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Who's paying the new Obamacare tax? You
Kaiser Health News via USA Today
When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers. But with an $8 billion tax on insurers due Sept. 30 — the first time the new tax is being collected — the industry is getting help from an unlikely source — taxpayers.
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Tick, tock: mhpa2014 early-bird deadline rapidly approaching
MHPA
The clock is ticking on the early-bird deadline for mhpa2014. Sign up before Sept. 8 to secure your discount for the premier event of the Medicaid managed care industry. And if you buy 5+ registrations at the same time, our group rate kicks in and you get $200 off each registration. For annual conference details including our updated agenda, please click here. For additional information, contact Sarah Swango at 202-857-5772.
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Is the Republican fight against Medicaid expansion over?
Washington Examiner
The Republican fight against Medicaid expansion is far from over, but there are fewer opponents than there used to be. The expansion of the government health insurance program was originally supposed to be mandatory under the Affordable Care Act, but the Supreme Court made it optional as part of a landmark decision on the law in June of 2012. In the wake of the decision, Republican governors flocked to announce they were declining to expand coverage.
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23 states still haven't expanded Medicaid: Which could be next?
The Washington Post
The recent announcement that Pennsylvania will expand its Medicaid program brings the country one state closer to the original expansion outlined under Obamacare. But because of the Supreme Court's 2012 decision making the expansion a voluntary program, there are still 23 states that haven't expanded public health insurance to all of their low-income residents.
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Sept. 3 Webinar Wednesday: 'Continence Management: Moving from Volume to Value by Reducing Waste & Improving Care' by First Quality
First Quality
Health plans taking on the adult population are also taking on the costs of managing incontinence. ABD, duals and MLTSS populations have a high percentage of incontinent members, who use disposable absorbent products to manage their condition. Please join Julie Hyer, director of Medicaid health plan programs, and Kim Owens, BBA, LPN, RAC-CT, of First Quality to learn more about how the current cycle for absorbent products affects cost and care related to direct product costs and ancillary medical costs, and how health plans can change the dynamic to achieve better outcomes and lower costs.
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Tennessee governor: Medicaid expansion proposal going to feds soon
Chattanooga Times Free Press
A long-expected plan for a Medicaid expansion in Tennessee could be placed before federal officials soon, Gov. Bill Haslam said. If the feds approve, an estimated 180,000 low-income state residents could be eligible for subsidized health insurance.
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South Carolina Medicaid expansion effort focuses appeal on low-income voters
The State
The South Carolina Progressive Network plans to focus its get-out-the-vote efforts this year on the 176,530 people who didn't get healthcare coverage because the state's political leaders turned down federal Medicaid expansion.
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Utah's alternative to Medicaid expansion still stalled
The Salt Lake Tribune
There's a persistent snag preventing federal health officials from agreeing, in concept, to Gov. Gary Herbert's Healthy Utah plan — the work requirement. Herbert said during a news conference that he's "cautiously optimistic" that he and the Obama administration's Health and Human Services will resolve their differences over that final stumbling block when he's in Washington later this month.
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Texas hospitals say they've lost insured patients to urgent care
The Texas Tribune via The New York Times
Opting to skip the wait at hospital emergency rooms, an increasing number of Texans are choosing to use urgent care centers that are popping up in strip malls and shopping districts. Promoting themselves as cheaper and quicker alternatives to hospital emergency rooms, the clinics cater to patients who need stitches, X-rays of broken bones or treatment of allergic reactions. Some clinics have been around for years, and about 300 open each year across the country.
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California bill would protect estates of many who received Medicaid
Capital Pubilc Radio via Kaiser Health News
A bill passed by the California legislature is putting Gov. Jerry Brown in a delicate position: Sign the measure and support consumer demands for a change in the state's policy on recovering assets from Medicaid enrollees, or keep the current system that generates about $30 million used to provide Medicaid benefits to more residents.
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Study: Medicaid payouts for office visits may influence cancer screening
Reuters
In states where Medicaid pays doctors higher fees for office visits, Medicaid beneficiaries are more likely to be screened for breast, cervical or colorectal cancer, according to a new study.
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Adherence programs have yet to fully embrace predictive analytics
AIS
When it comes to targeting patients for medication adherence interventions, many health plans continue to rely on pharmacy claim "triggers" such as a prescription not being picked up and retrospective adherence measures such as a medication possession ratio below 80 percent for a certain period of time. But only 7 percent of plans recently surveyed by AllazoHealth are using the newer method of predictive analytics to prioritize patients at risk of not taking their medications. Nevertheless, 60 percent of respondents said they are planning to use predictive analytics in the future.
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Federal officials order Medicaid to cover autism services
Kaiser Health News
Medi-Cal, as California's Medicaid plan is called, provides coverage of autism services for some children who are severely disabled by the disorder, in contrast to many states which offer no autism coverage. But one woman's son was approved for 30 hours a week of applied behavioral analysis, a type of behavior modification therapy that has been shown to be effective with autistic children, and she was worried that wasn't enough.

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Incumbents withstand pro-Medicaid vote in Arizona
The Arizona Republic
The Arizona Legislature's vote in 2013 to expand the state's Medicaid program got a welcoming reception from voters, as most of the Republican incumbents who supported it appeared to be withstanding challengers on their right. That issue, combined with a contentious decision to adopt Common Core standards for Arizona's schools, drew sharply defined battle lines in the Republican primaries.

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Brokers play key role in ACA, Medicaid enrollments
InsuranceNewsNet.com
A new report by the Kaiser Family Foundation has found that health insurance brokers played a key role in helping enroll Medicaid recipients and uninsured residents in four states under the Affordable Care Act. In some cases, brokers worked the front lines at sign-up centers. In other cases, brokers worked behind the scenes in coordinating enrollments with marketplace "assisters" to help people choose plans best suited to their needs.

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Did you miss Webinar Wednesday: 'Digital Strategy for Medicaid Health Plans' by Digital Strategy Yoga?
MHPA
View and download the Aug. 27 Webinar Wednesday by Digital Strategy Yoga, "Digital Strategy for Medicaid Health Plans," here. Other webinars are available to download, as well.
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National Hemophilia Foundation Annual Meeting Pre-Conference Symposium on Hemophilia Pharmacy Management: Sept. 18 in Washington, DC
National Hemophilia Foundation
The National Hemophilia Foundation Annual Meeting Pre-Conference Symposium on Hemophilia Pharmacy Management: "Steps for Success With Managed Care and Specialty Pharmacy" will take place Sept. 18 in Washington, D.C.

Specifically designed for specialty pharmacists, home health pharmacists, health plan pharmacists, managed Medicaid pharmacists, medical directors and other health care professionals with an interest in the management of patients with hemophilia, this free event is also a CME/CPE-certified activity. For more details including program overview, educational objectives, the full agenda, and free registration, click here.

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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Only 1 in 3 chose Medicaid plan in Florida (The Associated Press via Miami Herald)
How Texas' governor could warm to Obamacare's Medicaid expansion (Forbes)
Wyoming governor wants Medicaid proposal for legislature (Casper Star-Tribune)
CBO projects lower Medicare and Medicaid costs (Kaiser Health News)
Wisconsin loses $206 million by not fully expanding BadgerCare (Milwaukee Journal Sentinel via St. Paul Pioneer Press)

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


National Forum on Hospitals, Health Systems and Population Health: Partnerships to Build a Culture of Health | Oct. 22-24 | Hyatt Regency, Washington, DC
Robert Wood Johnson Foundation
Building partnerships to create a culture of health is the driving theme behind the National Forum on Hospitals, Health Systems and Population Health. Sponsored by the Robert Wood Johnson Foundation, the forum will bring together the people and organizations with the capacity and creativity to change health for the better, including hospitals, health systems, health plans, public health professionals, federal and state health officials and others.

Register for onsite attendance at the rate of $895 prior to Sept. 12, $995 after Sept. 12. To register at the co-sponsor registration rate, click here, and register using the discount code "pophealth."

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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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