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The News & Observer
The North Carolina Senate gave final approval Tuesday to a bill that would restructure the way healthcare and health insurance for the poor, elderly and disabled is handled in North Carolina. On a 34-10 vote, the Senate sent the bill back to the House, where its prospects are not entirely clear.
The bill would change the current fee-for-service system to a per-member monthly allotment, meant to encourage patients and medical providers to control costs in the Medicaid program. It calls for a mix of commercial insurers and in-state healthcare providers.
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The New York Times
The number of people without health insurance continues to decline and has dropped by 15.8 million, or one-third, since 2013, the Obama administration said Tuesday. The decline occurred as major provisions of the Affordable Care Act took effect. The law expanded coverage through Medicaid and through subsidies for private insurance, starting in 2014.
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The Hill
The Obama administration has warned Louisiana and Alabama that they could be violating federal law by cutting off Planned Parenthood from their states' Medicaid programs. The Republican governors in both states this month terminated their state Medicaid contracts with the organization in the wake of controversial undercover videos showing Planned Parenthood officials discussing the price of fetal tissue for medical research.
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The Associated Press via KTVI-TV
Missouri's state House leader has assembled a panel to review how to provide Medicaid healthcare. Republican Speaker Todd Richardson appointed lawmakers, providers and consumer group members to the task force Wednesday. An earlier message from Richardson described a task force for expanding Medicaid. A release from the speaker's office later corrected that.
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Kansas Health Institute
A recent Gallup poll shows that the percentage of uninsured Americans in some states has dropped dramatically since the federal Affordable Care Act. The drops are generally more dramatic in states that have embraced politically controversial portions of the law. In Kansas, which resisted those measures, the reduction in uninsured residents is small and within the poll's margin of error.
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Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
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The Texas Tribune
Relatives of children with disabilities are joining therapy providers in a lawsuit against the Texas Health and Human Services Commission, weeks before the agency is scheduled to slash payments to a therapy program for the poor. The families and therapy providers have asked a Travis County judge to stop the state from implementing the budget cuts on Sept. 1, alleging they will cause "immediate and irreparable injury" to thousands of children in the state's Medicaid program.
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Tampa Bay Times
Amid concern about the ballooning costs of Florida Medicaid, state Agency for Health Care Administration Secretary Elizabeth Dudek said Wednesday she had ordered audits for 31 hospitals that may be receiving more in Medicaid payments than is legally allowed. The hospitals include Kindred Hospital Tampa and Kindred Hospital St. Petersburg.
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Healthcare Dive
Beacon Health Options, the nation's premier behavioral health management company, announced that it began managing behavioral health care and substance use disorder services for West Virginia Family Health Medicaid members in 53 counties throughout the Mountain State. Up until July 1, behavioral health services were carved out of managed care and delivered through a fee-for-service model.
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MHPA
The agenda for mhpa2015 — "Medicaid Turns 50: Its ongoing evolution via managed care and best practices" — is now online. View all of the sessions we have in store for you as well as get info on registration, lodging, and sponsorships here.
For a taste of the conference, please watch this moving video of last year's event.
For more information, please contact Sarah Swango (sswango@mhpa.org/202-857-5772) or Erin Liberatore (ELiberatore@mhpa.org/202-857-5773).
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MHPA
Time is running out to submit member plan programs 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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Managed Medicaid regulatory changes carry significant information technology implications. What will you need to comply? Where will you find it? Download today to learn more!
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MHPA
Download the presentation (PDF)
For additional information, contact Ashley Wright at awright@mtm-inc.net, or visit www.mtm-inc.net.
For copies of other past webinars, visit here.
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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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Express-Scripts
Health plans are increasingly challenged with managing the costs associated with specialty medications while providing the specialized care these patients require to ensure medication adherence. Whether it's expensive hemophilia products or new oncology drugs in the pipeline, it is critical for plans to be able to provide the right patients access to the right medication at the best possible price with the highest level of care. Plans also need to take into consideration the new PCSK9 inhibitors — specialty drugs now being used in more common conditions like high cholesterol — where the total annual cost burden of therapy for U.S. payers and patients is on a path to become the most costly therapy class this country has ever seen.
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MHPA
Market Access World and Evidence Congress held an interview with keynote speaker MHPA CEO Jeff Myers, the keynote speaker of Market Access World USA 2015, which is scheduled for Sept. 30 and Oct. 1 in Philadelphia. Listen to Myers discuss the future of patient access, current challenges the sector is facing and why he will be attending this year's congress.
Join the congress to examine:
- Innovative pricing strategies for high-value drugs
- How to overcome barriers to patient access
- How to adapt to the changing models of the payers globally
- How you can meet payers' expectations
- Securing reimbursement for personalized medicines
Book now using code BR01.
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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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Sponsored by ...
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7701 Las Colinas Ridge, Ste. 800, Irving, TX 75063
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