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MHPA
Margie Shofer joins Medicaid Health Plans of America (MHPA) as the national trade association's new director of state policy. In this role, Shofer will serve as MHPA's lead for all state policy and regulatory issues that affect the Medicaid managed care industry.
Shofer comes to MHPA as a 15-year veteran of the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ). There she was a communications specialist who wrote, awarded and managed contracts to help AHRQ stakeholders translate health services research into practice and policy decisions.
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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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Bloomberg via The Baltimore Sun
Republican governors are pressing forward to expand Medicaid even after being stymied by lawmakers in their own party. As the Obama administration vows to help develop plans that will pass muster with conservatives, the governors of Utah and Wyoming said they still want the health care program for the poor broadened. Georgia Gov. Nathan Deal, who declined to act in 2013, may seek a federal waiver to make insurance available to more residents. Louisiana's Republican legislature also opened a legal door.
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The Associated Press via The Baltimore Sun
Virginia Democratic Gov. Terry McAuliffe says he'll make a renewed push to expand Medicaid now that Republican primaries are over and the U.S. Supreme Court recently issued a decision upholding the Affordable Care Act. McAuliffe said Thursday in a conference call with reporters that the Republican lawmakers who have previously blocked Medicaid expansion will be more open to compromise during next year's legislative session.
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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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Tampa Bay Times
After demanding that hospitals and insurance companies prove their Medicaid contracts are below state-mandated limits, Florida Gov. Rick Scott is dispatching Agency for Health Care Administration to audit those that did not send the state information by an Aug. 1 deadline. The audit announcement came in a letter Scott sent to AHCA Secretary Liz Dudek Monday.
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Miami Herald
Private insurers managing the healthcare needs of low-income, disabled and elderly Floridians with Medicaid will continue to fill prescriptions for home-based health therapists, medical equipment and infusion drugs after a Miramar-based company lost the contracts to coordinate and provide those services for patients statewide. Univita Health, a home healthcare company, lost all of its accounts this week with the HMOs contracted to manage the healthcare needs of Florida's Medicaid population, according to state healthcare officials.
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SHOWCASE
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Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
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The Associated Press via The Charlotte Observer
A lawyer representing 36 Republican lawmakers told a judge Thursday that keeping a hospital assessment in effect to help fund the Arizona's Medicaid expansion would gut a voter-approved law requiring a two-thirds vote for tax increases.
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The Arizona Republic
When is a fee a tax? That question is at the heart of a case argued Thursday in Maricopa County (Arizona) Superior Court that will ultimately land before the state Supreme Court and could profoundly influence state policy. Depending on the outcome, it could also put the health coverage of nearly 350,000 Arizonans in peril.
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The Associated Press via The Baltimore Sun
Arizona Gov. Doug Ducey plans to ask the federal government to approve major changes to the state's Medicaid insurance plan that are designed to encourage recipients to work, better utilize services and possibly cut state costs. The plan would apply only to able-bodied adults, about a quarter of the state's 1.7 million Medicaid recipients, and won't affect children, the elderly or disabled.
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Albuquerque Journal
A revolutionary but expensive treatment for hepatitis C will cost New Mexico's Medicaid program an estimated $140 million this year, even though the drugs are available only to the sickest patients who number fewer than 1,800, according to a recent report by the state Legislative Finance Committee. The report offers the first public data about costs New Mexico faces for new "near-perfect" treatments for hepatitis C, a deadly viral disease that attacks the liver.
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The Hill
Louisiana Gov. Bobby Jindal has canceled a contract that provides Planned Parenthood with state Medicaid funds. Medicaid, represents a major source of the group's government funding, at about 75 percent nationwide. In a statement, Jindal said that under his state's contract with the pro-abortion rights organization, "either party can choose to cancel the contract at will after providing written notice."
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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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MHPA
To request a copy of the presentation or for additional information please contact Neng "Bing" Doh, or visit www.healthcrowd.com.
For copies of other past webinars, visit here.
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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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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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