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Medicaid managed care drug rebates saved states, feds $1.6 billion in 1st year via pharmacy carve-in
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Department of Health and Human Services Office of Inspector General has released a new report, "States' Collection of Rebates for Drugs Paid through Medicaid Managed Care Organizations," which shows that 12 of the 22 states using a carve-in approach have collected $1.6 billion in rebates for utilization. More



House GOP eyes Medicaid per-person spending cap as possible block grant compromise
InsideHealthPolicy.com    Share    Share on FacebookTwitterShare on LinkedinE-mail article
House Republicans have discussed pushing a Medicaid per-person spending cap next year as a possible compromise to the Medicaid block grant proposal in the House-passed budget, according to U.S. Rep. Mike Burgess, R-Texas, but Democratic lobbyists say it is doubtful Congress could work out a deal in part because per-person caps would create bureaucratic nightmares. Nevertheless, the concept deals with one of the main arguments that Democrats make against block grants, which is that more people need Medicaid during economic downturns and block grants do not account for that counter-cyclical nature of the program. More

Census: Uninsured numbers decline as more young adults gain coverage
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Surprising some experts and giving President Barack Obama a potential boost eight weeks before Election Day, the number of people without health insurance fell for the first time since 2007, the Census Bureau said. The closely watched census report found that 48.6 million Americans were uninsured during all of 2011, compared to 49.9 million in 2010. The rate of uninsured dropped to 15.7 percent from 16.3 percent, the biggest percentage drop since 1999. More

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Mapping the effects of the ACA's health insurance coverage expansions
The Henry J. Kaiser Family Foundation    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Affordable Care Act includes several provisions that allow many individuals across the U.S. to be eligible for Medicaid or for federal tax credits to subsidize the cost of insurance. The following analysis from The Henry J. Kaiser Family Foundation and ZIP code tool estimate the share of the population in geographic areas across the U.S. who had family income up to four times the poverty level in 2010 and were either uninsured or buying coverage on their own. More

Medicare pilot program shows cost savings for treating dual eligibles
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Researchers released a deeper look at the Physician Group Practice Demonstration, one of the federal government's first pay-for-performance experiments to improve healthcare and reduce costs for the Medicare population. They found that it created significant savings — especially for dual eligibles, which is the population that receives health coverage through both Medicare and Medicaid and who often are the health system's sickest and costliest patients. More



Medicaid expansion: A closer look at vulnerable populations and state coverage opportunities
Health Affairs Blog    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Since the Supreme Court's verdict on NFIB v. Sebelius in late June, considerable national attention has converged around the question of whether states will opt to expand Medicaid coverage for adults with incomes below 138 percent of the federal poverty level. There has been little public focus on the opportunity for states to use the Medicaid expansion to increase access to coverage for vulnerable populations. Following are a few of the new opportunities available to states. More

Officials: Family, community ties key to fighting chronic disease among Latinos
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Mayra Alvarez, one of four daughters, said her mother makes ends meet in California by cleaning houses during the week and caring for an elderly person on weekends. And when it comes to deciding between paying for a preventive screening test for herself or spending the money on her youngest daughter's education, she said her mother would always choose the latter. "And I have to say, most American families would," said Alvarez, director of public health policy in the Office of Health Reform at the U.S. Department of Health and Human Services. Alvarez and health experts say that public health officials need to take into consideration family and community dynamics among Latinos as they tackle broad healthcare issues. More

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Arkansas governor supporting expansion of Medicaid
The Associated Press via The Courier    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Mike Beebe said he supports expanding Medicaid eligibility in Arkansas under the federal healthcare law after officials assured him the state could later opt out, setting up a potentially heated fight with Republican lawmakers as they try to win control of the state Legislature. Beebe, a Democrat who had said he was inclined to support the expansion, said he decided to back it after receiving those assurances in writing from the federal government. Beebe noted that the expansion will still require support from state lawmakers next year. More

California weighs promise, perils of duals program
California Healthline    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Advocates see potential for improvement but also are concerned about consumer protections in the transition of roughly 1.1 million Californians into Medi-Cal managed care. The state is launching a managed care pilot project for beneficiaries who are dually eligible for Medicare and Medi-Cal, California's Medicaid program. "This is really a critical moment in time for dual eligibles and represents an amazing time to improve care for duals," said Kevin Prindiville, deputy director of the National Senior Citizens Law Center office in Oakland, Calif. "But it's also a time to be very careful and cautious about how we proceed to move forward." More


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Spending slightly down in North Carolina's Medicaid program
North Carolina Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
During a recent meeting of the Health and Human Services oversight committee at the North Carolina Legislature, Steve Owen, Medicaid chief business officer, told lawmakers that compared to budget projections, the program had spent about $4 million dollars less than forecast. That figure comes to less than one half of 1 percent of total state dollars annually spent on the program that primarily serves disabled people, poor seniors in nursing homes and low-income children. More

Kentucky begins Medicaid open-enrollment for Medicaid managed care
The Kentucky Standard    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Kentucky Department for Medicaid Services has announced that Medicaid recipients in 104 Kentucky counties will have the opportunity to select coverage by a new managed care organization during this year's annual open enrollment period, which began Aug. 20 and runs through Oct. 19. Members are being notified by letter of the open enrollment period and about the options provided by CoventryCares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky. More



WellCare approved to participate in Florida's Long-Term Care Community Diversion Pilot Project in 19 Counties
Thomson Reuters via TMCnet.com    Share    Share on FacebookTwitterShare on LinkedinE-mail article
WellCare Health Plans Inc. announced that the Florida Department of Elder Affairs has approved WellCare of Florida to participate in 17 counties in support of the state's Long-Term Care Community Diversion Pilot Project. WellCare announced June 28 that it had received approval to provide services in Escambia and Santa Rosa counties and began serving members July 1. This approval of an additional 17 counties is effective immediately. More

TMG Health offering new TTY service supported by NexTalk
PR Newswire via FierceHealthcare    Share    Share on FacebookTwitterShare on LinkedinE-mail article
TMG Health, a national provider of expert solutions for health plans in the Medicare Advantage, Medicare Part D and Managed Medicaid markets, now is offering its clients a new TTY service supported by NexTalk, a provider of deaf, hard of hearing and foreign language accessible telecommunication solutions. The NexTalk TTY service, offered in conjunction with TMG Health's strategic sourcing solution or as part of a component solution for Member and Provider Call Center Services, is an advanced intuitive solution that can directly impact CMS Medicare Star Ratings and improve the member experience. More

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Passport Health Plan selects McKesson VITAL Nurse Advice Line services
Business Wire via TMCnet.com    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Passport Health Plan, a provider-sponsored, community-based Medicaid managed care plan based in Louisville, Ky., has selected McKesson to provide nurse advice line services to approximately 170,000 Medicaid members. Available 24/7, the McKesson VITAL Nurse Advice Line service will play a pivotal role in directing callers to the appropriate level of care, helping members navigate the healthcare system, and improving access to doctors and other healthcare providers. More

Free webinar by MHPA partner Baxter: Importance of Coordinated Care in the Management of Members with Hemophilia | 11 a.m. EDT Sept. 18
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
This webinar focuses on how managing coordinating care in hemophilia can improve outcomes and reduce costs. Best practice coordination of care includes the plan's relationship with the patient, specialty pharmacy and hemophilia treatment centers. Jeff Januska, PharmD, director of pharmacy services at CenCal Health, will discuss management of hemophilia patients through working with the state as well as outcomes associated with care through a specialty pharmacy. Also, Dr. Steven Pipe, associate professor, Department of Pediatrics and the Department of Pathology at the University of Michigan, will discuss the uniqueness of coordinated care through the hemophilia treatment center and demonstrated outcomes. NOTE: Since this is a free webinar, choose the "Invoice" option when signing up to proceed without having to enter any additional information. More

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Download slides for Verizon's webinar: Fraud Waste and Abuse — The Next Generation
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Thanks for attending Fraud, Waste and Abuse — The Next Generation. The presentation on understanding the patterns of fraud, where to find it, how to detect and when to act by Connie Schweyen, Debra Faulkner, MBA, MHA; and Dr. David Botsko, CFE, managing principals at Verizon Connected Healthcare, now is available on MHPA's website. More

Reaching, Retaining and Serving Dual Eligible Beneficiaries | Sept. 19-20 | Scottsdale, Ariz.
Healthcare Education Associates    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Explore effective marketing, outreach and engagement for Medicare/Medicaid dual eligibles. Healthcare Education Associates and the Risk Adjustment Initiative & Society for Education are pleased to present the Reaching, Retaining and Serving Dual Eligible Beneficiaries Summit, slated for Sept. 19-20 in Scottsdale, Ariz. This groundbreaking two-day intensive event designed to tackle the unique challenges of marketing and outreach to the dual eligible population, will feature MHPA President and CEO Thomas Johnson as a guest speaker. MHPA members get 15 percent off registration by using Priority Code: HMP122. Call Theresa Powers at 704-341-2437 or register online here.



Conference hotel completely sold out for MHPA's 2012 Annual Meeting | Oct 24-26 | Washington, DC
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
There are no more rooms available at the Hyatt Regency Washington on Capitol Hill. See the list of nearby hotels for available rooms. And if you haven't registered yet for the MHPA 2012 Annual Meeting, "A Pivotal Time for Medicaid Health Plans," you may register online now from your PC or PDA.

Free webinar by MHPA partner LexisNexis: Why Identity Management Matters to Medicaid | 1 p.m. EST Nov. 8
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As a Medicaid Plan you should not just be addressing the "what" of identity management — the technical side — but, more important, the question of "who?" How do we know who the person on the other end is who they say they are and what risks they may pose for the environments and systems they are attempting to enter? More



Insights webinar: Reduce Outsourcing Risk | 11 a.m. EST Dec. 20
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Details here.

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