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MHPA Board of Directors appoints Centene executive as
vice chair

MHPA
The board of directors of Medicaid Health Plans of America, the leading trade association representing the Medicaid managed care industry, has selected Joseph Musker, vice president of federal affairs at Centene, as its vice chair. Musker fills the seat vacated by Kearline Jones who recently assumed the role of chair of MHPA's board.
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MHPA to CMS: Let states reset Medicaid rates to address pricey drugs
Inside Health Policy
As CMS plans its first major update of Medicaid managed care regulations since 2002, MHPA is asking that states and Medicaid managed care organizations have the ability to adjust rates when new, higher-priced medications and procedures come into the market place, such as the hepatitis C drug Sovaldi, which costs an average of $84,000 for a treatment regimen.
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Gilead to raise price for new hepatitis C drug above $84,000
Reuters via Yahoo Finance
The next generation version of Gilead Sciences Inc.'s $84,000 hepatitis C drug, already under fire for its record-breaking costs, is going to be even more expensive. Gregg Alton, Gilead's executive vice president of corporate and medical affairs, declined to give an exact price for the new medicine, the first all-oral treatment for the virus which is expected to launch in October.
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Maker of costly hepatitis C drug Sovaldi strikes deal on generics for
poor countries

The New York Times
The maker of one of the costliest drugs in the world has announced that it has struck deals with seven generic drug makers in India to sell lower-cost versions of the medicine — a $1,000-a-pill hepatitis C treatment — in poorer countries.
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Sept. 17 Webinar Wednesday: 'Managed Medicaid Highlights: Approaches to Integrated Payment and Delivery Reform and Dual Eligibles' by Lilly
Lilly
Please join us for this Eli Lilly and Company webinar led by Ryan Urgo, director, federal government strategy at Lilly USA, as he provides context and current progress on CMS' financial alignment demonstration efforts that are in place to help coordinate care for dual eligible beneficiaries. He's also provide a snapshot of opportunities for Medicaid managed care and a better understanding of the effect on long-term care as well as highlight trends towards the use of managed care to treat this population.
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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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Schizophrenia is eight different diseases, not one
USA Today
New research shows that schizophrenia is not a single disease, but a group of eight distinct disorders, each caused by changes in clusters of genes that lead to different sets of symptoms. The finding sets the stage for scientists to develop better ways to diagnose and treat schizophrenia, a mental illness that can be devastating when not adequately managed, according to C. Robert Cloninger, co-author of a study recently published in the American Journal of Psychiatry.
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What's it like to live with schizophrenia? Get a glimpse at mhpa2014
MHPA
Experience a simulation of the delusions and hallucinations your patients may face with MINDSTORM 2.0, an immersive 3-D tool brought to you by MHPA partner and mhpa2014 sponsor Johnson & Johnson Health Care Systems. Learn how communication techniques, along with your clinical judgment, may be used to help involve patients in goal setting and informed treatment decisions. Visit J&J and our other valued exhibitors at mhpa2014's trade show at the Walter E. Washington Convention Center.

For mhpa2014's agenda, travel and lodging info, and registration, visit http://bit.ly/mhpa2014.

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How states have gamed Medicaid for hundreds of millions of dollars
The Washington Post
States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program.
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California to broaden autism coverage for children through Medicaid
Kaiser Health News and Los Angeles Daily News
Many autistic children from poor families don't get much outside help. The parents often lack the know-how and means of middle-class families to advocate for their children at schools and state regional centers for the developmentally disabled. A new initiative seeks to help level the playing field.
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Homecare firm rules Florida Medicaid market
Health News Florida
It's much too soon to say whether this summer's flood of Florida Medicaid patients into private managed-care plans will accomplish the state's goals of improving access to care and saving money. But one result is already clear: The overhaul is concentrating power in the hands of specialty companies over which the state has no direct control. Some say one such company has essentially taken over homecare services and equipment.
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Team of Florida gubernatorial candidate explores Medicaid expansion
Orlando Sentinel
Florida Democratic gubernatorial candidate Charlie Crist said his team is researching the prospect that he could sign an executive order on his first day in office to immediately and unilaterally expand the state's Medicaid program to cover uninsured Floridians.
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Sunshine Health offers comprehensive Medicaid, long-term care and child welfare services across Florida
PRNewswire via The Oregonian
Sunshine Health, a subsidiary of Centene Corporation, completed the final stages of implementation of the Managed Medical Assistance program in nine of 11 regions and the child welfare program, Foster Care, statewide on Aug. 1. Additionally, Sunshine Health's Long-Term Care program celebrates its first anniversary.
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Democrats borrow a GOP idea on healthcare costs
The Associated Press via
The Washington Post

Borrowing a Republican idea, a group including former senior Obama and Clinton advisers, is unveiling a novel proposal to let states take the lead in controlling health costs. Individual states would set their own targets to curb the growth of healthcare spending. If they succeed, they'd pocket a share of federal Medicare and Medicaid savings, ranging from tens of millions to $1 billion or more, depending on the state.

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CMS delays termination of MA, PDP plans with persistent low star ratings
Inside Health Policy
CMS is delaying for one year terminations of Medicare Advantage and prescription drug plans with persistent low performance ratings because it worries that the Star Ratings Program may disadvantage plans with unusually large numbers of poor enrollees, according to an agency memo.

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Who's paying the new Obamacare tax? You
Kaiser Health News via USA Today
When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers. But with an $8 billion tax on insurers due Sept. 30 — the first time the new tax is being collected — the industry is getting help from an unlikely source — taxpayers.

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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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Sept. 24 Webinar Wednesday: 'Federal Government Oversight of Medicaid at the State Level and How Health Plans Can Prepare' by Cody Consulting
Cody Consulting
Medicare Advantage plans are very familiar with the stringent requirements placed upon them by CMS, including the immediate actions and sanctions that can occur when compliance violations are identified through their auditing process. Cody Consulting will provide background on CMS' oversight of Medicare Advantage plans. More importantly, we will discuss why the federal government is expected to have more oversight of Medicaid at the state level in the near future.
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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    GAO slams Arkansas Medicaid expansion costs as HHS seeks to bring more states on board (Inside Health Policy)
Pennsylvania, health industry preps for Medicaid expansion (The Associated Press via WHTM-TV)
Study: Rise in ER visits after Medicaid expansion (The Associated Press via The Washington Post)
New lawsuit filed to block duals plan in California (California Healthline)
Rockefeller plans hearing to examine CHIP reauthorization (Inside Health Policy)

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


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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