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MHPA comments on GAO Medicaid managed care report
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Medicaid Health Plans of America's Thomas Johnson discusses the report in terms of Medicaid expansion and the Medicaid managed care market. More

Insights webinar: 'Provider Networks' | 11 a.m. EDT Monday, Sept. 24
Sellers Dorsey    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Sellers Dorsey will brief MHPA members on the provider network requirements for Qualified Health Plans in State Health Insurance Exchanges, including requirement to contract with essential community providers, what constitutes an ECP, access standards, special hospital contracting rules and implication of these policies for network management and provider relations. This webinar is $69 for MHPA members; $79 for nonmembers. More info and REGISTER here.

Medicaid opt-out states could increase your premiums — even if you have private insurance
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Debates over the health law's Medicaid expansion — and whether or not states should participate — has centered on how it would impact state budgets. A new paper suggests that the privately insured have a stake in the matter, too. Their premiums, the Academy of American Actuaries say, would rise if states decide to forgo the public insurance expansion. If a state decides not to expand its Medicaid program, residents between 100 and 133 percent of the Federal Poverty Line — individuals making between $11,170 and $14,893 — become eligible for subsidized health insurance on the public exchange. Those lower-income individuals "can be expected to have higher healthcare needs than the higher-income exchange enrollees." More

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Simpson-Bowles group launches $25 million campaign for 'meaningful' debt bill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A bipartisan group founded by former Clinton White House Chief of Staff Erskine Bowles and former U.S. Sen. Al Simpson, R-Wyo., has set aside $25 million for a "sophisticated, national campaign to encourage policymakers to pass meaningful debt legislation in the coming months." The two policymakers in December 2010 riled healthcare stakeholders by touting a plan to cut $400 billion from Medicare, some of which they would have used to permanently repeal the physician payment formula. The Fix the Debt Campaign said that the $25 million represents the biggest reserve for a bipartisan campaign, though it pales in comparison to partisan war chests. More

In 26-state dual-eligible demo, hospitals push insurers to pay Medicare rates
The Advisory Board Daily Briefing    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A CMS demonstration program launching in 26 states will require hospitals and health systems to negotiate rates for dual-eligible patients directly with insurers, rather than the federal government. Under the major demonstration project, 26 states will shift up to 2 million patients that are dually eligible for Medicaid and Medicare into managed care or managed fee-for-service plans. The project hopes to improve care coordination for the nation's sickest and costliest patients. More

AmeriHealth Mercy Health Plan to expand Medicaid programs in Pennsylvania
Central Penn Business Journal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Susquehanna Township-based AmeriHealth Mercy Health Plan now has a bigger slice of Pennsylvania's Medicaid pie. AMHP currently serves 18 counties, but thanks to two separate awards by the Department of Public Welfare's HealthChoices, its mandatory Medicaid managed care program for Medical Assistance recipients, AMHP will expand to 30 additional counties. The first award, which will take effect Oct. 1, named AMHP one of four health plans chosen for the expanded "New West" zone. More

HMS Holdings Corp. makes InformationWeek 500 for the 1st time
Business Wire via    Share    Share on FacebookTwitterShare on LinkedinE-mail article
HMS Holdings Corp., a provider of cost-containment services for Medicare, Medicaid and other healthcare payers, announced it debuted in this year's InformationWeek 500. The annual list tracks the nation's most innovative users of business technology. Compiled by InformationWeek, the list assesses companies' use of technology, budgeting, infrastructure, strategies and other business practices to highlight the best IT businesses in the country. More

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Final tally: Alabama voters approve budget rescue, 2-to-1
The Associated Press via The News Courier    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Alabama voters decided by a 2-to-1 margin to avoid dramatic cuts in state government by withdrawing $437 million from a state trust fund to help balance the General Fund budget for the next three years. Republican Gov. Robert Bentley thanked voters for "this temporary funding bridge from the Alabama Trust Fund to maintain essential services as we continue to streamline and right-size government." More

Wisconsin taxpayers need to pay nearly $650 million more in Medicaid costs
Milwaukee Journal Sentinel    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Taxpayers need to chip in about $650 million more toward state healthcare programs for the poor and elderly during the next two-year budget cycle, Gov. Scott Walker's administration said. The additional sums are needed because of rising healthcare costs, more people joining the programs, increased use of services by those in the programs and a lowering aid rate from the federal government. The funding request is for Medicaid programs, which are paid for jointly by state and federal taxpayers and cover nursing home stays and programs such as BadgerCare Plus for low-income people and Family Care for the elderly and disabled. More

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Indiana's Medicaid costs could rise $600 million
The Associated Press/WISH-TV    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The state of Indiana's Medicaid costs could rise by as much as $600 million over the next seven years, as the deadline for the new federal healthcare law approaches. That's according to new numbers presented to legislators by the state's Family and Social Services Administration. It's because of what the agency calls "the woodwork effect," administrators told the state's Health Finance Commission. More

Virginia's top health official to discuss federal healthcare overhaul
The Associated Press via The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Virginia's top health official will discuss the federal healthcare overhaul that was upheld over the summer and tell legislators what it will mean for Virginia. Virginia Secretary of Health & Human Resources Bill Hazel will address the Senate Finance Committee and update legislators on the Virginia Health Reform Initiative, a push from Republican Gov. Bob McDonnell's administration to recommend other healthcare changes to go along with the overhaul. The initiative is looking at everything from insurance and payment reforms to how treatment is delivered in an effort to reduce costs. More

Truth needle: McKenna's right on Medicaid — to a point
The Seattle Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Republican gubernatorial candidate Rob McKenna says 1 in 3 Washington residents would be eligible for Medicaid under the expansion allowed by the federal healthcare law. That's true, but there is more to the story. More

Consumer group: Medicaid expansion, positive move for Wyoming
KTWO-AM    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Republican Gov. Matt Mead recently announced that Wyoming won't meet an upcoming federal healthcare reform deadline that would specify whether Wyoming will establish its own health insurance exchange. Mead says he wants more information, including how long the federal government will help pay for it. In a letter to the governor, one Wyoming consumer group asked him to take a closer look at the data and move forward with the program they believe will benefit the state. Marguerite Herman of Project Healthcare, Consumer Advocates, says expansion of Medicaid to bring another 31,000 people under coverage would be paid for 100 percent to start, with about a 2 percent increase in costs for the state after three years. More

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Should Idaho expand its Medicaid program? Some answers could lie here
StateImpact Idaho    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Idaho Department of Health and Welfare now has a $100,000 study on Idaho's Medicaid program in its hands. The department commissioned the study in April, in preparation for the Medicaid expansion that was then required under the Affordable Care Act. In light of the U.S. Supreme Court's ruling, which made the Medicaid expansion optional for states, the study has gained even greater relevance. It's expected to inform the decision that now awaits Republican Gov. C.L. "Butch" Otter: Should the state expand Medicaid eligibility or not? More

Georgia's hemophilia program could get the budget ax
Georgia Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Through a state contract, Hemophilia of Georgia is helping dozens of patients get or keep health insurance and lifesaving medication for the inherited bleeding disorder. The money "saves lives and saves money," said Jeff Cornett of Hemophilia of Georgia. He noted that an uninsured patient with hemophilia can run up huge emergency room bills. But the state's Department of Public Health, in budget recommendations, would eliminate that hemophilia funding next fiscal year. The cut comes as a result of an order from Republican Gov. Nathan Deal's Office of Planning and Budget that state agencies reduce their budgets by 3 percent for this fiscal year and fiscal 2014. More

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AHIP Medicare and Medicaid Conference recap
American Journal of Managed Care    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The America's Health Insurance Plans Medicare and Medicaid Conference took place this week in Washington, D.C. A major topic at this year's conference was financial incentives and other health reform initiatives that aim to improve affordability of care. Dr. Robert A. Berenson, FACP, Institute Fellow, Health Policy Center, Urban Institute, spoke about controversial practices that should be reformed in order to improve the future of healthcare delivery. At the top of the list was the promise of shared savings that intend to reward physicians upon improvement. Other conference highlights follow. More

Did you miss Baxter's webinar? Download 'Importance of Coordinated Care in the Management of Members with Hemophilia' free from MHPA's website
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The presentation on coordinating care in hemophilia and how to improve outcomes and reduce costs by Jeff Januska, PharmD, pharmacy director at CenCal Health and Dr. Steven Pipe, associate professor, Department of Pediatrics and the Department of Pathology, University of Michigan, now is available on MHPA's website.

Conference hotel completely sold out for MHPA's 2012 Annual Meeting | Oct 24-26 | Washington, DC
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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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