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Modern Healthcare
The national conversion to ICD-10 diagnostic and billing coding on its first night was running pretty smoothly. One of the most maligned and feared events in healthcare history began with a whimper. "I think, by and large, at least the people we've worked with, they have done so much preparation that they're eager," said Ed Hock, managing director and ICD-10 guru with the Advisory Board Co., a healthcare consultant.
Most Medicaid plans said they aren't expecting any issues."Our plans are ready for the conversion to ICD-10," Jeff Myers, president and CEO of Medicaid Health Plans of America, said in a statement. "Not only is it mandated, but the switchover will give them far better insight into care management, which ultimately benefits the patients they serve."
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The Washington Post
Republican presidential hopeful John Kasich said Monday that some people don’t get him or his economic message, which he described as focused on ensuring that no American gets left behind. Before a crowd of several hundred students and residents at the University of Richmond, the Ohio governor called himself a "troublemaker" who's been at the center of battles to balance government budgets for decades.
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MHPA
mhpa2015 kicks off in Washington, D.C. in 35 days. See you there?
Check out our agenda updates and register at bit.ly/mhpa2015.
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KSTU-TV
Utah Gov. Gary Herbert weighed in on a new plan that would expand Medicaid to Utah’s poor and uninsured. He expressed cautious optimism that something would get done for thousands of Utahns waiting for Medicaid coverage. During a Monday interview, Herbert summed up his strategy sessions with fellow governors and health care leaders at the National Governor's Association retreat in Salt Lake City over the weekend.
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Deseret News
Utah Gov. Gary Herbert said Monday there may need to be changes made to the latest Medicaid expansion plan he and legislative leaders came up with after months of private meetings. Herbert said he's leaving it up to legislative leaders to decide what needs to be done to make UtahAccess+ palatable to lawmakers, especially in the House, where his Healthy Utah proposal stalled in the 2015 legislature.
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The Associated Press via Chicago Tribune
New York state spent more than $1.2 billion on diabetes-related medical services last year, according to a new report that suggests the costs associated with the chronic disease are likely to impose ever greater burdens on the state. Total Medicaid spending related to diabetes surged 31 percent in the past five years, the report from Comptroller Thomas DiNapoli found. Some 1.6 million New Yorkers — or 10 percent of the state's adult population — have been diagnosed with either Type 1 or Type 2 diabetes, and 460,000 of them are covered by the state's Medicaid program.
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Alaska Public Media
Alaskans have been able to sign up for Medicaid expansion for one month. Nearly 2,000 people have enrolled during that time. Anchorage Neighborhood Health Center estimates about 4,000 of it's patients are eligible for Medicaid expansion. Jonathan Casurella, a family practice doctor, said getting them enrolled can help transform their lives. He says many of his patients have untreated or minimally treated conditions that prevent them from working.
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Kaiser Health News
The Affordable Care Act unleashed a building boom of community health centers across the country. At a cost of $11 billion, more than 950 health centers have opened and thousands have expanded or modernized. In San Diego, new clinics have popped up on school campuses and busy street corners. Cramped storefront clinics have been replaced with gleaming, three-story medical centers with family medicine, radiology and physical therapy on site. They are outfitted to care for new immigrants in dozens of languages from Spanish to Somali.
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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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California Health Report
When one of the millions of people enrolled in California's low-income health program has a complaint or needs help, there's a number they can call. But for more than a year, that phone line was unreliable — tens of thousands of calls went unanswered.
In June, the California State Auditor found that the ombudsman phone system for the managed care Medi-Cal program was severely deficient and urged officials with the Department of Health Care Services to make upgrades. Between February 2014 and January 2015, an average of 12,500 calls went unanswered each month, the audit revealed. Some months, the telephone system rejected as many as 45,000 calls. The department launched part of an upgraded phone system on Sept. 30 and plans to roll out additional features later this month.
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The Washington Post
In a replay of the aftermath of the August slaying of two broadcast journalists in southwest Virginia, Gov. Terry McAuliffe on Friday said stricter gun laws and an expansion of Medicaid to treat the mentally ill could curtail gun violence such as the deadly Oregon college shooting. The rampage last week that left nine dead, plus gunman Chris Harper Mercer, is the latest in a series of attacks involving guns that have pushed politicians further to their partisan corners on gun control.
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The Texas Tribune
Following an outcry from dozens of state lawmakers, Texas’ top health agency announced Thursday it will make less drastic cuts than originally planned to a therapy program for children with disabilities, even if that means spending more than lawmakers budgeted for the program. Texas Health and Human Services Executive Commissioner Chris Traylor said in a letter to Texas Senate leadership that his agency would work to "preserve access to care even if it means" the full budget cuts lawmakers passed this year "cannot be achieved."
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Arkansas Online
Arkansas has been granted a three-month extension, until Dec. 31, to finish checking the incomes of 600,000 Medicaid recipients who have been enrolled for at least a year, the director of the state Department of Human Services said Monday. Human Services Director John Selig told the Legislature's public health committees that the state also is exploring changes, including using additional data sources, to speed up the processing of applications and annual income verifications.
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The Associated Press via Chicago Tribune
A much-anticipated report to lawmakers on Arkansas' hybrid Medicaid expansion won't resolve the muddied future of a program providing coverage to more than 200,000 people. But it could at least provide some clarity on the options the legislature faces — and how difficult finding consensus on the program will be.
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The Hill
Arkansas is fighting a federal judge's decision that the state cannot defund Planned Parenthood by canceling its Medicaid contracts. The solicitor general of Arkansas announced Monday that he would appeal the judge’s ruling, which was handed down on Friday. The move escalates an ongoing national legal battle over allegations that Planned Parenthood has mishandled aborted fetal tissue.
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The Hill
Former New York Rep. Bill Owens writes: "The national media have reported on Turing Pharmaceuticals' 5,000 percent price increase for Daraprim, a treatment for toxoplasmosis. There are numerous other pharmaceutical companies who have taken control of a drug and dramatically increased the price. After reading those stories and reflecting on comments made to me by a close friend and local pharmacist, I asked him to show me examples of price increases that he has seen in the last several years.
"He provided five examples reflecting the following dramatic price increases: Colchicine went from $18 per 1,000 milligrams (mg) to $578; Digoxin went from $0.88 per 100 mg to $78; Carac cream went from $402 for 30 grams to $2,425; Levothyroxine (a generic) went from $12 to $48 in six months; and Tasmar (100 milligrams), selling for $165.50 per 100 mg in 1998, increased to $4,525 in 2014, and then to $9,895 in 2015.
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Agency for Healthcare Research and Quality and MHPA
AHRQ, in an interagency collaboration with the HHS Office of Women's Health, the Health Resources and Services Administration, Medicaid Health Plans of America and the Institute for Medicaid Innovation, posted a chartbook on the health care of women. This chartbook provides information on individual measures that were summarized in the 2014 National Healthcare Quality and Disparities Report.
Key Findings:
- Women experienced lower access to care for 21 percent of measures compared to men.
- Compared to men, women received better quality of care for more than a quarter of measures tracked, including lower rates of suicide and cancer deaths.
- Through 2013, the most recent data available, 50 percent of healthcare measures showed improvement over time for women.
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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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