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MHPA's Jeff Myers talks access in Robert Pear NYT story on |
The New York Times
The recently released report by the Office of the Inspector General at the U.S. Department of Health and Human Services calls for the need for better oversight by the Centers for Medicare & Medicaid Services on state standards for access to care in Medicaid managed care. It discusses the variability in the state standards for network adequacy. Read the story on the report by famed health journalist Robert Pear of the New York Times, which includes comments from Jeff Myers, MHPA's president and CEO.
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House, Senate seeks Medicaid managed care info from MHPA
House Energy and Commerce and Senate Finance Committee leaders have asked organizations representing Medicaid plans for information on managed care plans. "We believe it is important for Congress to better understand the growing and evolving role managed care plays in the Medicaid program. ... Given the emerging diversity and growth within the program, we are particularly interested in providing private sector partners the opportunity to benefit from the consideration of an array of successful models for patient care," the bipartisan group wrote to MHPA.
CMS considers letting ACOs merge with part D plans, Medicaid; accept capitated pay
Inside Health Policy
CMS is considering letting accountable care organizations combine with drug plans and Medicaid and accept global payments, CMS innovation center head Patrick Conway said on Sept. 30. The agency plans to soon request input from the public on plan designs for CMS to test, and that "request for information" will provide an opportunity for plans to suggest changes to ACOs.
North Carolina lawmakers contemplate overhaul of state
North Carolina Health News
In the first of a series of meetings during this legislative interim, lawmakers started considering a radical overhaul of the program that provides health care to the state's low-income patients.
Oct. 1 Webinar Wednesday: 'Pharmacogenetic Testing in the Clinical Setting' by Millennium Health
Join Maria Chianta, Pharm.D., director of clinical strategy and programs at Millennium Health, to define pharmacogenetics and find out how it may influence medication efficacy and toxicity. She will discuss how the valuable information provided by pharmacogenetic testing may assist clinicians in providing more personalized medication therapy, leading to improved patient and financial outcomes by reviewing information from the medical literature. Lastly, Dr. Chianta will review current evidence supporting its incorporation into medication management.
Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
mhpa2014: T-minus 26 days and counting
Have you registered for mhpa2014 yet? From Oct. 26-28 in Washington, D.C., we will be launching THE conference for Medicaid MCOs in 2014. Stay tuned for the release of the mhpa2014 conference mobile app (sponsorship still available) and other useful info that we'll be rolling out in these last few weeks leading up to our main event.
For our updated agenda and registration information, please visit http://bit.ly/mhpa2014.
Money talks: Obamacare initiative makes headway in Republican states
President Barack Obama's plan to extend health coverage to millions of poor Americans remains highly contentious, yet it is gaining momentum among several initially reluctant states where financial pragmatism is trumping ideology. Up to a dozen states, including several led by Republicans, could move forward with plans to expand coverage under Medicaid after the November elections. They take their cue from Pennsylvania and other states that have won Washington's approval to add commercial innovations to the 50-year-old government program to make it more palatable to conservatives.
As Obamacare pays medical bills, red states pressured on Medicaid
A new report showing the continued pileup of unpaid medical bills in states that didn't expand Medicaid under the Affordable Care Act is escalating criticism on these Republican-led areas of the country to expand the health insurance program for the poor.
Confusion remains over Pennsylvania governor's Obamacare alternative
The Philadelphia Inquirer
Two months before Healthy Pennsylvania — Gov. Corbett's private-market version of Medicaid expansion — opens for business, advocates for the low-income uninsured have no idea what benefits packages will be offered or what criteria will be used to place people in plans.
Advocates call for action on Indiana Medicaid plan
Healthcare advocates and industry lobbyists are asking federal officials for speedy approval of Indiana's Medicaid expansion request. Leaders from the Indiana Hospital Association, the Indiana State Medical Association and other groups said that the expansion is critical to providing care for the state's working poor.
Tennessee governor presses ahead on Medicaid expansion talks
The Associated Press via Charlotte Observer
Tennessee Gov. Bill Haslam said he's still in talks over finding a way to expand Medicaid in the state despite pushback from fellow Republicans in the state legislature. The governor said in a conference call that he wants to find a solution acceptable both to the U.S. Department of Health and Human Services and to largely skeptical lawmakers in Tennessee, who must approve any deal under a law passed earlier this year.
Texas and Florida expand Medicaid — for children
Kaiser Health News and USA Today
Republican lawmakers in Florida and Texas snubbed the Affordable Care Act's Medicaid expansion for adults, but their states did broaden the program this year — for school-aged children. Those states were among 21 — including some big Democratic-led states, such as California — that were required to widen Medicaid eligibility for children between the ages of 6 and 18 by 2014.
California governor vetoes bill limiting estate recovery for Medi-Cal enrollees
San Jose Mercury News
In a blow to tens of thousands of low-income Californians newly enrolled in Medi-Cal under a provision in the Affordable Care Act, Gov. Jerry Brown vetoed a bill that would have limited the state's seizure of assets from their estates after they die — a legal wrinkle that most only discovered after they had signed up for the healthcare plan for the poor.
California to launch Medicaid-funded teledentistry
Kaiser Health News
California Gov. Jerry Brown has signed into law a bill that would require Medi-Cal, the state's insurance program for the poor, to pay for dental services delivered by teams of hygienists and dentists connected through the Internet. California is among the first states to launch such teledentistry services, which are intended to increase the options for patients in remote and underserved areas. Other states, like Oregon, Colorado, Hawaii and West Virginia, are interested in creating their own teledentistry programs but are farther behind, advocates for the projects said.
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.
Oct. 8 Webinar Wednesday: 'Using the Massachusetts Health Care Reform Experience to Understand Your New Medicaid Members' by HFI
This webinar will serve as a preview of Healthcare Financial Inc.'s (HFI) presentation at mhpa2014 on Oct. 28, which will include an interactive discussion of data, insights and recommendations.
Missed our previous issues? See which articles your colleagues read most.
Did you miss our Sept. 24 Webinar Wednesday?
Get a free copy of the well-attended "Federal Government Oversight of Medicaid at the State Level and How Health Plans Can Prepare" by Cody Consulting, as well as other past webinar presentations here.
Aetna job opportunities
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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