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More than 7.2 million additional Americans covered under Medicaid and CHIP
U.S. Department of Health & Human Services
Over the last year, we've seen the Affordable Care Act deliver on a number of important milestones as we work toward more accessible, affordable, quality healthcare. New options have meant that 10.3 million previously uninsured Americans can now rest a little easier knowing that they are covered. And millions more can rest assured that quality, affordable health insurance will be available through the Marketplace if they ever need it, without worrying about being charged more or denied coverage because of a pre-existing condition. This historic expansion of coverage has happened while healthcare spending growth has fallen to the slowest rate on record, which strengthens our nation's budget outlook and keeps more of Americans' paychecks in their pockets.
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Aug. 13 Webinar Wednesday: 'Asked and Answered: Mobile Tech, Member Engagement, and the Keys to Accountable Assessments'
Health: ELT
As Medicaid members become more digitally connected, health plans must adapt to make the best use of all that's available to both enterprise and consumer. There are numerous spaces in which mobile technologies can affect a health plan's interaction with its members with better tools for employees and members alike. Join mobile technology and digital engagement strategist, Amanda Havard, chief innovation officer at Medicaid engagement, logistics and technologies company Health: ELT, to gain insight into these key areas.
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mhpa2014 session on fraud and abuse and Medicaid costs
MHPA
Join Ronald Wisor, a partner at Hogan Lovells who counsels healthcare companies on regulatory compliance and reimbursement, for Fraud and Abuse: Incentives Driving up Medicaid Costs, a discussion on the multiple areas where clinician incentives are driving costs for Medicaid. The session, sponsored by Millennium Labs, will use a case study of the drug testing industry, which is expanding rapidly in response to the mounting crisis of opioid abuse and drug diversion.

For details on this and other insightful sessions at the premier event for the Medicaid managed care industry, please click here for our latest agenda. Don't forget: Sign up before Sept. 8 to grab the early-bird discount.

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PhRMA: Part D premium projections repudiate PCMA's warning Sovaldi would hike seniors' costs
Inside Health Policy
Brand drug makers recently asserted that CMS' projection of stable Part D premiums next year show that complaints about Sovaldi's price are much ado about nothing; but the drug plans and pharmacy benefit managers that had warned the hepatitis C drug would drive up premiums say the latest projections are merely an example of insurers doing a good job of controlling costs, and a key drug price control advocate said premiums likely would have fallen were it not for Sovaldi.
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GOP eyes Obamacare votes if Senate flips
The Hill
Republicans plan to hold a series of votes on repealing Obamacare if they win control of the Senate in November, according to a report. The votes would set the tone for a new, GOP-led Congress and create a showdown with President Barack Obama, who would almost certainly veto any legislation rolling back parts of the healthcare law.
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MyCare Ohio transition continues
JD Supra
Ohio's transition to Medicaid managed care continues. The Ohio Department of Medicaid, the contracting agency with the five managed care companies now providing services to Ohio's dual eligible population, is providing more information to Ohio providers during this transition period. Those dual eligible (eligible individuals for both Medicare and Medicaid) are being transitioned into these managed care private sector insurance programs.
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HHS figures: Missouri led nation in Medicaid roll reductions
The Associated Press via Springfield News-Leader
Missouri's Medicaid program is leading the nation in the number of people dropped from its rolls. New figures from the U.S. Department of Health and Human Services show that Missouri's Medicaid enrollment dropped by 37,260 people in June, compared with its average enrollment from July through September of last year.
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South Carolina Medicaid dealing with application backlog
The Associated Press via Augusta Chronicle
South Carolina's Medicaid agency is working to process thousands of applications backlogged through the federal online marketplace. As of Aug. 1, the state Department of Health and Human Services had reviewed more than 60 percent of the 38,000 applications the federal government began transferring in mid-February. Of those, 13,000 await more information from the applicant.
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Prison inmates' prerelease application for Medicaid take-up rates in Oregon
Urban Institute
People returning from prison to the community have historically been uninsured, despite having physical and behavioral health problems that may perpetuate a cycle of relapse and reoffending. We describe Oregon's pre-Affordable Care Act process to enroll released prisoners into its state-financed Medicaid program for childless adults. Sizeable numbers participated, including many with mental health and substance abuse problems. Those leaving prison were as likely as the general population to submit Medicaid applications and less likely to be denied. Challenges arose when the application process straddled prison release, but the ACA simplifies the process and may increase enrollment efficiency.
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Appalachian Kentucky: What ails it ails the nation
USA Today
Appalachian Kentucky is one of the unhealthiest regions in the nation, ranking poorly on numerous health measures. Some experts worry what's happening there could be a harbinger of what is in store for the U.S. as a whole if disturbing trends, such as rising obesity, don't change.
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Medicaid admissions and readmissions: Understanding the prevalence, payment and most common diagnoses
Health Affairs
Reducing hospital readmissions is a way to improve care and reduce avoidable costs. However, there have been few studies of readmissions in the Medicaid population. The following attempts to characterize acute care hospital admissions and 30-day readmissions in the Medicaid population through a retrospective analysis in 19 states.
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CHIP premiums adversely affect enrollment, especially among
lower-income children

Health Affairs
Both Medicaid and the Children's Health Insurance Program, which are run by the states and funded by federal and state dollars, offer health insurance coverage for low-income children. Thirty-three states charged premiums for children at some income ranges in CHIP or Medicaid in 2013.
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Obamacare creates 'upheaval' at free clinics
Kaiser Health News via USA Today
Pam Milliken was among the 70 percent of patients at West Virginia's Wheeling Health Right Center who enrolled in Medicaid after the state expanded the program under the Affordable Care Act. Worried that patients like Milliken would leave their care and struggle to find doctors accepting new Medicaid patients, the clinic took a rather radical step: It became a Medicaid provider and started billing the state-federal health insurance program for the poor.

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Leadership change at MHPA Board of Directors
MHPA
Frank J. Siano will be stepping down as board chair of Medicaid Health Plans of America. Siano is leaving his post as vice president of business development, Medicaid, at Aetna and therefore will pass the reins to Kearline D. Jones, vice president of government relations and compliance at Health Partners Plans, who will transition from vice chair to chair of MHPA's board.

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Hep C patients considering suing states restricting Sovaldi coverage
Inside Health Policy
Patients infected with hepatitis C are preparing to sue in short order states that restrict Medicaid coverage of Sovaldi, and they're using as a model a lawsuit that cystic fibrosis patients recently filed in Arkansas, where Medicaid uses a prior authorization policy to curb use of the cystic fibrosis drug Kalydeco, according to Donna Cryer of the Global Liver Institute.

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Upcoming Webinar Wednesdays
MHPA
Here are some upcoming Webinar Wednesday events to mark on your calendars:
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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Michigan prisoners may get $1,000-per-pill hepatitis C care (The Detroit News)
Feds grant Florida 3-year Medicaid managed-care renewal (The Associated Press via Modern Healthcare)
Accenture selected as lead Texas Medicaid vendor (Business Wire via Technology Marketing Corporation)
Feds return Indiana Medicaid waiver request (The Associated Press via The Indianapolis Star)
Medicaid reform could cut deep at rural North Carolina hospitals; defense from MHPA's Jeff Myers (The Associated Press via WNCN-TV)

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


Aetna job opportunities
Aetna
The following are job opportunities from Aetna. Visit here, and enter Req # for full description and details.
    MD/Psychiatrist; Newark, Delaware; Req# 19223BR
    This successful candidate will become the Delaware Physicians Care (DPCI) Medical Director for Behavioral Health and will serve as our expert physician resource in the areas of utilization management, quality management, case management and overall medical management. This critical role sits at the intersection of behavioral and physical health services in helping DPCI to develop holistic programs to improve the quality and outcomes of our constituent members.

    MD/Physical Health; Newark, Delaware Req# 19166BR
    The position entails duties and responsibilities of Medical Director for Delaware Physicians Care (DPCI). The successful candidate will serve as a critical contributor to the DPCI medical management team in the role of clinical expert to the various functional areas including utilization management, case management and quality management. A key component of this position is to use the clinical credentials, experience and judgment in rendering benefit determinations based on medical necessity.

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