This message was sent to ##Email##
|
|
|
|
|
|
Modern Healthcare
This summer, the Obama administration conceded it would need more time than expected to evaluate a large-scale test to better manage benefits and care for low-income and disabled Americans. The states participating in the initiative appear willing to stick with it, although two big ones expressed significant reservations.
Twelve states have rolled out three-year demonstrations under the Affordable Care Act to better coordinate health benefits provided to Americans who are eligible for both Medicare and Medicaid and, as a result, currently receive splintered care at extremely high costs to both programs.
READ MORE
The Fiscal Times
Alarmed by the tens of billions of dollars in Medicare and Medicaid fraud and overpayments annually that are draining the federal healthcare system, the Obama administration has quietly stepped up its auditing and enforcement efforts to crack down on doctors, hospitals and other medical facilities cheating on their billings.
READ MORE
MHPA
Time is running out on your chance to save on mhpa2015 registration. Check out our updated agenda and other details then lock in your discounted rate.
READ MORE
 |
|
Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
|
|
Kaiser Health News
California legislators passed a bill postponing a controversial plan that would have shifted tens of thousands of medically fragile children into Medi-Cal managed care plans. The bill, A.B. 187, passed both houses Thursday and will be sent to Gov. Jerry Brown for his signature.
READ MORE
California Healthline
California officials last week started to collect the so-called "clawback" money from pharmacies — money the state wants to recoup from payments made during the time a 10 percent rate reduction was held up in court. In 2011, California lawmakers agreed to cut Medi-Cal provider rates by 10 percent, and for 18 months that law was on hold while the courts deliberated its legality. When the judicial decision went the state's way in June 2013, that 10 percent reduction was imposed in stages — but the state also felt it was due the money from that 10 percent reduction when it was unimplemented law during that 18-month court wrangle.
READ MORE
Vail Daily
Northwest Colorado's ski resort region has the state's second-highest percent of people without health insurance, according to a Colorado Healthcare Access Survey. While Colorado's uninsured rate dropped to 6.7 percent, the rate of uninsured people in Region 12 — Eagle, Pitkin, Summit, Garfield and Grand counties — is 11.7 percent, down from 19.4 percent in 2013.
READ MORE
 |
|
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.
|
|
The Associated Press via Chicago Tribune
South Carolina's Medicaid agency is reviewing dozens of private providers for possible fraud after payments for certain behavioral health services skyrocketed. The agency says it has referred seven cases so far to the attorney general's office for potential prosecution. A review of records suggests providers overbilled on hours, billed for services not given and provided unnecessary services.
READ MORE
Kansas Health Institute
The Kansas Department for Aging and Disability Services is reviewing a waiting list for developmental disability services after counties reported discrepancies between how many residents they have waiting and how many are on the state's list. There are more than 3,000 Kansans with intellectual and developmental disabilities (I/DD) on the KDADS waiting list for Medicaid-covered support services meant to allow them to remain in their homes and communities rather than live in institutions. Officials from Johnson County and Sedgwick County said that they know of more than 150 residents total missing from the state's I/DD waiting list.
READ MORE
Idaho Statesman
Idaho paid six providers about $820,000 in Medicaid payments after those providers had been cut off from other states' Medicaid programs for reasons including "fraud, integrity or quality," according to a federal report. Two additional providers were still in Idaho Medicaid's roster but did not receive payments.
READ MORE
 |
|
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
|
|
Kaiser Health News
Tribes, healthcare advocates and government officials across the nation are trying to enroll as many Native Americans as possible in Obamacare, saying it offers new choices to patients and financial relief for struggling Indian hospitals and clinics. Under the health law, many uninsured Native Americans can get coverage under the expanded Medicaid program for low-income Americans or buy subsidized plans through insurance exchanges. That allows them to receive treatment from private doctors and hospitals rather than rely solely on government and tribal facilities.
READ MORE
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.
READ MORE
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.
READ MORE
|
Missed last week's issue? See which articles your colleagues read most.
|
|
Don't be left behind. Click here to see what else you missed.
|
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.
READ MORE
Sponsored by ...
|
|
|
|
|
|
|
|
|
7701 Las Colinas Ridge, Ste. 800, Irving, TX 75063
|
