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The Associated Press via The Baltimore Sun
Far-reaching legislation designed to change how North Carolina government bills Medicaid patient treatment is going to Gov. Pat McCrory after the General Assembly approved Tuesday a final compromise measure that was years in the making. The legislation, voted for separately by the Senate and House, lays out the pathway by 2018 or 2019 to end the current fee-for-service system in which Medicaid in North Carolina reimburses doctors and hospitals for each service performed on a patient. Medicaid critics contend the practice has led to cost overruns and uncertainty.
The North Carolina Medical Society and N.C. Hospital Association opposed permitting managed-care companies to enter into contracts. Nearly 40 states already have some kind of coordinated care for Medicaid enrollees, according to Medicaid Health Plans of America. Jeff Myers, the group's CEO, praised the final legislation Tuesday night.
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MHPA
Melanie Bella, former director of the Medicare-Medicaid Coordination Office at CMS and currently senior vice president of Policy & Strategy at Alignment Healthcare, will present breakout session "Statistically Sicker: Integrating and Managing the Dual Eligible." Don't miss it, and register today.
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The Courier-Journal
Kentucky Gov. Steve Beshear, in a statement Tuesday Morning, ripped Republican gubernatorial nominee Matt Bevin for suggesting that he would save money by seeking a waiver from the federal government to revamp Kentucky's Medicaid expansion. Bevin has wavered on how he would attack the the expansion while continually saying that Kentucky can't afford it. On some days, he says he would do away with the expansion, on others he has called for seeking a federal waiver to redesign the system and on one occasion, he said he would "tweak" it.
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KSL-TV
Details of the much-anticipated new plan for Medicaid expansion from Gov. Gary Herbert and legislative leaders will be rolled out Tuesday to lawmakers in closed-door meetings before being unveiled publicly. But the governor has yet to sign off on a final proposal, his spokesman, Jon Cox, said Wednesday.
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The Associated Press via The Baltimore Sun
As lawmakers prepare for next year's political battle over Medicaid expansion, supporters said the state of New Hampshire's ability to tackle a growing drug abuse problem will be dramatically reduced if the program comes to an end. "Medicaid expansion kind of allowed substance misuse providers to go from 0 to 60 from a service standpoint," said Abby Shockley, executive director of the New Hampshire Alcohol and Other Drug Service Providers Association.
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Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
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The Dallas Morning News
A judge in Travis County, Texas, indicated Tuesday that he'll probably block Texas' plan to sharply reduce Medicaid payments to therapists next week. After two days of testimony on the proposed cuts, state District Court Judge Tim Sulak announced he's inclined to grant several home-care companies' request that he stop the new rates from taking effect Oct. 1.
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Vermont Public Radio
Vermont is tied with Massachusetts for having the lowest rate of uninsured residents in the country. But that success might be coming at a high price. An unexpected spike in Medicaid costs has put the program and its thousands of new enrollees under heightened scrutiny.
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State of Reform
Alaska Gov. Bill Walker announced this week that Alaska was named as one of six states chosen to participate in the 2015-2016 Medicaid Leadership Institute beginning in October. The other states named by The National Governors Association and the Center for Health Care Strategies are Connecticut, Nevada, New Mexico, North Carolina and Pennsylvania.
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With an emphasis on innovative initiatives and data-driven solutions, DentaQuest is partnering with health plans to fundamentally change the way oral health is delivered in America. Integrating preventive oral health programs not only offers members a wider portfolio of choice - it is also a proven driver of cost control.
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The Plain Dealer
Ohio Senate President Keith Faber said Wednesday the Senate will quickly move legislation to prevent state and federal funding from being used for services at Planned Parenthood. Faber said legislation is directly tied to hidden-camera footage shot by anti-abortion activists that purported to show the health organization sells body parts from aborted fetuses. Planned Parenthood has said the videos were deceptively edited and the organization's affiliates may accept donations to cover abortion costs but do not sell fetus parts.
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Milwaukee Journal Sentinel
The Wisconsin Assembly on Thursday will consider a measure to strip Planned Parenthood of more government funding. The debate comes as Republicans who control the legislature struggle over separate legislation that would ban research using fetal tissue from abortions. Democrats have argued the effort to block federal money from going to Planned Parenthood in Wisconsin would increase public health problems and future taxpayer costs by causing people without other options to lose access to birth control and screenings for sexually transmitted diseases.
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PartnerRe
There have been many breakthroughs in medical therapies and pharmaceuticals. With these innovative treatment practices, the economic consequences are significant and it is essential for payers to take a hands-on approach in the management of their claims costs.
Join esteemed professionals for a detailed examination of the claims for inappropriate billing practices and errors, significant inflation of charge and more important, non-covered services. Unfortunately, there has been a lot of confusion on what is and is not covered by insurers. During this webinar, PartnerRe will discuss these issues as well as how health plans can most effectively manage these potentially high-dollar events.
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Managed Medicaid regulatory changes carry significant information technology implications. What will you need to comply? Where will you find it? Download today to learn more!
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MHPA
Market Access World and Evidence Congress held an interview with keynote speaker MHPA CEO Jeff Myers, the keynote speaker of Market Access World USA 2015, which is scheduled for Sept. 30 and Oct. 1 in Philadelphia. Listen to Myers discuss the future of patient access, current challenges the sector is facing and why he will be attending this year's congress.
Join the congress to examine:
- Innovative pricing strategies for high-value drugs
- How to overcome barriers to patient access
- How to adapt to the changing models of the payers globally
- How you can meet payers' expectations
- Securing reimbursement for personalized medicines
Book now using code BR01.
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Inovalon
As an MHPA member, Inovalon invites you to attend the 7th annual Client Congress 2015, where MHPA President and CEO Jeff Myers will be an expert speaker among others. Be a part of this special event in which healthcare leaders from the United States converge for two and a half days to gain insights on innovating with big data analytics at the point of care, analyzing and improving clinical and quality outcomes and succeeding in healthcare payment reform.
Download the brochure for the full agenda. Register today.
For questions, contact Inovalon at 301-809-4000, Ext. 1309 or via email.
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