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Capitol Hill briefing tomorrow (Wednesday, July 18) on Serious Mental Illness and Medicaid Managed Care
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



DGA chairman O'Malley on Medicaid expansion: 'Each governor has a unique set of challenges'
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
So what does the chairman of the Democratic Governors Association make of the fact that in more than half a dozen states, Democratic governors are waiting to make a decision on whether they'll implement a key aspect of President Barack Obama's signature healthcare law? "Every governor has a unique set of challenges; some have greater political challenges to overcome than others," DGA chairman and Maryland Gov. Martin O'Malley told reporters at the National Governors Association annual meeting. While seven Democratic governors have yet to make up their minds on the Medicaid expansion, 22 Republican governors are undecided, as well. More

Governors put off healthcare questions, for now
The Associated Press via Yahoo News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Millions of uninsured people may have to wait until after Election Day to find out if and how they can get coverage through President Barack Obama's healthcare law. More than two weeks after the Supreme Court gave the green light to Obama's signature legislative achievement, many governors from both parties said they haven't decided how their states will proceed on two parts under their control: an expansion of Medicaid, expected to extend coverage to roughly 15 million low-income people, and new insurance exchanges, projected to help an additional 15 million or so purchase private insurance. More

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Many governors still unsure about Medicaid expansion
The New York Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
How well the new healthcare law succeeds in covering millions of the poorest Americans largely will depend on undecided governors of both parties, who gathered in Williamsburg, Va., and spoke of the challenges of weighing the law's costs and benefits in a highly charged political atmosphere and a time of fiscal uncertainty. The Supreme Court's ruling that the states should have the choice of whether to expand their Medicaid programs has set the stage for a frenzied year and a half in which governors will have to analyze their options, devise plans, negotiate with the federal government and successfully navigate the thorny statehouse politics that often accompany any big change. Much of the law is set to take effect in 2014, when many governors will be facing re-election. More

GOP governors won't pay political price for rejecting Medicaid expansion
NationalJournal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Now that they have a choice, thanks to the Supreme Court, many governors are saying no or delaying a decision when it comes to expanding Medicaid in their states. And while there is broad public support for Medicaid, chances are they won't suffer political consequences as a result. In fact, it's the safest path for conservative governors under pressure from the right to reject the new health law. Twenty-five conservative leaders have written a letter urging all 50 governors to decline the Medicaid expansion and not to establish state-level health insurance markets or exchanges under the Affordable Care Act. More



CMS should slow down on duals demos, groups say; MHPA endorses program as is
POLITICO    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Is the push to change how "dual eligibles" get their healthcare going too far, too fast? That's a question that's beginning to be heard from lots of quarters — including the Medicare Payment Advisory Commission, the American Medical Association, some analysts and now at least one key lawmaker. Healthcare providers and policy analysts broadly agree that the current care environment for dual eligible beneficiaries needs to change — and fast. The approximately 9 million people on both Medicare and Medicaid tend to have multiple health problems, and their care is highly fragmented and very expensive. More

Week ahead: All quiet on the health reform front
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
This week's healthcare schedule will remind some of a quieter, simpler time — a time before healthcare reform. Now that the Supreme Court has ruled on the Affordable Care Act and the House has voted to repeal the law for a second time, the issue may finally recede somewhat on Capitol Hill. This is especially true as August recess approaches and as other issues — such as Medicare payments to physicians — cry out for attention before Jan. 1. The one exception is a possible healthcare repeal vote in the Senate, recently promised by Minority Leader Mitch McConnell, R-Ky. 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.


Georgia tables Medicaid revamp
The Atlanta Journal-Constitution    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A nearly yearlong effort to reshape Georgia's Medicaid program largely has been put on hold amid uncertainties surrounding the U.S. Supreme Court's recent healthcare law decision and effects of the November elections. Georgia Department of Community Health Commissioner David Cook said it would be imprudent for the state to make sweeping changes to the massive health care program for low-income Georgians with so many unknowns in play. More

No clear path ahead for possible Medicaid expansion in Missouri
Springfield News-Leader    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Jay Nixon continues to hedge on whether he would support increasing the number of Missourians eligible for Medicaid as part of the federal healthcare overhaul. Nixon was in Springfield to announce a grant to help biomedical startup businesses at Mercy Hospital. During the event, Nixon repeated previous statements that he intends to continue meeting with lawmakers and stakeholders around Missouri before making a decision on Medicaid. More

In Pennsylvania, Medicaid cuts reduce options for dental care
Kaiser Health News/Essential Public Radio/NPR    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid, a program funded jointly by the federal government and the states, covers the poor and disabled, and coverage varies by state. Most states don't pay for any dental care. Now, in Pennsylvania, Republican Gov. Tom Corbett has reduced Pennsylvania's 2 million adult Medicaid patients to basic dental care, eliminating root canals, periodontal disease work and limiting the number of dentures a patient can receive. The plan now covers little more than cleanings, fillings and extractions. The Pennsylvania Department of Public Welfare estimates it is saving $42 million this year. Spokeswoman Anne Bale explains they needed to save this money. More

Beshear creates Kentucky Health Benefit Exchange; no decision on Medicaid expansion
The Lane Report    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Steve Beshear has issued an executive order establishing the Kentucky Health Benefit Exchange, a requirement of the federal Affordable Care Act. The Kentucky Health Benefit Exchange is an online marketplace that will provide one-stop shopping for individuals to enroll in qualified health coverage plans. Those plans may be offered through the exchange or coverage through other federal or state health care programs, including Medicaid and the Kentucky Children's Health Insurance Program. More


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Researchers reveal concerning number of NYC Medicaid recipients don't take prescribed medications
Newswise    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Read the full article and view/download the MHPA Center for Best Practices Treatment Adherence Best Practices Compendium by clicking here.

A new study published online this month in the Journal of Urban Health conducted by researchers in the Department of Population Health at NYU Langone Medical Center, the New York City Department of Health and Mental Hygiene, and the New York State Department of Health found only 63 percent of New Yorkers on Medicaid with chronic conditions including hypertension, diabetes and high cholesterol are adherent to medication regimens. Non-adherence to medications is associated with higher costs of care, increased hospitalizations and even death.
More

Minnesota announces $41 million contract to set up health exchange
MinnPost    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Minnesota has announced a $41 million contract with the Virginia-based Maximus firm to design and maintain a state-run health insurance exchange mandated in the federal health insurance reform law. The state is one of at least 15 to move forward with a health insurance exchange using executive branch authority, and Gov. Mark Dayton has been a strong proponent for a state-run exchange rather than the more rigid federal option. More

Free webinar: A Coventry Health Care Story — How One Plan Built the Ultimate Cost-Containment Solution | 1-2 p.m. EDT July 25
Verisk Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Free webinar on how Coventry Health Care unveiled the next-generation of claims editing and fraud prevention solutions and improved their claims payment accuracy. Topics to be discussed include Prepayment Fraud Prevention; Real-Time Editing; and Clinical Validation. For more information: webinars@veriskhealth.com. Register here.

Insights webinar: 'How Can We Get Risk-Based Capital Relief' by Summit Reinsurance Services Inc. | 11 a.m. EDT Aug. 13
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid enrollment is expected to grow by an estimated 14 million to 16 million lives due to the expanded Medicaid eligibility provisions of the Patient Protection and Affordable Care Act. As a result, many Medicaid health plans have legitimate concerns about meeting risk-based capital requirements. Summit Reinsurance Services Inc. will be presenting information on quota-share reinsurance solutions for risk-based capital relief. Click here to register.

Free webinar from MHPA partner Verizon: Fraud Waste and Abuse — The Next Generation | 2 p.m. EDT Sept. 12
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Understanding the patterns of fraud, where to find it, how to detect, and when to act. The old pay-and-chase model of fraud management is inefficient and costly. Connie Schweyen, Debra Faulkner, MBA, MHA; and David Botsko, Ph.D., CFE, managing principals at Verizon Connected Healthcare, will show you how to catch crime before it happens and how a near real-time fraud management solution can ensure near-time results. More

Insights webinar: State Oversight in the Medicare and Medicaid Arenas: The Different Impact of Federal Preemption in Each Program and Potential Changes in the Years Ahead | 11 a.m. EDT July 30
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State regulators play crucial roles in oversight of plans operating in both the Medicaid managed care and Medicare managed care environments, but the scope of regulatory oversight is very different, based on the express federal preemption that applies to Medicare plans, but not to Medicaid plans.
  • The webinar first will review preemption under federal Medicare law and look at recent pushback against this preemption by state regulators and the implication for Medicare plans.
  • We'll next examine the role of conflict preemption in the Medicaid program. While there is no express preemption in Medicaid law, courts in recent years have invalidated some state statutes and regulations because they conflict with federal Medicaid laws.
  • The webinar will conclude with a discussion of the limits on federal power in Medicaid arising from the U.S. Supreme Court's opinion on the Affordable Care Act and a preliminary discussion of the opinion's implications.
Register here.




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.

2012-2013 Best Practices Compendium submissions due by 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 tpowers@healthcare-conferences.com. More

MHPA on Twitter, LinkedIn and Facebook
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