Health plans seek leverage when physicians submit extremely high bills
Managed Care Magazine Share
In March, newspapers in New Jersey reported that Aetna was suing several New Jersey physicians over medical bills for out-of-network care, bills Aetna said were unconscionable More
Bipartisan children's caucus prepares for supercommittee
The Hill Share
The bipartisan House Congressional Children's Caucus will kick off its activities for this session of Congress next month, days before the deficit supercommittee is due to start weighing deep cuts to the nation's health care programs. More
Supercommittee may risk Medicare, Medicaid to avoid automatic cuts
Fierce Healthcare Share
Now that all 12 members of the debt "supercommittee" are finally in place, the race to trim $1.2 trillion off the deficit by Thanksgiving begins. More
Upton talks supercommittee in Michigan — 8th Circuit plans oral arguments
Rep. Fred Upton spoke at a public event at the Cass County, Mich., Council on aging, and the crowd sure did have questions about what exactly the supercommittee was going to cut. More
9 states, Washington DC defend health care reform's constitutionality
Cardiovascular Business Share
California Attorney General Kamala D. Harris has filed a brief in the U.S. Court of Appeals for the Eighth Circuit supporting the constitutionality of the Patient Protection and Affordable Care Act, and urging the court to affirm the states' rights to protect the health and safety of its citizens. More
Kentucky hospitals slow to sign up for Medicaid managed care
The Ashley Independent Share
Kentucky plans to be up and running with its new managed care delivery of Medicaid services by October 1 — but ain the week ending Aug. 19, only 15 or so of the state's hospitals had signed on with one of the three managed care providers. More
New tax to pay for Medicaid in Michigan
The Republican-led Michigan Legislature approved a new mechanism to help fund Medicaid in the state, facing what backers say is an expected federal prohibition against the state's existing tax. More
Report: Colorado Medicaid system plagued by delays
The Denver Post Share
Colorado's Medicaid program has had significant delays in determining applicants' eligibility, according to a federal review that raised the question of withholding money from the state if problems are not solved. More
Congresswoman Matsui announces $1 million for California Children's Health Insurance enrollment efforts
Congresswoman Doris Matsui Share
Congresswoman Doris O. Matsui, D-Calif., announced that the California Primary Care Association has been awarded $1,000,000 in federal grants. This grant will further their efforts to identify and enroll children into available health insurance programs, by providing them much-needed coverage and financial. More
Arizona ruling: AHCCCS copays break law
The Arizona Republic Share
A federal appeals court ruled that mandatory copayments charged to Arizona's poorest residents violate federal law. The three-judge panel of the 9th U.S. Circuit Court of Appeals said federal health officials failed to show how the copays, imposed in November after a seven-year court battle, served any purpose besides cutting the state's Medicaid budget. More
Administration may give states second chance to avoid fully federally run insurance exchange
The Washington Post Share
The Obama administration said that states that have not adopted their own insurance exchanges may get a second chance to avoid getting one run solely by the federal government. More
Register now for Medicaid Health Plans of America's 2011 annual meeting, 'The Changing Landscape for Medicaid Health Plans,' Nov. 6-8 at the Hyatt Regency Washington on Capitol Hill in Washington, DC
Keynote speakers: Former HHS Secretary Donna Shalala; Political Strategist and Commentator Donna Brazile and more.
Issues addressed: health reform implementation, quality improvement, cost-containment and improving access to care.
Other meeting highlights: pre-conference, networking opportunities, sponsor tradeshow and entertainment by The Capitol Steps.
Click here for more details
Click here for sponsorship opportunities
CLICK HERE TO REGISTER ONLINE
The World Congress presents the 2nd Annual Health Care Reform Congress on Health Insurance Exchanges
World Congress Share
The latest legislation, building the business plan, examining state-by-state implementation
Sept. 19-20 | Washington, D.C.
SAVE $300 on your current registration fee when you mention PROMO CODE: MXB855 and PRIORITY CODE: HL11022-12549! (Not valid for government rate. Cannot be combined with additional discounts or applied to a current registration.) Call 800-767-9499 or visit www.worldcongress.com/exchanges for more information or to register today.
The World Congress Presents the 2nd Annual Health Care Reform Congress on Medical Loss Ratios
World Congress Share
Best Practices for Preparing and Adhering to New Reform Mandates and Regulations
Sept. 19-20 | Washington, D.C.
SAVE $300 on your current registration fee when you mention PROMO CODE: MXB855 and PRIORITY CODE: HL11041-12550! (Not valid for government rate. Cannot be combined with additional discounts or applied to a current registration.) Call 800-767-9499 or visit www.worldcongress.com/MLR for more information or to register today.
Opal Events' 2nd Annual Medicaid Business in Focus: CFO Forum, Sept. 26-27, Crystal Gateway Marriott, Arlington, Va., complimentary registrations to Health Plan, Physicians Group, and Hospital Employees until Sept. 2.
Opal Events Share
The conference explores medical management strategies as an answer to the growing problems that Medicaid health plans face. This event will offer medical management strategies that are grounded in evidence-based clinical practices, predictive outcomes modeling, member engagement, and multi-disciplinary professional collaboration. For more information see the conference agenda or visit the conference webpage.
Standard registration: $1895; Government Employees: $995. However, Opal Events is offering Complimentary Registrations to Health Plan, Physicians Group, and Hospital Employees until Sept. 2. To register, please click here.
If you would like more information about this event, please call 212.532.9898 x 0 or email at firstname.lastname@example.org.
Free Webinar: Thomson Reuters presents 'Medicaid Expansion: who will your future members be?' Oct. 11, 2 p.m. EST
An estimated 16 million people will soon gain coverage through the expansion of Medicaid. For health plans that will serve this population, this dramatic growth requires adjustments to business strategies for membership growth, as well as network and care management strategies to serve the unique needs of this population. Health Plans that drive these strategies from a deeper understanding of consumers will be enabled to compete more successfully in this rapidly changing market. Tony Glebe, Vice President of Analytic Consulting and Research Services and Gary Pickens, Chief Research Officer at the Center for Healthcare Analytics at Thomson Reuters, will share their research and insights into the varying size of Medicaid expansion across the country, and the health behavior and attitudinal profiles of the individuals gaining coverage through expanded Medicaid. To log in, go to www.pcconf.com and click join. Call-in number: 1.800.839.9416; Participant ID for video and audio portions: # 3183287. Questions? Please contact Thanh Buscarini at 202.857.5728.
Free Webinar: Ethicon Endo-Surgery presents 'Minimally invasive procedures: What's the value for health plans?'
'Minimally Invasive Procedures: What's the Value for Health Plans?'
Oct. 12, 2011 3-4:30 p.m. EST There are over 4.4 million general surgical procedures annually. Once patients have exhausted other treatment alternatives and surgery becomes a necessary procedure, providing a minimally invasive approach, also referred to as laparoscopic surgery, improves clinical outcomes, decreases the hospital stay and brings a faster return to normal activity, and costs the payor and the patient less money, when compared to standard open or abdominal surgery. Developing a product to encourage appropriate use of minimally invasive procedures can provide significant clinical and economic savings to patients and payors. Dr. Lou Hochheiser, Chief Medical Leader, Humana, Inc., will explore what health plans can do to drive the use of Minimally Invasive Procedures.
To register, click here.
Questions? Please contact Thanh Buscarini at 202.857.5728.
MHPA's August Best Practice of the Month: 'Biggest Winner' Nutrition Program
Health Partners Share
Each month, MHPA features a Best Practice selected from MHPA's 2010-2011 Best Practices Compendium, a collection of programs and services from member health plans that combines innovation, expertise, and caring to improve the health of Medicaid recipients of all ages. MHPA has selected the "Biggest Winner" Nutrition Program by Health Partners as its August 2011 Best Practice of the Month.
Read a description of "Biggest Winner," the specific actions taken and the resulting outcomes on MHPA's website at http://bit.ly/qQO8Yt.
For more information on Health Partners, click here.
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