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Politico
The Trump administration is redoubling efforts to allow Kentucky to impose controversial Medicaid work requirements after a federal court halted its attempt to overhaul the safety-net program three weeks ago.
CMS plans to announce that it will open a new 30-day federal comment period on the Kentucky plan — allowing the administration to potentially show it's addressing the court's concerns, POLITICO first reported on Wednesday. An agency spokesperson subsequently confirmed that the agency would again seek feedback "to better inform any future decision on the demonstration that was remanded back to the department for further review."
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The Washington Post
There's a significant population of Medicaid recipients who would lose their healthcare coverage if states began requiring them to work — regardless of whether they got a job. Seema Verma, administrator of the Center for Medicaid and Medicare Services, calls it "a subsidy cliff." Others refer to it as "a Catch-22." Either way, thousands of low-income Americans lose their insurance.
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The Plain Dealer
Once Ohio Medicaid patients with mental health or addiction problems enter the healthcare system, they must be treated on par as those with physical ailments. That means no extra co-pays, prior authorizations or limits on hospitalization or counseling that wouldn't be imposed on physical health care in Medicaid. The barriers that many patients in the mental health system know too well are supposed to have been recently eliminated.
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Project Transition
Learn how one provider is challenging the status-quo in behavioral healthcare and advocating for society’s most vulnerable members to discover their life worth living by providing a recovery experience like no other. Individuals with serious mental illness (including dual diagnosis) are empowered and able to realize a life in the community, on terms they define with the right treatment and services. In Philadelphia, PA and Nashville, TN, a unique extended behavioral support program has been proven to reduce cost and increase positive outcomes, by combining apartment-style community living with intensive, daily, evidence-based programming. This setting helps minimize stigma and create normalized social expectations and consequences.
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NPR
Medicaid, which uses state and federal tax dollars to pay for healthcare for 76 million poor or disabled Americans, tries to ensure that patients get drugs that work the best and yet are also affordable. States put those drugs on what they call "preferred drug lists." While Medicaid must pay for nearly all drugs by law, states can make it harder to get more expensive or less effective drugs by requiring doctors to fill out cumbersome administrative paperwork to prescribe those not on the preferred lists.
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Veyo is a full-service transportation brokerage designed specifically for healthcare. By integrating consumer technology with rideshare fleets, we have decreased costs and increased efficiencies. Operating in eight states with over 6 million completed trips and a 97.1% on-time rate, we're changing NEMT - one trip at a time. Learn More
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The Hill
Novartis will not raise drug prices in the U.S. this year, the company's CEO told Bloomberg on Wednesday. The announcement comes after Pfizer agreed to temporarily hold off on increasing the prices of some drugs after receiving criticism from President Trump.
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Bloomberg
The Trump administration moved swiftly in the past 24 hours to implement pieces of its plan to bring down drug prices, preparing several significant steps as one of the biggest U.S. drug makers said it would bring down the cost of some medicines. The Health and Human Services Department on Wednesday night submitted a proposal to the White House that would curb kickback exemptions that allow drug makers to offer insurers and pharmacy-benefit managers rebates widely blamed for keeping drug prices high. Earlier that day, the Food and Drug Administration released a plan to boost the market for so-called biosimilars, which are generic copies of expensive drugs that contain living organisms.
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The Hill
The Trump administration is exploring ways to safely import certain drugs from foreign countries, part of an effort to lower the price of prescription medicine. The Food and Drug Administration is forming a working group to examine how the U.S. could import pharmaceuticals from abroad "in the event of a dramatic price increase for a drug produced by one manufacturer and not protected by patents or exclusivities," the Department of Health and Human Services said in a statement Thursday.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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STAT
Food and Drug Administration Commissioner Scott Gottlieb on Wednesday accused drug makers who manufacture pricey biologic medicines of using "unacceptable" anti-competitive tactics to keep competitors off the market, costing Americans billions. The tactics — some of which Gottlieb will refer to as a "toxin" — have prevented other drug makers from launching biosimilar medicines, highly similar versions of the same drugs.
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You know you need to be prepared to respond quickly to CMS audit requests – including A&G history, activity, and status. Find out how effective, automated A&G management can protect revenue, improve network quality, ensure regulatory compliance, and lower the cost of disenrollment.
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MHPA
In "HIV: The Great Debate on Clinical Approach vs. Cost Considerations," Express Scripts' chief medical officer Dr. Steve Miller will present information from our newly released HIV report exploring utilization, cost considerations and different clinical approaches in the treatment of HIV. We'll also explore both sides of the debate on effectively managing costs while providing appropriate clinical care in the treatment of HIV, specifically the use of multi-drug to single drug treatment regimens.
Register now to experience this and more at the largest Medicaid-only conference in the country!
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