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The Hill
Vermont Sen. Bernie Sanders is introducing legislation aimed at fighting high prescription drug prices, as he attacks pharmaceutical companies for their "outrageous profits." The presidential candidate, challenging Hillary Clinton from the left, has made attacking high drug prices one part of his push on healthcare, where he also calls for a "single-payer" system of government-provided insurance for all.
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The Wall Street Journal
A federal judge said Tuesday he has an "inclination" to deny Pfizer Inc.'s four-year-old request to throw out a Justice Department lawsuit accusing the drug maker's Wyeth unit of overcharging government Medicaid health programs for the heartburn drug Protonix, according to a federal court website.
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MHPA
mhpa2015 will help your plan manage disease-specific costs while providing quality care in sessions like "Controlling Oncology Costs," "Managing Drugs with Complex Conditions" and "Differentiating Strategies from Tactics in Hepatitis C Management."
Check out our updated agenda for details on these presentations and other valuable sessions. Register before Monday, Sept. 14, to save on registration.
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MHPA
Time is running out to submit member plan programs that highlight best practices for Medicaid and CHIP beneficiaries. You have until Friday, Sept. 4, to send in your submissions for inclusion in the 2015-2016 MHPA Best Practices Compendium that will be released at mhpa2015 in November. Selected best practices will be honored during an awards luncheon at mhpa2015.
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Modern Healthcare
The CMS is making permanent a fast-track avenue for Medicaid enrollment through the federal program that provides food assistance for low-income Americans. States facing backlogs in enrolling eligible Medicaid beneficiaries will be able to continue to use data from the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) to identify individuals with incomes at the state's Medicaid income eligibility threshold.
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Modern Healthcare
Michigan has submitted a take-it-or-leave-it request to alter the terms of its Medicaid expansion, and coverage for about 600,000 residents is at stake. Under the proposed waiver, residents above the federal poverty level who have been enrolled in Medicaid for 48 months would have to buy a private plan through HealthCare.gov or see their cost-sharing obligations rise to 7 percent of their income. Under the current structure of the program, beneficiaries with incomes between 100 percent and 138 percent of the federal poverty level pay 3 percent to 5 percent of their income for premiums and cost-sharing.
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Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
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The Associated Press via The Charlotte Observer
The White House on Tuesday praised the decision by Alaska Gov. Bill Walker to expand Medicaid to thousands of residents over the wishes of the Republican-led Legislature, calling it the "right decision." Alaska on Tuesday became the 29th state to expand Medicaid, opening up health care through what it calls the Healthy Alaska Plan to an estimated 20,000 low-income residents.
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Alaska Dispatch News
Tuesday marked the first day for thousands of newly eligible Alaskans to enroll in Medicaid after Gov. Bill Walker expanded the program, but it was a quiet afternoon at a state office in Anchorage that handles applications. Two people waited in chairs. Another stood. And those three weren't waiting at the state Division of Public Assistance to enroll.
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With an emphasis on innovative initiatives and data-driven solutions, DentaQuest is partnering with health plans to fundamentally change the way oral health is delivered in America. Integrating preventive oral health programs not only offers members a wider portfolio of choice - it is also a proven driver of cost control.
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Kansas Health Institute
An advisory committee charged with helping Kansas state officials design a system for regulating the use of prescription mental health drugs for Medicaid patients met for the first time Tuesday. The nine-member committee spent nearly two hours discussing the pros and cons of "prior authorization" policies that would allow the three private insurance companies that manage KanCare, the state's Medicaid program, to approve or disapprove mental health drug prescriptions.
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The Blade
In a decision that could have far-reaching effects, a federal appeals court ruled Tuesday that Ohio must count an applicant's spouse as a member of his family when determining eligibility for financial assistance to pay Medicare bills. A three-judge panel of the Cincinnati-based U.S. 6th Circuit Court of Appeals told the state it can't exclude a beneficiary's spouse when it comes to income calculations simply because the federal law doesn't define the word "family."
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The Associated Press via Chicago Tribune
The Wolf administration said Tuesday that it had completed the transfer of more than 1 million adult Medicaid enrollees into a single, new benefits package it had created as the program expands to record numbers under the 2010 federal healthcare law. The process that the Human Services Department finished included the dismantling of changes that Pennsylvania Gov. Tom Wolf's predecessor had sought to make to Medicaid coverage as part of Pennsylvania's embrace of the Medicaid expansion.
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The Boston Globe
The soaring costs of insuring the state of Massachusetts poorest residents drove health care spending in the state up 4.8 percent last year, double the rate of growth in 2013, dealing a setback to the state's efforts to contain medical costs. The increase far exceeds inflation, which was 1.6 percent last year and blows past a state goal of holding healthcare spending growth to 3.6 percent annually, according to a report to be issued Wednesday by the state Center for Health Information and Analysis.
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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! MORE
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MHPA
For a copy of the presentation, contact Dr. Kevin Stephens, OB/GYN and senior national medical director for Optum.
Download the presentation (PDF)
For additional information, contact Darren Levitz at darren.levitz@optum.com, or visit www.optum.com.
For copies of other past webinars, visit here.
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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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Inovalon
As an MHPA member, Inovalon invites you to attend the 7th annual Client Congress 2015, where MHPA President and CEO Jeff Myers will be an expert speaker among others. Be a part of this special event in which healthcare leaders from the United States converge for two and a half days to gain insights on innovating with big data analytics at the point of care, analyzing and improving clinical and quality outcomes and succeeding in healthcare payment reform.
Download the brochure for the full agenda. Register today for the early-bird rate of $499 with a two-for-one discount. (Regular individual rate is $699.) Use priority code: MHPA. The offer expires at 4 p.m. ET, Sept. 17.
For questions, contact Inovalon at 301-809-4000, Ext. 1309 or via email.
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