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  Mobile version    RSS    Subscribe    Unsubscribe    Archive    Media Kit Sep. 12, 2013

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Reluctant states face Medicaid: Yes? No? Punt?
Politico
Obamacare signup starts less than a month, but a few states are still answering a basic question: Are they in, or are they out of the law's massive expansion of Medicaid?
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Petition drive on Arizona Medicaid referendum falls short
The Arizona Republic
Searing summer heat, a lack of volunteers and vigorous opposition doomed a conservative Republican effort to refer Arizona's Medicaid expansion law to the ballot. Organizers of the petition drive said they fell about 5,000 signatures short of the 86,405 needed by a Sept. 11 deadline to block the measure until the November 2014 election. That allowed the law to take effect, broadening eligibility for the government run health-insurance program for the poor, beginning Jan. 1.
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MHPA adds Arizona Medicaid Director Tom Betlach to 2013 roster
MHPA
Tom Betlach, Medicaid director for Arizona, will be on the MHPA 2013 state Medicaid director panel on Monday, Oct. 21, moderated by NAMD executive director Matt Salo. Betlach reports to Gov. Jan Brewer and is responsible for the health coverage of 1.3 million Arizonans at an annual cost of $8.5 billion.

The agency administers multiple sources of governmental and private funds and is responsible for regulatory oversight and compliance of Medicaid managed care health plans and healthcare providers to assure quality of care, fiscal accountability and cost containment. Betlach earned his bachelor's degree in political science from the University of Wisconsin and his master's degree in public administration with an emphasis in finance and budgeting from the University of Arizona.

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Pennsylvania governor weighing Medicaid expansion if tied to changes
The Philadelphia Inquirer and Kaiser Health News
Pennsylvania Gov. Tom Corbett is considering an expansion of Medicaid to cover hundreds of thousands of uninsured residents if he can also win significant changes to the existing part of the entitlement program, which otherwise would continue in its current form.
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Feds won't let Pennsylvania governor keep children in CHIP
PennLive
The Obama administration has informed Pennsylvania Gov. Tom Corbett that about 50,000 children with lower incomes will have to switch from CHIP to Medicaid as a result of the Affordable Care Act. Corbett opposes moving children out of Pennsylvania's popular CHIP health insurance program, arguing it will cause disruptions such as forcing some children to change doctors.
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Webinar Wednesdays are back! 'Opportunities to Improve Medication Adherence:' A free webinar by Eli Lilly and Co. | Sept. 18 | 3 p.m. EST
MHPA
The introduction of three new medication adherence measures, each with a triple weight, makes Medicare Advantage and Part D pharmacy measures matter more than ever. But focus on driving improvement in medication adherence proliferates many other government and private insurer programs. In fact, medication adherence is a subject of importance now to Medicare, plans, hospitals, integrated delivery systems, retail pharmacies, industry and patients. With the patient at the center of these measures, you will learn key patient insights from a consumer marketer around medication adherence.
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Draft report: Missourians favor Medicaid expansion
St. Louis Post-Dispatch and Kaiser Health News
They traveled to six, far-flung Missouri cities. They held marathon public hearings. They got detailed state briefings. So what did the 52-member House Citizens and Legislators Working Group on Medicaid Eligibility and Reform conclude? That people want both Medicaid expansion and reform.
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Deadline nears for US Supreme Court appeal of 10 percent Medi-Cal provider cut
California Healthline
State officials recently began phased-in implementation of a 10 percent reduction in Medi-Cal reimbursement rates, but that doesn't mean efforts to rescind or reverse the cut have subsided, according to provider groups. Legislative efforts to undo the decision appear to have stalled, with two bills currently sitting in committee as the state legislature begins its final week of the session.
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Medicaid directors: CMS shouldn't publish FUL pricing until final rule comes out
Inside Health Policy
The National Association of Medicaid Directors believes CMS should not publish its recalculated Federal Upper Limit pricing for Medicaid drugs before the agency is ready to release the final FUL rule required by the Affordable Care Act, which is scheduled for January, as the HHS Office of Inspector General pushes CMS to implement the new FULs due to pricing concerns.
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White House officials: Healthcare 'data hub' is ready
The Washington Post
Obama administration officials, facing criticism that they are behind schedule in implementing the president's healthcare law, said that they have finished a major piece of the technology that will help millions of Americans sign up for insurance this fall.
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WellCare names Kulich to lead WellCare of Georgia
PRWeb via Houston Chronicle
WellCare Health Plans, Inc., a leading provider of managed care services for government-sponsored healthcare programs, has announced that Roman Kulich has joined the company as region president of Georgia and South Carolina. In this role, he will have day-to-day leadership responsibility for WellCare of Georgia, the company's largest health plan by membership.
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HMS Holdings Corp. makes InformationWeek 500 for 2nd consecutive year
BusinessWire via The Wall Street Journal
HMS Holdings Corp. — a leading provider of cost-containment services for Medicare, Medicaid, and other healthcare payers — has announced that it made the InformationWeek 500 for the second consecutive year. The annual list tracks the nation's most innovative users of business technology.
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Molina Healthcare Names New President in Illinois
BusinessWire via Pharmacy Choice
Molina Healthcare, Inc. recently announced that Andy Bhugra has been named president of its wholly owned subsidiary Molina Healthcare of Illinois. In this role, Bhugra will be responsible for the development, growth and operational oversight of the Illinois health plan as well as the implementation and execution of various strategic initiatives.
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New MHPA Issue Brief: 'Addressing the Needs of Members with Hemophilia in Medicaid Managed Care: Issues and Implications for Health Plans'
MHPA Center for Best Practices
Hemophilia is a rare, inherited blood disorder affecting approximately 20,000 people in the U.S. The condition can be catastrophically expensive and requires highly specialized life-long care to prevent disability. Medicaid health plans may soon be enrolling more individuals with hemophilia due to Medicaid expansion and enrollment of disabled populations.

This brief discusses current treatment issues as well as care management, financial and patient advocacy considerations for health plans. It provides evidence references and web links for more information. Health plan strategies to improve hemophilia care may serve as a model for managing any rare disease in Medicaid managed care. Download the Issue Brief for free here.

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Recent webinar presentations from First Quality, Millennium Labs, PwC, Deloitte and others available free on MHPA website
MHPA
View PDFs or listen to audio for the following webinars: Additional webinars can be viewed here.
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US allows Indiana to offer health program outside of Obamacare
Reuters
The federal government will allow Indiana to operate its own health program temporarily, Gov. Mike Pence said, making it the first state to receive such a major exception this year under President Barack Obama's signature medical reform law.

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Study predicts 113 million US obesity cases by 2022
The Hill
The United States will have 133 million obese and 81 million overweight residents by the year 2022, leading the trend of growing waistlines across the developed world, a new study predicted.

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Nearly half of US births are covered by Medicaid
Kaiser Health News
About half the births in the United States are paid for by Medicaid — a figure higher than previous estimates — and the numbers could increase as the state-federal health insurance program expands under the Affordable Care Act, according to a study recently released.

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Sign up for a free trial to Health Exchange Alert, a news service from InsideHealthPolicy.com
Inside Washington Publishers
The Affordable Care Act's mandated health exchanges are on the front burner for policymakers and should be for you, too. Stay on top of the evolution and implementation of health exchanges with Health Exchange Alert, the news service from InsideHealthPolicy.com. Act now by clicking here to activate a no-obligation, four-week free trial to gain immediate access to InsideHealthPolicy.com and Health Exchange Alert.

Your free trial will include access to the numerous articles and documents posted every business day, as well an email alert every morning highlighting the latest news. You'll also have access to our three weekly newsletters (Health Exchange Alert, Inside CMS and FDA Week), which you can download in PDF format and circulate.

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Deloitte job opportunities
Deloitte Consulting LLP
Health plans face a number of unique market and regulatory pressures that impact how they conduct business today and in the future. Deloitte Consulting LLP is one of the world's leading management consulting firms for executable strategy, operations, technology and human capital advisory services, and it is uniquely positioned to provide business solutions to our clients.

Deloitte's Government Programs practice is seeking candidates who have consulting, compliance and operational experience as it relates to Medicaid, Medicare Advantage and Medicare D plans.

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

    North Carolina Medicaid reform plan on right track (Carolina Journal)
Affordable Care Act needs fixes to address costs by Rep. Kyrsten Sinema, D-Ariz. (The Arizona Republic)
Medicaid 'coverage gap' looming for the poor in 21 states (McClatchy)
US allows Indiana to offer health program outside of Obamacare (Reuters)
Wyoming state leaders mull Medicaid expansion options (Casper Star-Tribune)

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


Navigant job opportunities in DC, Chicago
Navigant
Navigant is a specialized, global expert services firm dedicated to assisting clients in creating and protecting value in the face of critical business risks and opportunities. Navigant's Healthcare Practice strives to be the premier independent management consulting practice assisting senior level healthcare executives deal with their core business challenges.

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MHPA on Twitter, LinkedIn and Facebook
MHPA
Follow us on Twitter, LinkedIn and Facebook to get industry-related news and the latest MHPA announcements.
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