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MHPA
On Monday, July 27, MHPA sent its comments to United States Secretary of Health and Human Services Sylvia Mathews Burwell on the proposed rule modernizing Mediciad managed care regulations.
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HealthCrowd
Join Neng Bing Doh, CEO of HealthCrowd, for a presentation on how macro healthcare trends are requiring a transformation in Medicaid member communications. This webinar will cover current hot topics including how to scale text messaging programs to affect HEDIS scores, using multiple modalities "in concert" to improve member experience while optimizing outreach budget, the need to move away from transactional communications, and how to make each outreach campaign better than the last. Accompanied by case studies and even comics, this webinar will be one every health plan employee can derive value from.
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The Hill
A high-stakes highway funding bill avoided more Obamacare drama late Monday night after Utah Sen. Mike Lee abruptly dropped his highly tactical plan to sidestep Senate rules and force a repeal vote. For several days leading up to the vote, the firebrand conservative had pledged to use arcane Senate procedure to attach an amendment repealing Obamacare to the highway bill.
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The Associated Press via WPTV-TV
Insurers participating in Florida's new Medicaid managed care program say they've lost $542 million through 2014 and want the state to raise their rates. But after losing major federal funding for hospitals, Gov. Rick Scott doesn't want to use any more state money for the Medicaid program.
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Alaska Dispatch News
When Alaska Gov. Bill Walker talked Medicaid expansion, Republican expansion opponents talked Medicaid reform. But when those opponents refused to let Walker's expansion proposal come to a vote in the legislature, they also chose not to advance their own reform efforts, while criticizing the existing Medicaid system as "broken."
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The Columbus Dispatch
In the old days, inmates got $75 and a one-way bus ticket when they got out of an Ohio prison. Now, they can get something more valuable — a Medicaid card. Three state agencies are aggressively pushing to get the majority of the roughly 21,000 people who are released from prison every year enrolled in Medicaid up to 90 days before they walk out the door. Services don't begin until they are released, unless they are hospitalized.
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The Associated Press via The Baltimore Sun
Democrats plan to renew efforts next year to expand Medicaid eligibility in South Carolina, saying that's the most important way to continue the work of their slain colleague, Sen. Clementa Pinckney. It will be a tough sell in a state where Republican opposition hasn't budged since a 2012 U.S. Supreme Court ruling upheld the federal healthcare law but made its intended Medicaid expansion an option. But Democrats hope the legislature's decision to remove the Confederate flag from Statehouse grounds — a move long thought impossible — indicates opinions can change.
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SHOWCASE
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Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
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Kansas Health Institute
Kansas Gov. Sam Brownback said Friday he's unconvinced Medicaid expansion is an answer to the financial woes of rural Kansas hospitals and suggested they should innovate instead. During a news conference Friday, Brownback was asked about a Reuters story on the improving financial fortunes of public hospitals in states that expanded Medicaid under the federal Affordable Care Act versus the stagnation of hospitals in states that did not.
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Chicago Tribune
Another pressure point in the Springfield, Illinois, stalemate was relieved Thursday when a federal judge ruled that payments owed to many Cook County healthcare providers who serve the poor must be made despite the absence of a state budget. The ruling opens the spigot for much of an estimated $8 billion in state taxpayer contributions to the Medicaid program to go out without delay while Republican Gov. Bruce Rauner and Democrats who control the General Assembly remain locked in a political fight that has stalled agreement on a spending plan for the budget year that began July 1.
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The Associated Press via KOLD-TV
A hearing for arguments on the constitutionality of a fee collected from hospitals to pay for an expansion of Arizona's Medicaid program has been postponed. The hearing had been scheduled for Friday in Maricopa County Superior Court but Judge Douglas Gerlach has reset it for July 30.
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U.S. Government Accountability Office
Nationwide, estimates using 2008-2013 data indicated that approximately 17 percent of low-income, uninsured adults (3 million) had a behavioral health condition, defined as a serious mental illness, a substance use condition or both. Underlying these national estimates is considerable variation at the state level.
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MHPA via YouTube
Thanks to all of you who made our 2014 annual conference a smashing success. For a recap of the event, please watch this short video.
This year, we will examine Medicaid's 50-year evolution through thought-provoking sessions on the latest in managed healthcare operations, policies and populations, as well health plan best practices. Please visit our mhpa2015 home page for info on registration, lodging and sponsorships.
For more information, please contact Erin Liberatore via email or by phone at 202-857-5773.
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MHPA
We are pleased to announce that we are now accepting submissions from member plans that highlight best practices for Medicaid and CHIP beneficiaries. The Center for Best Practices Advisory Committee will review submissions for potential inclusion in the 2015-2016 MHPA Best Practices Compendium that will be published in November 2015. Additionally, the selected best practices will be honored during the MHPA annual conference luncheon.
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Janssen Healthcare Innovation
Care4Today Mobile Health Manager is a free and secure mobile app and website that helps patients schedule and manage their health care while enabling remote interaction with their care providers. This presentation will walk through both the free application that sits on the patient phone, as well as the provider-side dashboard that allows the remote monitoring of patient-entered adherence information.
Please join Jon Zifferblatt, M.D., MPH, leader, mental health and Fran Devlin, marketing director/mobile health manager for Janssen Healthcare Innovation (JHI), where they will highlight the use of the platform in an applied context of supporting patients with serious mental illness. They will also discuss lessons from a real-world implementation of the platform at a behavioral health program in California as well as future plans for development.
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MTM
Home and community-based services (HCBS) can help waiver populations and other special needs members with costly chronic health conditions avoid expensive long-term care and reduce readmissions — but coordinating these services can be a daunting task for case managers. As a service coordinator, MTM partners with health plan case managers to relieve the burden of coordinating disparate provider networks. MTM created a comprehensive solution that offers high-quality network building, credentialing and monitoring; continuous performance tracking and trending; and consolidated claims adjudication and payment, including 100 percent claims verification.
In this webinar, MTM Vice President of Client Services Aaron Crowell will demonstrate how the organization's HCBS coordination model can help solve health plans’ biggest challenges in connecting members to nonclinical care. Additionally, Vice President of Field Health Services Cindi Scollins with WellCare — one of MTM's HCBS clients — will discuss how this model has benefited members using innovative services like equine therapy in the Florida market.
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LexisNexis Health Care
Member information, demographic or other is at the heart of every health plan's operations. Unfortunately, this information is often siloed, incomplete or completely unavailable. This is particularly true for minor populations and the "underbanked" or those with little to no credit fingerprint against which information can be verified or gathered.
Please join Albert Gimbel, senior director of product management for LexisNexis Health Care, and explore the challenges with member demographic data and, more important, what payers can employ to solve the data challenge and ensure they have the information they need to locate, contact, engage and manage their member populations.
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MHPA
Download the presentation (PDF)
For additional information, contact Bruce Taylor at bruce-t.taylor@roche.com or visit www.roche.com or www.accu-chek.com.
For copies of other past webinars, visit here.
Project Transition
Project Transition enables people with serious mental illness, co-occurring substance use disorder and/or a dual diagnoses of SMI and IDD live meaningful lives in the community on terms they define. This position is responsible for the planning, development, and implementation of marketing and sales strategies. View the complete job description.
To apply, please email your resume to Adorable Harper.
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North Carolina Department of Health and Human Services
The Senior Medicaid Strategist has responsibility for the execution of the day to day activities in all efforts related to implementing Medicaid Reform for DMA. This position acts a project manager by directing internal and external resources to successfully operationalize reform policy. This individual will report directly to the DHHS Deputy Secretary for DMA.
For more details and to apply: click here.
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Aetna
Aetna seeks an experienced RN with managed care, leadership and prior authorization expertise. Reinforces clinical philosophy, programs, policies and procedures. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
Visit here and search for requisition #24937BR to learn more and apply.
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