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Inside Health Policy (Subscription only or sign up for free trial)
The House Energy & Commerce health subcommittee passed a number of bills to the full committee on Friday, Sept. 7, including the ACE Kids Act. Francis Rienzo, vice president for government relations and advocacy for Medicaid Health Plans of America, said after Wednesday's legislative hearing on the bill that plans have continuing concerns about access to local care, possible care fragmentation and conflicts of interest that could occur when providers are in charge of where a costly beneficiary receives care. Rienzo said that while the bill has undergone some changes, the plans' concerns were not all addressed.
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The Hill
The Senate will vote next week on a package of bills aimed at curbing the nation's opioid epidemic, Majority Leader Mitch McConnell (R-Kentucky) announced Thursday. McConnell's spokesman said that Democrats had dropped their holds on the legislation.
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The Hill
Blue Cross Blue Shield of Tennessee will stop covering OxyContin next year as part of a push to fight the opioid epidemic, it announced Thursday. The move by the largest health insurance company in a state hit hard by the opioid epidemic marks a new step in fighting the crisis, and takes a drastic move against one of the most prominent drugs that helped fuel the epidemic.
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Project Transition
Learn how one provider is challenging the status-quo in behavioral healthcare and advocating for society’s most vulnerable members to discover their life worth living by providing a recovery experience like no other. Individuals with serious mental illness (including dual diagnosis) are empowered and able to realize a life in the community, on terms they define with the right treatment and services. In Philadelphia, PA and Nashville, TN, a unique extended behavioral support program has been proven to reduce cost and increase positive outcomes, by combining apartment-style community living with intensive, daily, evidence-based programming. This setting helps minimize stigma and create normalized social expectations and consequences.
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The Hill
Secretary of Health and Human Services Alex Azar on Thursday met with Republican lawmakers on the House Ways and Means Committee to discuss ways to lower drug prices. President Trump has railed against drug prices and his administration has rolled out a series of actions seeking to lower prices, though many say the moves have been relatively modest.
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ABC News
The Trump administration early this year started allowing states to require that their Medicaid beneficiaries work and, to date, 11 states have applied for waivers to set such work rules. Medicaid work requirements could promote "better mental, physical and emotional health" and "help individuals and families rise out of poverty and attain independence," Brian Neale, a top Medicaid official for the administration who has since left his post, wrote in a letter to state directors of the health program.
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MedPage Today
"Community engagement" policies — or work requirements — for Medicaid would result in narrow savings if correctly applied, but would likely lead to eligible beneficiaries losing insurance due to challenges in navigating the red tape, researchers reported. If work requirements were instituted nationwide, 2.8 percent of enrollees would no longer be eligible for coverage, representing roughly 0.7 percent in total Medicaid spending, according to Anna Goldman, MD, MPH, of the Harvard T.H. Chan School of Public Health in Boston, and colleagues.
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CNN
As many as 4,600 Medicaid recipients in Arkansas have lost their benefits for the rest of this year after failing to meet the state's new work requirements. Arkansas became the first state ever to implement work requirements, after gaining approval from the Trump administration earlier this year. Under the new rules, which took effect in June, recipients must work, go to school, volunteer or search for jobs for at least 80 hours a month or be stripped of their coverage until the following year.
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The Hill
Michigan is asking the Trump administration to approve work requirements for thousands of low-income adults who gained health care under Obamacare's Medicaid expansion. Under the proposal, beneficiaries between the ages of 19 to 62 will have to work, volunteer or attend job training for at least 80 hours a month to keep their benefits.
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The New York Times
In this conservative state, which has not supported a Democratic presidential candidate in more than a half-century, a grass-roots campaign to expand Medicaid is building considerable momentum as Election Day approaches. If it wins approval here, it could happen almost anywhere.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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Idaho Statesman
There's a new player in the fight over Medicaid expansion — or at least, new jerseys for some varsity members of the team. The newly formed Work, Not Obamacare PAC is aimed at "educating voters about Prop 2," said PAC chairman Bob Tikker, president of Tikker Engineering. In November, Idaho voters will consider Proposition 2 — otherwise known as the Medicaid expansion ballot initiative — which would expand Medicaid eligibility to everyone under 138 percent of the poverty line. And with two months to go before the election, expect to see a lot of money going into both sides of the campaign.
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You know you need to be prepared to respond quickly to CMS audit requests – including A&G history, activity, and status. Find out how effective, automated A&G management can protect revenue, improve network quality, ensure regulatory compliance, and lower the cost of disenrollment.
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WKYT-TV
A healthcare executive is Kentucky's new Medicaid commissioner. Health and Family Services Cabinet Secretary Adam Meier announced Tuesday that Carol H. Steckel is the state's new commissioner for the Department of Medicaid Services. Steckel has led WellCare Health Plans' development of Medicaid policy for the past five years.
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MHPA via YouTube
Watch this short recap of MHPA17 to get a feel of the excitement, energy, and content of MHPA's annual conference.
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Financial Times
The American healthcare landscape is brimming with uncertainty. Pressures and priorities vary among stakeholders but whether it's pharma, payer, PBM, provider or patient, everyone is looking for value. The FT Pharma Pricing and Value Summit will discuss the future of pharmaceutical pricing and market access in an evolving healthcare environment. MHPA President and CEO Jeff Myers will give his insights at the Pricing pressures and healthcare reform panel on issues such as what could fuel pricing pressures on pharma, healthcare reform and the market access landscape, and overcoming political barriers in healthcare.
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