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MHPA
Kentucky Gov. Matt Bevin is delaying submitting changes to the state’s Medicaid program due to the large number of comments the state received regarding the proposal. They were initially due to the federal government on Monday. Part of Bevin's Medicaid plan would mandate that recipients work or volunteer at least 20 hours per week after their first year of receiving Medicaid benefits.
There are questions, however, about how the work requirement would be monitored. Jeff Myers, CEO of Medicaid Health Plans of American (MHPA) said health plan providers would want to make sure they're not the ones on the hook for collecting volunteer and work information. "MHPA would strongly encourage the state to work with its participating plans to reduce the overall administrative burden of this requirement on the plans," he said.
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MHPA
As more payers and pharmaceutical companies strike value-based purchasing (VBP) deals, CMS recently unveiled notices on these arrangements within the Medicaid program. While the agency encouraged states to consider these deals as a way to mitigate the growing costs of drugs, the July 14 notices to Medicaid agencies and participating drug manufacturers were sorely lacking in details about how such agreements could be structured without impacting a manufacturer's Medicaid best price.
"Even if [pharma] companies want to do this [i.e., enter into VBP deals], it isn't clear how they can and what they can do," said Jeff Myers, president and CEO of the Medicaid Health Plans of America. He told Drug Benefit News that it's "absolutely amazing" that companies "ask CMS, 'What would look like a safe harbor?'" and CMS' response is "three pages of 'please read the rules.'"
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The Hill
The Centers for Medicare & Medicaid Services on Monday announced the regional participants in its largest initiative to reform primary care. The five-year Comprehensive Primary Care Plus (CPC+) aims to shift payers and primary care doctors to what's being called a value system based on patient outcomes.
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Kaiser Health News
Experts estimate that about half of all people turning 65 today will need daily help as they age, either at home or in nursing homes. Such long-term care will cost an average of about $91,000 for men and double that for women, because they live longer.
In California and across the U.S., many residents can't afford that, so they turn to Medicaid, the nation's public health insurance program for low-income people. As a result, Medicaid has become the safety net for millions of people who find themselves unable to pay for nursing home beds or in-home caregivers. This includes middle-class Americans, who often must spend down or transfer their assets to qualify for Medicaid coverage.
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New Hampshire Union Leader
New Hampshire is looking for someone to take charge of its $1.4 billion Medicaid budget at a time of big changes in the federally subsidized health insurance program for low-income individuals and families. Katie Dunn, who served as Medicaid director for more than 10 years, and prior to that as director of public health, has accepted a position as a senior policy advisor to a national health policy organization, according to NH Department of Health and Human Services Commissioner Jeffrey Meyers.
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Alabama Public Radio
Alabama doctors will be paid less for handling certain cases for the state’s Medicaid agency. As of Aug. 1, Alabama will no longer compensate doctors for what are known as "enhanced payments" for specific primary care visits and services. The higher-than-usual fees were paid for by the Federal Affordable Care Act in 2013 and 2014.
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The Arizona Republic
Thousands of low-income immigrants in Arizona who are eligible for full medical benefits under the state's Medicaid program are being improperly assigned to less robust coverage by a state agency, a federal lawsuit alleges. The lawsuit filed this month in U.S. District Court in Phoenix contends that lower-income refugees, asylum seekers and other immigrants who qualify for Medicaid coverage are being shifted to emergency-only medical coverage even though they qualify for full benefits that pay for outpatient care and prescription drugs.
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Kaiser Health News
For undocumented immigrants, finding affordable health care has been an ongoing battle. They’ve claimed some victories — undocumented children in California, for example, can now enroll in Medi-Cal, the state's Medicaid program. But there are few low-cost healthcare options for adults who are in the country illegally.
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MHPA
We're weeks away from mhpa2016, the largest Medicaid managed care annual conference.
Register here.
Learn more about mhpa2016 by visiting us at medicaidconference.com.
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