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Reuters
Advocacy groups on Tuesday filed a lawsuit challenging the decision by President Donald Trump's administration to allow Arkansas to impose work requirements on Medicaid recipients in the state. The lawsuit, filed against the U.S. Department of Health and Human Services in federal court in Washington on behalf of three Medicaid recipients in the state, claims that the federal Medicaid law does not allow the administration to approve work requirements.
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The Hill
New data released by the state of Arkansas on Wednesday show Medicaid enrollees are struggling to comply with the state's new work requirements, putting thousands at risk of losing healthcare.
The requirements — which mandate that some Medicaid beneficiaries work or complete similar activities to retain benefits — went into effect in June after being approved by the Trump administration.
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Forbes
UnitedHealth has invested $350 million since 2011 in affordable housing in 14 states. And the nation's second-largest health insurer, Anthem has committed more than $380 million to affordable housing over the last decade. And other insurers, such as Humana, are investing and partnering in certain communities as part of a "Bold Goal Initiative" that targets a variety of social determinants.
State Medicaid programs, working with health insurers, are also opening up to covering more nontraditional services and the health plan lobby is pushing state legislatures and governors to spend more money on social determinants of health. "All of our members are starting to look at this," said Jeff Myers, president of Medicaid Health Plans of America, which represents most major health insurers including Centene, Unitedhealthcare and Wellcare Health Plans. "Obviously, states cannot afford to pay for everything, but until you meet those basic needs, it's almost impossible to address their healthcare. It's hard to get a diabetic to focus on eating well if they don't know where they are going to live."
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Project Transition
Learn how one provider is challenging the status-quo in behavioral healthcare and advocating for society’s most vulnerable members to discover their life worth living by providing a recovery experience like no other. Individuals with serious mental illness (including dual diagnosis) are empowered and able to realize a life in the community, on terms they define with the right treatment and services. In Philadelphia, PA and Nashville, TN, a unique extended behavioral support program has been proven to reduce cost and increase positive outcomes, by combining apartment-style community living with intensive, daily, evidence-based programming. This setting helps minimize stigma and create normalized social expectations and consequences.
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Modern Healthcare
Ohio's Medicaid department is directing its managed-care organizations to quit their contracts with pharmacy benefit managers because of opaque pricing practices officials said cost the state millions of dollars.
The state's five managed-care plans must strike up new contracts with companies able to manage pharmacy services using a more transparent pricing model by Jan. 1, 2019.
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Veyo is a full-service transportation brokerage designed specifically for healthcare. By integrating consumer technology with rideshare fleets, we have decreased costs and increased efficiencies. Operating in eight states with over 6 million completed trips and a 97.1% on-time rate, we're changing NEMT - one trip at a time. Learn More
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The Hill
The Trump administration is using new powers to propose a significant decrease in how many opioids drug companies can manufacture in the U.S. in 2019.
The Justice Department and Drug Enforcement Administration (DEA) are proposing an average 10 percent decrease next year in the manufacturing quotas for six frequently misused opioids.
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CNN
More than 72,000 Americans died of drug overdoses in 2017, up nearly 7 percent from 2016, according to preliminary data from the U.S. Centers for Disease Control and Prevention. The 2017 preliminary death count for all 50 states and the District of Columbia represents a twofold increase over a decade, the CDC says.
The authors of the report say the 2017 numbers may be an underestimate because states' investigations into some overdose deaths may not be complete.
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The Hill
CVS Caremark will allow its clients to exclude coverage of drugs with extremely high launch prices under a new program the company said is aimed at pressuring manufacturers to lower drug costs.
According to CVS, launch prices have been steadily rising for years, and are completely up to the discretion of the manufacturer. The high prices put an unsustainable burden on the country's health system, CVS said.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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Health Affairs
The nation's opioid crisis is well documented, but the effect on pregnant women and infants has been overlooked. Opioid use disorder in pregnancy has increased along with an increase in neonatal opioid withdrawal, or neonatal abstinence syndrome (NAS). Medicaid covers roughly half of all births, and more than 80 percent of NAS births, so the motivation of those working with the program to help and find solutions is high. This post on the effect of the opioid crisis on pregnant women and babies in Medicaid covers barriers in care delivery, policy obstacles and recommendations to improve outcomes.
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You know you need to be prepared to respond quickly to CMS audit requests – including A&G history, activity, and status. Find out how effective, automated A&G management can protect revenue, improve network quality, ensure regulatory compliance, and lower the cost of disenrollment.
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MHPA via YouTube
Watch this short recap of MHPA17 to get a feel of the excitement, energy, and content of MHPA's annual conference.
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Financial Times
The American healthcare landscape is brimming with uncertainty. Pressures and priorities vary among stakeholders but whether it's pharma, payer, PBM, provider or patient, everyone is looking for value. The FT Pharma Pricing and Value Summit will discuss the future of pharmaceutical pricing and market access in an evolving healthcare environment. MHPA President and CEO Jeff Myers will give his insights at the Pricing pressures and healthcare reform panel on issues such as what could fuel pricing pressures on pharma, healthcare reform and the market access landscape, and overcoming political barriers in healthcare.
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