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The Hill
Jeff Myers, CEO of Medicaid Health Plans of America, is the top advocate for insurers under Medicaid managed care, where states will contract with a private company to run their Medicaid programs, which he argues is a smarter system than the traditional model of the government paying healthcare providers directly.
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Forbes
The expansion of Medicaid benefits, thanks largely to the Affordable Care Act, helped increase enrollment in private health plans by 3.4 million in the last year, according to a new report from consulting firm PwC. Managed-care plans are taking on an unprecedented role in providing health coverage to poor Americans thanks in part to more states opting to go along with the ACA's Medicaid expansion.
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Modern Healthcare
The CMS is teaming up with state Medicaid directors to set guidelines for managed Medicaid plans to ensure network adequacy. In April, the CMS finalized a sweeping managed Medicaid rule meant to strengthen current regulations regarding network adequacy. The rule required states contracting with plans to develop and enforce minimum time and distance standards for providers. States would be in charge of determining those standards.
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The Hill
Republican presidential nominee Donald Trump's healthcare plan would erase all of the coverage gains from ObamaCare and then some, while Democrat Hillary Clinton's plan would bring the nation's uninsured rate to another historic low, according to a new analysis.
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Today
Mylan CEO Heather Bresch was in the hot seat on Capitol Hill on Sept. 21, citing development costs and middlemen for the soaring price of the company's EpiPen. Democrats and Republicans alike expressed outrage, with Rep. Elijah Cummings saying the pharmaceutical company has "jacked up the price of a lifesaving product for no discernable reason."
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STAT
You can add Colorado to the list of states being sued for refusing to widen access to the hepatitis C medications in its state Medicaid program. The lawsuit, which is seeking class action status, was filed on behalf of two Colorado citizens in response to a longstanding policy by the state Medicaid program to restrict coverage only to people with the most advanced stages of liver disease, such as cirrhosis.
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The Tennessean
The owner of a nursing home 80 miles northeast of Nashville claimed more than $2 million in Medicaid expenses that were instead spent for personal use, including purchases at discount stores, restaurants, furniture stores, nail salons, personal travel and, in one instance, to help pay for the wedding of the owner's daughter.
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St. Louis Post-Dispatch
It could be as long as a year before a new state law allowing doctors to charge Medicaid patients late fees for missing an appointment goes into effect. And, even then, the future of the controversial law backed by Missouri's Republican-led Legislature remains in limbo. Lawmakers recently overrode Democratic Gov. Jay Nixon's veto of the measure allowing for the late fees and giving doctors the ability to refuse to schedule new appointments until the missed appointment fee is paid.
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