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'Churning': The latest watchword for states working on health reform
California Healthline
Fluctuating insurance coverage is not a new problem for the U.S. health care system.

For years, individuals have gained or lost eligibility for federal health insurance programs as their incomes change.

The process is known as "churning" — a healthcare insider buzzword that is becoming more familiar to the public as state officials search for ways to prevent it, particularly under the Affordable Care Act.
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Michigan Senate offers multiple Medicaid expansion plans
Michigan Capitol Confidential
The Michigan Senate took action on expanding Medicaid in Michigan by reporting three bills out of committee. The bills reported out of the Senate Government Operations Committee now are technically before the full Senate where they can be voted on for possible passage, which reportedly could take place Aug. 27.
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The 48th anniversary of Medicare and Medicaid
A statement by HHS Secretary Kathleen Sebelius via Pharmacy Choice
July 30 marked the 48th anniversary of Medicare and Medicaid becoming law, a sacred promise our country made to older and low-income working Americans and families that they will have the medical care they need to live healthier lives.

The historic pledge acknowledges that after contributing a lifetime of hard work to our nation's well-being, our seniors will be able to live their golden years with the security and peace of mind that comes with having affordable health coverage under Medicare.

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MHPA 2013 — Updated agenda for 'Health Reform from East to West: Preparing Medicaid Health Plans for 2014' | Oct. 20-22 | National Harbor, Md.
Register now for MHPA 2013, Medicaid Health Plans of America's annual conference Oct. 20-22 at the Gaylord National Resort & Convention Center in National Harbor, Md. Register by Aug. 31 to receive the early-bird discount. Details on conference and registration can be found here.
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KanCare: Aims to achieve savings and quality improvement
Kansas Health Institute
In 2013, Kansas moved most of its Medicaid beneficiaries to a managed care model known as KanCare. Kansas contracted with three companies — Amerigroup Kansas Inc., Sunflower State Health Plan Inc. and UnitedHealthcare of the Midwest — to act as managed care organizations (MCOs) for Medicaid beneficiaries. The MCOs are required to deliver all current Medicaid services without reducing payment rates to providers that agree to work with the MCOs.
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New Hampshire official: Medicaid expansion may bring disruptions
The New Hampshire Union Leader via Pharmacy Choice
Adding 22,000 people to the healthcare system may cause some short-term disruptions, a state insurance official told the commission studying Medicaid expansion.

However, Tyler Brannen, health policy analyst for the state Insurance Department, said within six to 10 months, providers will respond to the new payers and make adjustments.

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Latest Ohio Medicaid expansion proposal introduced
The Plain Dealer
Add another Medicaid proposal to the Ohio Statehouse agenda.

Democratic Sen. Capri Cafaro unveiled the latest legislative measure aimed at reforming and expanding Medicaid in Ohio. And while Cafaro’s proposal included some new policy, the senator focused mostly on trying to dispel a central Republican complaint — Medicaid expansion would siphon money from state coffers.

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Florida set for launch of Medicaid managed long-term care program
Florida Today
Florida's Agency for Health Care Administration and the Department of Elder Affairs will host a public launch event with community stakeholders, partners and representatives from each of the seven health plans selected to provide services via the Statewide Medicaid Managed Care Long-term Care program.
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WellCare employees donate school supplies for Tampa Bay Area students
As part of Metropolitan Ministries' annual Backpacks of Hope collection drive, employees of WellCare Health Plans, Inc. donated more than 3,000 school supplies that will help approximately 200 local students during the new school year. A team of WellCare volunteers joined Metropolitan Ministries' staff to prepare the backpacks and landscape the nonprofit's Tampa campus.
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TMG Health hosts clients at National Operations Center
TMG Health via KHQ
TMG Health, the leading provider of technology-enabled solutions for Medicare Advantage, Medicare Part D and Managed Medicaid plans, received strong support from its clients at the company's annual Client Forum held at TMG Health's new National Operations Center in Jessup, Pa. Under the conference theme, "Connect-Collaborate-Contribute," the forum convened management executives and operations leaders from TMG Health's Client base of Health Plans and Pharmacy Benefit Managers to discuss forward-thinking strategies and initiatives that will shape the future of processing in the government health programs market.
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Improve blood-lead testing HEDIS scores

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To find out how to feature your company in the MHPA eNewsletter and other advertising opportunities, Contact James DeBois at 469-420-2618.

Reminder: MHPA Best Practices Compendium Submissions Due Aug 16

Submit your best practices for inclusion in the 2013-2014 Best Practices Compendium. Details here.
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'Medicaid/Commercial Exchange Churn: Creating Market Advantage:' A free webinar by Altegra Health | Aug. 7 | 3 p.m. EST
Health plans that serve both Medicaid and the Commercial Exchange will face operational and financial challenges as enrollee income levels shift. State-specific Medicaid expansion and benefit changes can further exacerbate these challenges. If well managed, enrollee turnover can become a market advantage. This webinar will discuss proactive strategies to address operational, service and financial challenges related to the anticipated turnover between Medicaid and the Exchange enrollees.
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Sign up for a free trial to Health Exchange Alert, a news service from
Inside Washington Publishers
The Affordable Care Act's mandated health exchanges are on the front burner for policymakers and should be for you, too. Stay on top of the evolution and implementation of health exchanges with Health Exchange Alert, the news service from Act now by clicking here to activate a no-obligation, four-week free trial to gain immediate access to and Health Exchange Alert.

Your free trial will include access to the numerous articles and documents posted every business day, as well an email alert every morning highlighting the latest news. You'll also have access to our three weekly newsletters (Health Exchange Alert, Inside CMS and FDA Week), which you can download in PDF format and circulate.

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'The Value of Medication Monitoring with Urine Drug Testing in the Clinical Setting:' A free webinar by Millennium Labs | Aug. 21 | 3 p.m. EST
This webinar will help you better understand how Urine Drug Testing provides an evidenced-based monitoring tool that can enhance the clinician-patient relationship. There is an emphasis on differences in testing methodologies, illustrated with case studies involving UDT results.
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New webinar: 'Financial Impact of Incontinence: Guiding Patients/Families toward Cost Effective Management,' by First Quality | Aug. 28 | 3 p.m. ET
Incontinence affects individuals of all ages and disabilities. There are a number of ways to manage incontinence that are patient-centered while containing costs. This webinar, with Christine Pruneau RN, RAC-CT scheduled to be the speaker, will discuss:
  • Types and causes of incontinence — why this matters
  • Choosing the right product and incontinence type — how to decrease costs
  • Solutions to manage incontinence while being cost effective
  • Frequently asked questions on incontinence and educational pieces available

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'Opportunities to Improve Medication Adherence': A free webinar by
Eli Lilly and Co. | Sept. 18 | 3 p.m. EST

The introduction of three new medication adherence measures, each with a triple weight, makes Medicare Advantage and Part D pharmacy measures matter more than ever. But focus on driving improvement in medication adherence proliferates many other government and private insurer programs. In fact, medication adherence is a subject of importance now to Medicare, plans, hospitals, integrated delivery systems, retail pharmacies, industry and patients. With the patient at the center of these measures, you will learn key patient insights from a consumer marketer around medication adherence.
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Budget cuts force scale back of healthcare fraud investigations
The Washington Post
Facing major budget and staff cuts, federal officials are scaling back several high-profile healthcare fraud and abuse investigations, including an audit of the state insurance exchanges that are set to open later this year as a key provision of the Affordable Care Act.

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Feds to Florida: Not too late for Medicaid expansion
Miami Herald
Federal officials recently renewed calls for Florida lawmakers to accept an estimated $50 billion over the next 10 years to expand Medicaid, the joint state and federal health insurance program for the poor, to cover an additional 1 million Floridians who would otherwise remain uninsured even after Jan. 1 when healthcare reform begins in earnest.

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Medicaid in North Carolina's final HHS budget
North Carolina Health News
Lawmakers released their compromise state budget, a document that provides for $20.6 billion in state spending over the upcoming year.

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Providence Health & Services job opportunity
Providence Health & Services
Providence, the largest healthcare system and largest private employer in Oregon, is calling a full-time health plan Medicaid program director in Portland, Ore. In this position, you will:
  • Lead the development, implementation and ongoing operation of Medicaid products and services, with full responsibility for revenue and expense for the Medicaid product line.
  • Direct and coordinate all activities associated with the Medicaid program to assure that corporate performance objectives are met in a timely, effective and efficient manner.
  • Establish and lead a comprehensive Medicaid program for Providence Health Plans in conjunction with Providence Integrated Delivery System.
Please view more details about this job here, position number 33824. You can reach the recruiter Judy Stenson-Musa directly at 503-893-7479.

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Deloitte job opportunities
Deloitte Consulting LLP
Health plans face a number of unique market and regulatory pressures that impact how they conduct business today and in the future. Deloitte Consulting LLP is one of the world's leading management consulting firms for executable strategy, operations, technology and human capital advisory services, and it is uniquely positioned to provide business solutions to our clients.

Deloitte's Government Programs practice is seeking candidates who have consulting, compliance and operational experience as it relates to Medicaid, Medicare Advantage and Medicare D plans.

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Navigant job opportunities in DC, Chicago
Navigant is a specialized, global expert services firm dedicated to assisting clients in creating and protecting value in the face of critical business risks and opportunities. Navigant's Healthcare Practice strives to be the premier independent management consulting practice assisting senior level healthcare executives deal with their core business challenges.

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Recent webinar presentations from dLife, PwC, Deloitte and others available free on MHPA website
View PDFs or listen to audio for the following webinars: Additional webinars can be viewed here.
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Missed our previous issues? See which articles your colleagues read most.

    Medicaid in North Carolina's final HHS budget (North Carolina Health News)
Massachusetts duals demo increases plans' protections against pay rates (InsideHealthPolicy)
The cost of not expanding Medicaid (The Henry J. Kaiser Family Foundation)
New Hampshire residents left in limbo as legislature blocks Medicaid expansion (The Boston Globe)
HHS secretary hopes Texas will reconsider decision not to expand Medicaid (The Dallas Morning News)

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

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