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Senators question cost of $1,000 hepatitis drug
The Hill
Two high-ranking senators have lent their voices to the chorus demanding to know why Gilead's new hepatitis C drug Sovaldi costs $1,000 a pill. Oregon Sen. Ron Wyden, chairman of the Senate Finance Committee, and Iowa Sen. Chuck Grassley, the Judiciary Committee's ranking member, are asking the specialty drugmaker how they justify the high price of the medication, which can cost more than $84,000 per treatment.
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It's not just about Sovaldi: Johnson & Johnson's results
boosted by hepatitis C drug

The Wall Street Journal (subscription required)
Sales of a new hepatitis C drug helped boost Johnson & Johnson's second-quarter earnings by 9.1 percent to $19.5 billion, but the company's executives said they don't expect the pill's sales to keep pace and outlined several challenges facing the overall healthcare market.
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Oregon moves closer to limiting access on hepatitis C drugs as Senate investigation begins
The Oregonian
The state of Oregon appears to be nearing what could be a first-in-the-nation stance limiting availability to Medicaid patients of new hepatitis C treatments that offer great promise at a very high price of $84,000 per three-month treatment. On July 31, a state committee will consider guidelines intended to limit treatment only to patients who face serious liver damage without the drug. If adopted later this year, the approach would reduce the state's costs from an estimated $168 million in the coming year to about $40 million.
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North Carolina governor: 'Door open' to Medicaid expansion
The Washington Post
North Carolina Gov. Pat McCrory said he would leave the door open to expanding Medicaid under the Affordable Care Act if federal officials allow his state to craft a plan that fits its own individual needs. In an interview on Charlotte, North Carolina, NPR affiliate WFAE, McCrory defended North Carolina's refusal to expand existing Medicaid programs until fixes are made.
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July 16 Webinar Wednesday: 'The Politics and Policy of
CHIP Reauthorization'

Healthcare Lighthouse
This webinar will focus on the policy and political considerations Congress must soon address relating to the Children's Health Insurance Program, for which funding is scheduled to halt on Sept. 30, 2015. Launched in 1997 as a bipartisan, block grant program, CHIP now covers over 5 million kids across the country. Many states have standalone CHIP programs, while others have merged it with Medicaid.
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Medicaid, CHIP enrollment up 11.4 percent since September 2013
California Healthline
Between September 2013 and May, about 6.7 million U.S. residents had signed up for Medicaid or the Children's Health Insurance Program under the Affordable Care Act, bringing the total number of individuals enrolled in the programs to almost 66 million, according to a CMS report.
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HHS offers states $100 million to improve Medicaid
The Hill
The Department of Health and Human Services is offering $100 million to state Medicaid programs to reform payment systems and improve patient care. Governors and state Medicaid directors had pressed the Centers for Medicare and Medicaid Services for funds to review and improve the health program.
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More signs that health coverage is growing under Obamacare
Politico
Millions of Americans have gained health insurance since Obamacare went into effect, according to several new surveys that show the law is bringing down the nation's uninsurance rate after its "train wreck" of a start. Three new surveys released in rapid succession found substantial numbers of newly insured adults. None of those findings will put to rest the political debate about the cost, structure and wisdom of the Affordable Care Act, but they do give advocates firm evidence that the law is meeting coverage goals.
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Texas state agency prepares to expand STAR+PLUS program
The Athens Review
The Texas Health and Human Services Commission is preparing to expand the STAR+PLUS Medicaid Managed Care program on Sept. 1. Most people in Texas who have Medicaid get their services through managed care. In this system, the member picks a health plan and gets Medicaid services through that health plan's network of providers. Most health plans offer Medicaid members extra services not available through traditional Medicaid.
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Texas sees rise in Medicaid signups
The Texas Tribune
More than 80,000 additional Texans have enrolled in Medicaid or the Children's Health Insurance Program since the rollout of the Affordable Care Act last fall, despite Republican state leaders' decision not to expand eligibility to poor adults, according to federal figures.
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Michigan reached its health insurance enrollment goals 8 months early
The Washington Post
Michigan Gov. Rick Snyder has announced that the state had reached its first-year goal of signing up 322,000 residents for the Healthy Michigan Plan eight months early. About 477,000 Michigan residents are eligible for the Health Michigan Plan, the state's expanded Medicaid program for low-income residents. To be eligible, individuals cannot qualify for or be enrolled in Medicare or other Medicaid programs and must have income at or below 133 percent of the poverty level.
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Arkansas senator to pursue new waiver for healthcare innovation
Arkansas News
An Arkansas state senator says he plans to file legislation next year that would authorize the state to seek a federal waiver to allow innovations on healthcare coverage that could go far beyond what the state did with the so-called private option. Sen. David Sanders, one of the architects of the private option, Arkansas' version of Medicaid expansion, said he will file a bill in the 2015 session to authorize application for an "innovation waiver" under Section 1332 of the federal Affordable Care Act.
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Medicaid fight re-emerges in GOP Arizona legislative primaries
The Arizona Republic
Last year's fight at the Arizona Legislature to expand the state's Medicaid program isn't over. It's continuing to play out this summer in the Republican primaries, and the direction of the next legislature likely hangs in the balance.
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Medicaid expansion could be campaign issue in Senate races
Hattiesburg American
The debate over whether to expand Medicaid could be a key issue in the competitive Senate races in Louisiana and Mississippi, political experts say. "This is an issue that would seem to have a lot of potential, because both states have large populations of uninsured people," said Albert Samuels, a political scientist at Southern University in Louisiana.
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Medicaid change on long-term care delayed in Georgia
Georgia Health News
A Georgia state health agency has delayed approval of a change in the Medicaid eligibility system for people in long-term care whose incomes are above the government program's thresholds. The Department of Community Health's board had been set to approve a switch for some lower-income Georgians — who now use "Qualified Income Trusts" to qualify for Medicaid — to a "medically needy" eligibility program.
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NAMD director discusses Medicaid's future with Kip Piper
MediStrategy
In an episode of the podcast MediStrategy, National Association of Medicaid Directors Executive Director Matt Salo spoke about the significant changes underway in the $500 billion Medicaid program, payment and delivery reform priorities of state Medicaid directors and challenges faced by state Medicaid executives.

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Iowa Medicaid director leaving for university job
The Des Moines Register
Iowa's Medicaid director is leaving the job to take a position at the University of Iowa. Jennifer Vermeer has run the huge program since 2008. Vermeer will become assistant vice president of medical affairs at the University of Iowa Health Care, according to a Department of Human Services news release. Her resignation is effective Aug. 21.

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Report: Uninsured rate dropped after Obamacare exchanges opened
The Hill
The percentage of uninsured people in the U.S. dropped, from 20 percent to 15 percent, after the Obamacare marketplaces opened last year, according to a new study. The Commonwealth Fund polled between July and September of 2013, before the new exchanges went into effect, and then again between April and June this year, after the ObamaCare enrollment period ended.

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mhpa2014 early-bird rate expires Sept. 8
MHPA
Sign up before Sept. 8 to save on mhpa2014 registration. The mhpa2014 agenda focusing on Medicaid beneficiaries boasts presentations from CMS officials, CME sessions for clinicians, a healthy pregnancies and babies track, a state Medicaid directors panel and much more. For registration info and more details on our annual conference, please click here.
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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Illinois moving on with Medicaid managed care plan (The Associated Press via Pantagraph.com)
Medicaid managed care arriving in South Florida (Miami Herald)
Horizon NJ Health to launch MLTSS program (PRWeb)
Sesame Street asks: Can you tell me how to get to North Carolina? (Morning Consult)
Insurers to actuaries: Factor new drugs, devices into Medicaid capitation rates; MHPA's Myers comments (Inside Health Policy)

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


Aug. 6 Webinar Wednesday: 'Where am I? Finding and Impacting Members to Improve Quality Ratings, Reduce Administrative Costs, and Transform Processes'
LexisNexis
The changing landscape of healthcare has only increased our dependency on member and provider data to fuel administrative processes, quality initiatives, and coordination of care. With more than half of Medicaid enrollees being assigned to managed care organizations, data provided by states and other entities on these members are critical to supporting your efforts to locate, enroll, and manage their health and costs.

In this webinar, you will:
  • Get a better understanding of the seriousness of data quality issues across healthcare
  • Discover new ways to verify, augment, and monitor provider and member data
  • Hear real-world case studies where data quality issues were identified and resolved to drive quality and performance ratings, efficiency, and savings

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