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MHPA sends letter to CMS on Medicaid managed care regulations update
MHPA
On Sept. 4, MHPA sent a letter to Center for Medicaid and CHIP Services Director Cindy Mann describing ways in which CMS can help create a strong and viable Medicaid managed care program via the latest regulatory update. Included are comments on rate-setting and actuarial soundness, fraud and abuse, quality and the health insurer fee.
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WellCare, Centene Medicaid winners in Florida; comments from
MHPA's Myers

Health News Florida
AudioBriefWith the multibillion-dollar, four-month enroll-a-thon for Florida's Statewide Medicaid Managed Care program now complete, totals show WellCare Health Plans still on top. Additionally, MHPA President and CEO Jeff Myers said that many states have moved their Medicaid populations into managed care, including Louisiana, California and New York, but others are still talking about it, "so Florida is not lagging."
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Editorial: Obamacare tax merry-go-round
Bayoubuzz.com
Get a load of how Obamacare health-insurance premium taxes work. According to MHPA: "This situation results in the federal government taxing itself and taxing state governments to fund the higher Medicaid managed care payments required to fund the ACA health insurer fee."
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mhpa2014 early-bird goes the way of the dodo bird soon
MHPA
The early-bird deadline for mhpa2014 is just days away. Sign up before Sept. 8 to secure your discount for the premier event of the Medicaid managed care industry. If you buy five registrations at the same time, the 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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The end of healthcare's historic spending slowdown is near
The Washington Post
The historic slowdown in healthcare spending has been one of the biggest economic stories in recent years — but it looks like that is soon coming to an end. As the economy recovers, Obamacare expands coverage and baby boomers join Medicare in droves, the federal Centers for Medicare and Medicaid Services' actuary now projects that health spending will grow on average 5.7 percent each year through 2023, which is 1.1 percentage points greater than the expected rise in GDP over the same period. Healthcare's share of GDP over that time will rise from 17.2 percent now to 19.3 percent in 2023, or about $5.2 trillion.
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Medi-Cal autism coverage to start soon
California Healthline
In a draft plan for providing autism therapy to Medi-Cal beneficiaries, California state officials tentatively set a date of Sept. 15 for the services to begin. Medi-Cal is California's Medicaid program. That is big news for low-income families of roughly 4,000 to 6,000 children in California who have need of the medically necessary, standard-of-care treatment known as applied behavior analysis — of Autism Deserves Equal Coverage, a statewide advocacy group.
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States that decline to expand Medicaid give up billions in aid
McClatchy via The State
If the 23 states that have rejected expanding Medicaid under the 2010 healthcare law continue to do so for the next eight years, they'll pay $152 billion to extend the program in other states — while receiving nothing in return.
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Utah governor pushing for Medicaid work requirement tossed from Pennsylvania plan
Deseret News
Utah Gov. Gary Herbert isn't backing down from insisting on a work requirement in his Healthy Utah alternative to Medicaid expansion, even though Pennsylvania's governor dropped the same mandate to win federal approval.
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Indiana, several other states look to expand Medicaid next year
Kaiser Health News
With the long-awaited deal to expand Medicaid finally struck between Pennsylvania and the Obama administration, 27 states and the District of Columbia have adopted a key coverage plank of the Affordable Care Act. And the momentum continues to grow in Republican-led states, as Tennessee and several others look to expand coverage to low-income residents in 2015.
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Missouri's Medicaid applicants get put on hold
St. Louis Post-Dispatch via Kaiser Health News
Enrolling in Missouri's Medicaid program has not been easy. Many applicants have experienced a barrage of problems when trying to sign up for the program, including long delays until coverage kicks in, lost paperwork and a lack of one-on-one interaction with caseworkers. State officials have blamed a new computer system used to process Medicaid applications. But there is another reason why some Missourians struggle to get help.
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Maine rolls back health coverage even as many states expand it
USA Today and Kaiser Health News
While much of America saw an expansion of coverage this year, low-income Maine residents lost benefits. On Jan. 1, just as the Affordable Care Act was being rolled out nationwide, MaineCare terminated coverages, leaving thousands of residents without insurance.
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Obama: Estonians should have built HealthCare.gov
The Hill
The Obama administration's disastrous rollout of HealthCare.gov may have happened because it didn't turn to Estonia, President Barack Obama joked. During a press conference in Tallinn, Estonia, after meeting with President Toomas Hendrik Ilves, Obama praised the northern European nation's progress in moving many government functions online.
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Millennium Laboratories changes name to Millennium Health
Millennium Health
Millennium Laboratories has changed its name to Millennium Health, a move that better reflects the company's market position as a broad health solutions company.
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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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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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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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Sept. 10 Webinar Wednesday: 'Under-capitated Plan Members in Medicaid Managed Care' by Human Arc
Human Arc
In many states, Medicaid managed care plans are capitated at higher rates for members with disabilities, due to typically higher medical costs. With several million people across the country potentially eligible for SSI or SSDI but not enrolled, plans often miss out on millions in revenue each year. Identifying members who are potentially disabled to address this revenue gap can be challenging.

Please join Human Arc to learn how to effectively identify and enroll (non-classified) disabled Medicaid health plan members in SSI/SSDI in an effort to secure capitation payments that more appropriately reflect actual health utilization.

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MHPA's Suchi Madan presents at AIS virtual conference: 'Dual-Eligibles Programs: Initial Results, Successes and Remaining Challenges' | Sept. 17
AIS
Preliminary results are already available on some CMS-backed and state initiatives for Medicare-Medicaid dual eligibles. What is working? Where must participating plans and states now focus to solve remaining problems?

Get the details of bottom-line solutions during AIS' Sept. 17 virtual conference, "Dual-Eligibles Programs: Initial Results, Successes and Remaining Challenges." Register now to find out the initial results and lessons learned from CMS-backed and state duals demos. SAVE $125 — use coupon code "VIRTUAL125" at checkout.

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Drug Pricing News: A new service from InsideHealthPolicy.com.
Inside Health Policy
Drug pricing policies have prompted a major fight among insurers, pharmacies, healthcare providers, drug makers, patient advocates and healthcare managers at the state and federal levels. The stakes are potentially huge, and you can't afford to miss a beat in the drug-pricing debate.

That's why InsideHealthPolicy.com has created Drug Pricing News — an email alert service on the latest news and developments in the fight over setting drug prices. Sign up for a free one-month trial to InsideHealthPolicy.com, and get access to Drug Pricing News.

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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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