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Opinion: Medicaid managed care still is best solution
The News Star    Share    Share on FacebookTwitterShare on LinkedinE-mail article
For more than two decades, many states across the country, in an effort to improve health outcomes and manage costs, have moved from state-administered fee-for-service Medicaid programs to Medicaid managed care plans operated by private healthcare companies. In fact, according to the Centers for Medicare and Medicaid Services, more than 71 percent of Medicaid beneficiaries nationwide were enrolled in managed care plans in July 2010. There are many compelling reasons to move to Medicaid managed care. More

Cognosante's Ackley interviewed live today on Medicaid Matters Talk Show at 2012 Medicaid Enterprise Systems Conference
Marketwire via Hispanic Business    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Cognosante, a leading provider of IT services for healthcare organizations, announced that Susan Ackley, Standards Practice director, appeared on the Medicaid Matters Talk Show on Aug. 21 during the 2012 Medicaid Enterprise Systems Conference in Boston. Ackley was interviewed by show host Richard Yadon. More

AHA becomes latest to pressure HHS for Medicaid expansion answers    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The American Hospital Association is pressing the Department of Health and Human Services for answers on whether states can phase in an expansion of Medicaid for low-income adults in increments over several years and whether the administration will use Section 1115 Waivers to encourage states to expand their programs, according to an Aug. 20 letter the hospital group sent Secretary Kathleen Sebelius. More

Upton, Pitts push CMS to issue ACA regulations, respond to states' Medicaid expansion questions    Share    Share on FacebookTwitterShare on LinkedinE-mail article
House Energy and Commerce Republicans say CMS should provide answers by Sept. 3 to the many exchange and Medicaid expansion questions Medicaid directors and Republican governors asked following the Supreme Court's ruling on the health reform law. In an Aug. 20 letter to CMS Acting Administrator Marilyn Tavenner, committee Chairman Fred Upton, R-Mich., and health subcommittee Chairman Joe Pitts, R-Pa., write that CMS also needs to specify when the administration plans to issue outstanding regulations on exchanges and Medicaid, and when they are expected to be completed. More

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Medicaid directors seek more efficient managed long-term care waiver reviews    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid directors say CMS should set deadlines for reviewing state waiver applications for managed long-term care programs and the agency should speed reviews, in some cases skipping the approval process. The National Association of Medicaid Directors, in a recent letter, urged CMS to work with states to develop quality measures for Medicaid beneficiaries receiving long term care services. More

GOP governors fight with hospitals over Medicaid opt-in
The Fiscal Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In a battle to see who will pick up the cost of expanding Medicaid, hospitals are playing tug of war with financially distressed states that have chosen to opt out of the program. When the Supreme Court decided states could not be penalized for not expanding Medicaid under the Affordable Care Act, Republican Governors Bobby Jindal of Louisiana, Rick Perry of Texas, and Rick Scott of Florida quickly announced that their states would not participate. The three governors, whose states have among the highest uninsured populations and some of the most limited Medicaid programs in the country, say their states can't afford Medicaid expansion and don't want the federal government interfering with their programs. More

KanCare MCOs to take on case management role
Kansas Health Institute    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Kansas officials are encouraging people currently employed as case managers for physically disabled and elderly Medicaid enrollees to apply for similar jobs with the three insurance companies chosen to implement KanCare, Gov. Sam Brownback's Medicaid makeover plan. The insurance companies are expected to take over Medicaid services on Jan. 1, pending federal approval of the governor's plan. More

Poll: Most Californians support reform
California Healthline    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A Field Poll recently released shows that only 17 percent of Californians are aware of the state's nascent Health Benefit Exchange but a high percentage of Californians like the basic tenets of healthcare reform and the exchange, according to Mark DiCamillo, director of the Field Poll. "It's definitely low, and that is somewhat to be expected, given that they haven't done any outreach or marketing yet," DiCamillo said. More

Montana weighs expanding Medicaid rolls
The Associated Press via Houston Chronicle    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Montana lawmakers are trying to decide whether it's worth spending up to $119 million to expand the state's Medicaid program to include as many as 57,000 more people now that a U.S. Supreme Court decision has given them the option. A decision by Montana legislators, who don't meet in full session until January, won't be easy because of the unanswered questions left by the high court's ruling, a panel of experts told an interim committee of lawmakers. More

Washington state officials seek to greatly expand Medicaid
The Columbian via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The outlook for Washington's medically uninsured population may be a bit rosier by 2014, particularly for the more than 300,000 low-income people who may find themselves eligible for the state's Medicaid rolls. But the desired expansion comes with a hefty price tag for the federal government, potential risk for the state and new concern for healthcare providers already stretched to care for current Medicaid patients. The Medicaid program currently serves about 1.2 million people in Washington. In the last several years, as the state's purse strings tightened, the medical program for low-income residents has faced cuts to provider reimbursement rates and services. More

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Virginia moving on implementing health reform
Richmond Times-Dispatch    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Virginia has made progress in updating its computer system for verifying eligibility for Medicaid and has passed insurance regulations in preparation for implementing federal healthcare reform, according to a report by a nonprofit organization tracking states' efforts. But Virginia is behind in some key areas — it hasn't created health insurance exchanges or marketplaces where people could buy affordable health insurance plans, and it may not be producing enough doctors to care for hundreds of thousands of newly insured people expected to be covered when reform is fully implemented. More

New Mexico revises Medicaid overhaul plan
The Associated Press via The Denver Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
New Mexico Gov. Susana Martinez's administration has asked the federal government to approve a revised plan to overhaul a program providing healthcare for a fourth of New Mexico's population. The Human Services Department's latest Medicaid proposal comes nearly six months after the administration initially unveiled a blueprint to improve healthcare for needy New Mexicans while slowing the growth rate of a program costing nearly $4 billion a year. About a fourth of the money comes from the state budget, with the federal government paying the remainder. The administration hopes to implement the Medicaid overhaul in January 2014. More

GAO: States reported billions more in supplemental payments in recent years
U.S. Government Accountability Office    Share    Share on FacebookTwitterShare on LinkedinE-mail article
States reported $32 billion in Medicaid supplemental payments during fiscal year 2010, but the exact amount of supplemental payments is unknown because state reporting was incomplete. On expenditure reports used to obtain federal funds filed with the Department of Health and Human Services' Centers for Medicare & Medicaid Services, states reported $17.6 billion in Disproportionate Share Hospital payments in 10 among 50 states, and $14.4 billion in non-DSH supplemental payments to hospitals and other providers among 30 reporting states. More

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Maryland, DC tap outside consultants to adopt changes in healthcare law
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Affordable Care Act is proving to be a boon for professional services firms, with Maryland and the District awarding millions of dollars in contracts to healthcare consulting and actuarial firms to study and advise on ACA-related provisions, including creating state-run health insurance exchanges. About 75 contracts have been awarded nationally in connection with various parts of the federal healthcare law, and between 40 and 45 of those are related to setting up health insurance exchanges, according to Herndon-based Deltek, which analyzes the contracting market. More

Register online today for MHPA's 2012 Annual Meeting
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Register online for the MHPA 2012 Annual Meeting in October at the Hyatt Regency Washington on Capitol Hill in Washington, D.C. The pre-conference "Developments in the States" will run from noon to 6 p.m. Oct. 24 and will feature state Medicaid directors and leadership from Michigan and Florida health plan associations who will discuss current trends and what's in store for Medicaid health plans at the state level. The main event, "A Pivotal Time for Medicaid Health Plans," kicks off Oct. 25, just two weeks before Americans vote in a presidential election that, with the addition of Wisconsin Congressman Paul Ryan to the Republican ticket, will decide the future of Medicaid. For meeting details, including travel/lodging info and agendas, click here. Remember: Sign up before Aug. 31 to take advantage of the early-bird discounts on both conference and pre-conference fees. Register online from your PC or PDA here.

Insights webinar: Reduce Outsourcing Risk | 11 a.m. EDT Aug. 27
CGS    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The CGS presentation, "Reduce Outsourcing Risk with a Vendor Qualification and Review Process," demonstrates how to qualify a supplier during the selection process using a defined set of scoring criteria, and how to use the same criteria to manage the supplier during ongoing operations. More

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Free webinar: Making the Business Case — Fundamentals, Opportunities and Risks for Health Plans Considering the Dual Eligible Market | 1 p.m. EDT Aug. 29
Sellers Dorsey    Share    Share on FacebookTwitterShare on LinkedinE-mail article
This webinar by MHPA partner Sellers Dorsey will examine the opportunities and potential risks for Medicaid health plans to manage the duals population. Health plan execs will learn the crucial external and internal points that influence their decisions such as market size, provider capacity, ROI, provider contracting constructs, compliance risk and capacity for clinical integration. Presenters: Mike Fox, senior consultant, is a leading expert in major Medicaid managed-care expansion, oversight, contract and rate development. Having both state Medicaid agency and health plan experience, he offers a deep understanding of managed care policy, operations and business development. Also, Kip Piper, senior consultant, is a top expert in Medicaid, Medicare and health reform. Kip advises health plans, hospitals and health systems, state Medicaid agencies, drug and device manufacturers, and investment firms. His experience includes senior adviser to the CMS administrator, head of Wisconsin Medicaid, state health commissioner and health plan executive. Click here to register.

Insights webinar: Evolving Toward a New Model of Care | 11 a.m. EDT Sept. 10
Daiichi Sankyo Inc.    Share    Share on FacebookTwitterShare on LinkedinE-mail article
This presentation reviews the challenges that PCPs face, case studies where PCMH has been undertaken, and barriers/challenges associated with its implementation. More

Free webinar from MHPA partner Verizon: Fraud Waste and Abuse — The Next Generation | 2 p.m. EDT Sept. 12
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Understanding the patterns of fraud, where to find it, how to detect, and when to act. The old pay-and-chase model of fraud management is inefficient and costly. Connie Schweyen, Debra Faulkner, MBA, MHA; and David Botsko, Ph.D., CFE, managing principals at Verizon Connected Healthcare, will show you how to catch crime before it happens and how a near real-time fraud management solution can ensure near-time results. More

Free webinar by MHPA partner Baxter: Importance of Coordinated Care in the Management of Members with Hemophilia | 11 a.m. EDT | Sept. 18
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
This webinar is focused on coordinating care in hemophilia, improve outcomes and reduce costs. Best practice coordination of care includes the plan's relationship with the patient, specialty pharmacy, and hemophilia treatment centers. A managed Medicaid plan will discuss management of hemophilia patients through working with the state as well as outcomes associated with care through a specialty pharmacy. A hemophilia physician will discuss the uniqueness of coordinated care through the hemophilia treatment center and demonstrated outcomes. More

Free webinar by MHPA partner LexisNexis: Why Identity Management Matters to Medicaid | 1 p.m. EST Nov. 8
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As a Medicaid Plan you should not just be addressing the "what" of identity management — the technical side — but, more important, the question of "who?" How do we know who the person on the other end is who they say they are and what risks they may pose for the environments and systems they are attempting to enter. More

2012-2013 Best Practices Compendium submissions Aug. 24 deadline approaches
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Click here for details.

Reaching, Retaining, and Serving Dual Eligible Beneficiaries | Sept. 19-20
Healthcare Education Associates    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Explore effective marketing, outreach and engagement for Medicare/Medicaid dual eligibles. Healthcare Education Associates and the Risk Adjustment Initiative & Society for Education are pleased to present the Reaching, Retaining, and Serving Dual Eligible Beneficiaries Summit, slated for Sept. 19-20 in Scottsdale, Ariz. This groundbreaking two-day intensive event designed to tackle the unique challenges of marketing and outreach to the dual eligible population, will feature MHPA President and CEO Thomas Johnson as a guest speaker. MHPA members get 15 percent off registration by using Priority Code: HMP122. Call Theresa Powers at 704-341-2437 or register online here.

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