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Inside Health Policy (Subscription required)
Most hospitals and health systems are ready for the move to the new ICD-10 code set Oct. 1, according to the College of Healthcare Information Management Executives, though CMS says it could take a few weeks to understand how well implementation is going.
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MHPA
It's not just the new 30. It's also the number of days left until mhpa2015 kicks off in Washington, D.C.
Check out our agenda updates and register at bit.ly/mhpa2015.
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Argus Leader
An advisor to Gov. Dennis Daugaard says a plan to expand Medicaid in South Dakota earned an initial "go-ahead" Tuesday from a top federal health administrator. Daugaard's Senior Advisor Kim Malsam-Rysdon said the governor felt confident about the potential for expansion after meeting with U.S. Secretary of Health and Human Services Sylvia Burwell in Washington, D.C.
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The Salt Lake Tribune
Utah lawmakers got their first preview of a proposal hammered out in closed-door meetings by legislative leaders and Gov. Gary Herbert, seeking to provide health insurance coverage to as many as 126,500 low-income Utahns. A key component, and likely a key challenge to passage of the newly rebranded Utah Access Plus proposal, is that it calls on medical providers — hospitals, doctors, pharmaceutical companies, home healthcare providers and others — to cover the bulk of the cost for the expanded coverage. The idea is that they will be the ones who will benefit from the new revenue.
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Complex Clinical Reviews. Dependent Audits. And More.
Contact HMS today!
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Providence Journal
With Rhode Island Gov. Gina Raimondo's administration in the midst of its Reinventing Medicaid initiative to realize $70 million in savings in the coming year, the state's top Medicaid official has announced that she is resigning. Medicaid Director Deidre Gifford is leaving the $124,165 job she has held for more than a year at the end of October. Gifford plans to seek career opportunities in Washington, D.C., where her husband, former state health director David Gifford, works for the American Health Care Association.
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The Hill
The House passed legislation on Tuesday to give states flexibility to withhold Medicaid funding from health providers that offer abortions. Passage of the bill on a 236-193 vote is timed as conservatives demand to defund Planned Parenthood amid tension surrounding its use of fetal tissue donations. Within a day, the House is expected to clear a government spending bill lasting through Dec. 11 that's free of policy riders as soon as the Senate passes it. The federal government will shut down Oct. 1 absent congressional action.
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Modern Healthcare
The CMS has sent letters to Medicaid consumers who received tax credits to purchase insurance through the Affordable Care Act marketplace. The agency says these people will have to terminate marketplace coverage and pay back the amount of the credit they've received. A CMS spokeswoman declined to say how many people fall into this group only noting it was "a small number."
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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 Pew Charitable Trusts
If Arizona gets its way, its able-bodied, low-income adults will face the toughest requirements in the country to receive health care coverage through Medicaid. Most of those Medicaid recipients, and new applicants, would have to have a job, be looking for one or be in job training to qualify for the joint federal-state program for the poor. They would have to contribute their own money to health savings accounts, which they could tap into only if they met work requirements or engaged in certain types of healthy behavior, such as completing wellness physical exams or participating in smoking cessation classes. And most recipients would be limited to just five years of coverage as adults.
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The Wall Street Journal
For many patients, the emergency department is their only reliable access to health care. The latest surge is attributed to newly-insured Medicaid patients looking for care and struggling to find it. But that’s only part of the situation. Patients are vulnerable. They get hurt, they are old, they are young, they are weak, they are bleeding, they have collapsed. Healthcare economists, administrators and process managers opine that patients without "true emergencies" should be directed to family doctors, urgent-care centers and outpatient clinics.
Patients are chastised for "unnecessary" visits that can cost thousands of dollars. That might sound reasonable but ignores what patients experience and perceive. Remember: You can't teach patients economics lessons when they don’t feel well.
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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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The Hill
As Sen. Bill Cassidy (R-La.) watches the debate over drug prices explode onto the 2016 campaign trail, he worries of an over-simplified conversation. Cassidy cited a costly drug used to treat hepatitis C, which is straining state and federal budgets nationwide. One course of treatment costs about $84,000.
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As industry experts in Managed Care eligibility and payment reconciliation software, our innovative and user-friendly solutions are designed specifically to improve efficiencies and increase profitability. MORE
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HealthCrowd
The webinar will address a host of issues covered by the new ruling, including a member's right to revoke prior consent, a health plan's liability for calling and texting reassigned mobile numbers and the exemption for healthcare messages that are regulated through the Health Insurance Portability and Accountability Act (HIPAA). Marc Roth, HealthCrowd's TCPA Counsel and co-chair of Manatt, Phelps & Phillips, LLP's TCPA Compliance and Class Action Defense Group will report on the ruling, examine its implications and provide valuable guidance on how to stay compliant and avoid pitfalls.
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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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