for policy direction on key Medicaid expansion issues that have been left unclear by the Supreme Court's recent health reform ruling, including whether a state can do a limited expansion of Medicaid eligibility instead of completely expanding to 133 percent of the federal poverty level as called for by the law, if states can phase-in their expansion to low-income adults beyond 2014, and whether states that previously expanded Medicaid eligibility would be eligible for the law's higher matching rate even if they decide against proceeding with the full expansion. More

House GOP defends 2nd repeal vote on healthcare law
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
House Republicans defended their repeat bid to repeal the 2010 healthcare law, even as they offered no guarantees they'd be able to wipe the law off the books. The House will vote for a second time on Wednesday to fully repeal President Barack Obama's signature domestic policy achievement, less than two weeks after the Supreme Court upheld it as constitutional. The repeal bill is going nowhere in the Democratic Senate, but freshman Rep. Nan Hayworth, R-N.Y., insisted the vote is not meaningless. More

Hospital bills unpaid as South Carolina shuns Medicaid expansion
Bloomberg    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Shirley Johnson gets her medical care at Palmetto Health Baptist hospital's emergency room in Columbia, S.C. She goes when her back gives out or when a benign tumor near her ribcage swells and throbs. She goes for headaches, heartburn, and spider bites, leaving the hospital a sheaf of unpaid bills. "I owe so much money," said Johnson. "The last time I went just for my toe. It cost $1,000." Johnson, 49, with no dependents, isn't eligible for Medicaid. And in two years, when President Barack Obama's healthcare overhaul allows the expansion of Medicaid to cover 17 million more Americans, she still may be left behind. Gov. Nikki Haley, a tea party-backed Republican, was among the first state leaders to oppose expanding Medicaid. More

Christie delays decision on healthcare law
The Wall Street Journal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
New Jersey Gov. Chris Christie said he still is deciding whether his state will implement two provisions of the national healthcare law championed by President Barack Obama. Christie said he plans to make up his mind on authorizing state-run exchanges where people can buy health insurance and an expansion of Medicaid by the beginning of 2013. But his wait-and-see approach already separates him from some other prominent Republican governors. More

Medicaid expansion appears unlikely in Arizona after Supreme Court ruling
Arizona Capitol Times via Dolan Media Newswire    Share    Share on FacebookTwitterShare on LinkedinE-mail article
If the feds can't force Arizona to move forward with the massive Medicaid expansion, it's a near certainty the Republican-led Legislature won't do it for them. Though the U.S. Supreme Court upheld the core of President Barack Obama's Affordable Care Act, it ruled that the federal government couldn't force states to expand healthcare for the poor by threatening to take away other Medicaid funding. More

Georgia healthcare in limbo
The Atlanta Journal-Constitution    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Georgia hospitals were depending on the healthcare law to ease the burden of treating hundreds of thousands of uninsured patients each year for free. But that relief may never come. While upholding the law, the U.S. Supreme Court ruled states could reject the massive expansion of the Medicaid program that is a cornerstone of the Patient Protection and Affordable Care Act. For hospitals, not expanding the health program for poor and low-income Georgians would mean having to treat almost as many uninsured patients as ever while facing significant cuts to their reimbursements. More

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Medicaid directors ask lawmakers if states, CMS should lead provider audits    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The National Association of Medicaid Directors has asked key lawmakers to provide clear direction to both CMS and the states on their respective roles in what NAMD says has increasingly become a disjointed and ineffective approach to fighting waste, fraud and abuse in Medicaid. The group is seeking clarity, as well as new open pathways for data sharing between CMS and the states, in a response to Senate Finance Committee members' call for stakeholder input on ways to solve problems plaguing Medicare and Medicaid's program integrity efforts. More

Capitol Hill Briefing on Serious Mental Illness and Medicaid Managed Care | July 18 | Washington, DC
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The MHPA Center for Best Practices is holding a briefing titled "Challenges in SMI, Solutions in Medicaid Managed Care," from 2-3:15 p.m. July 18 in the Rayburn House Office Building, Room 2218, Washington, D.C. More

Altegra Health, First 'Third-Party Submitter'

Altegra Health is the first ‘Third-Party Submitter’ to receive certification in Encounter Data Front End Testing from the Centers for Medicare and Medicaid Services (CMS). This certification reflects our expertise in encounter reporting, risk adjustment analytics, and data management. Altegra Health continues to be a health care services leader.

Agenda available for MHPA's 2012 Annual Meeting | Oct. 24-26
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The agenda for the MHPA 2012 Annual Meeting at the Hyatt Regency Washington on Capitol Hill in Washington, D.C., is now online at MHPA’s website. The meeting agenda for A Pivotal Time for Medicaid Health Plans includes keynote speeches from Tim Engelhardt, director of models and demonstrations at the CMS Medicare-Medicaid Coordination Office; 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. Also read about our new pre-conference, "Developments in the States" as well as other informative sessions and presentations at this three-day event. View the full agenda and register here.

Insights Webinar on July 16: Improving Member Retention/Reducing Churn
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Paul Frenkel and Lance Scott of Altegra Health present on most effective methods of outreaching to/communicating with Managed Medicaid members to ensure they remain enrolled in Medicaid and therefore stay enrolled in their plan. For more information and to register, click here.

2012-2013 Best Practices Compendium submissions due July 31
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Click here for details.

Job Opportunity: Supervisor of Advertising and Production at Health Partners (Philadelphia)
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For more details and to apply online, click here.

2nd Annual Leadership Summit on Medicaid | July 24-25, Arlington, Va.
The World Congress    Share    Share on FacebookTwitterShare on LinkedinE-mail article
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    Share on FacebookTwitterShare on LinkedinE-mail article
Thomas Johnson, president and CEO of MHPA, participates as a faculty member of the 2012 Dual Eligibles Best Practices Summit. 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 More

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