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Democratic governors seen as unlikely to push previous plan seeking more managed care for duals    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Maryland Medicaid Director Charles Milligan recently told Inside Health Policy that it is unlikely Democratic governors would again pursue a proposal pitched last year to Congress that sought to give states new authority to enroll dual eligibles into managed care settings and cap federal payments to score savings, though he cautioned that with the lame-duck session still roughly a month away it is premature to say for certain. The plan would codify the two payment models of the CMS duals office financial alignment demonstration — managed fee-for-service and capitation — and allow states to require duals to enroll in one or both of those models. More

1st 2 debates reveal 2 campaigns, stripped to core arguments
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
It took three hours and 33,000-plus words, including 57 mentions of "jobs," seven "Bibi's" and one "Big Bird." But the first two debates revealed something that long months of speechifying had not: two campaigns, stripped down to their core arguments. Tonight, President Barack Obama and Mitt Romney will take the stage again, in a town-hall style debate at Hofstra University in New York. This meeting may have a different tone from their first — Obama, in particular, is under pressure to be more aggressive. But both candidates seem likely to return to the same basic sales pitch. More

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Go/no-go date looms this week for KanCare
Kansas Health Institute    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Several developments will help officials this week in the administration of Kansas Gov. Sam Brownback decide if their KanCare Medicaid reforms will move forward on the original timeline of a Jan. 1 launch or whether the program will get pushed to a later, yet-to-be-decided date. A few things are scheduled to happen over the course of the next five days that will shape that decision, according to Brownback officials. Among them: Sometime this week, completion of the last of the state's "readiness reviews" of the three managed care companies is due. More

Case managers encouraged to apply for MCO jobs in Kansas
Kaiser Health Institute    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Across Kansas, Medicaid-funded programs that help the disabled, brain-injured and frail elderly live in community settings and avoid expensive moves to nursing homes are encouraging their front-line case managers to go to work for the KanCare managed care companies. "I'm helping them put their resumes together, I'm writing letters of recommendation for them, and we're doing practice job interviews," said Janet Williams, who owns communityworks inc., an Overland Park, Kan., company that provides case management and rehabilitation services for about 500 people with brain injuries. More

New Jersey governor considers new Medicaid math
WNYC-FM/NPR/Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As a way to reduce the number of uninsured, states are being encouraged to set more generous income limits for Medicaid as part of the Affordable Care Act. If states comply, they can get 100 percent federal funding in the first three years, declining to 90 percent funding over time. Typically, states and the federal government share the burden at a ratio that’s closer to 50-50. The new funding might seem like an offer states can't refuse, but several are, including Florida, Texas, Wisconsin and Arizona. And New Jersey Gov. Chris Christie has hinted he wants to follow the lead of those states and their Republican governors, who believe the Medicaid expansion will end up costing states too much in the long run. More

States, providers watch closely as 9th Circuit Court takes up Medi-Cal cuts case    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A three-judge panel on the 9th Circuit Court is expected to deliver a decision early next year on whether California can move forward with a 10 percent Medicaid rate cut — a decision anxiously awaited by both providers and states because of its potentially broader policy implications as federal and state policymakers grapple with budget cuts. The decision could come as federal lawmakers are engaged in deficit-cutting talks and, one healthcare expert familiar with the case pointed out, California is in the middle of its budget cycle. The panel recently heard the case, the latest step in a protracted legal battle over California provider payment cuts proposed in June 2011. More

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California plans, providers behind talk of capping Medicaid spending per person    Share    Share on FacebookTwitterShare on LinkedinE-mail article
California government officials, providers and Medicaid plans are behind lobbying efforts to cap Medicaid spending per person, sources following the effort say, because state officials and providers see the policy as a way to avert Medicaid cuts during entitlement-reform talks next year and some Medicaid plans in California believe they would profit under per capita caps. Stakeholders from multiple states including California were slated to discuss the per capita caps in Chicago, a source says. More

Report: Michigan could save $1 billion by expanding Medicaid eligibility
The Detroit News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Michigan could save $1 billion over 10 years and provide health insurance to 600,000 residents if it expands Medicaid eligibility as allowed by the national health care reform law, according to a report. The U.S. Supreme Court upheld the constitutionality of the Affordable Care Act in June, but one provision was not upheld: penalizing states that opt out of the laws expanding Medicaid. More

Would Medicaid expansion bankrupt or save Texas' budget?
The Texas Tribune    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Rick Perry has compared Texas Medicaid to the Titanic, but economists and business advocates from both sides of the political aisle say Texas shouldn't let the program sink just yet. They argue the political rhetoric against the federal government should be thrown overboard and Texas should expand Medicaid under federal healthcare reforms because it is a practical decision for the state budget. More

Ohio officials spread word on new Medicaid benefit
The Associated Press via Lancaster Eagle Gazette    Share    Share on FacebookTwitterShare on LinkedinE-mail article
State officials are spreading the word about a plan to better coordinate care for Medicaid beneficiaries with severe mental illness who also face chronic medical issues, such as heart disease or diabetes. Under the new service, providers would partner with doctors, pharmacists, social workers and others to better address patients’ mental and physical health needs. The benefit now is available to Medicaid recipients in Butler, Adams, Scioto, Lawrence and Lucas counties. All of Ohio's 88 counties are expected to provide the service by 2013. More

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Free webinar: 'Exchange Health Plan Management Functions: URAC Accreditation & Quality Measures for Health Insurance Exchanges' | 3 p.m. EDT | Oct. 23
URAC    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In this complimentary webinar, URAC will present an overview of its accreditation process and quality measures as they relate to qualified health plans that participate on Health Insurance Exchanges, including how URAC information may be utilized by state insurance regulators and state exchanges. For more information and to register, click here.

Countdown to MHPA's 2012 Annual Meeting; 'Diabetes Disparities' workshop for all attendees
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
If you haven't signed up yet for the MHPA 2012 Annual Meeting, "A Pivotal Time for Medicaid Health Plans," slated for Oct. 24-26, now is the time to register online from your PC or PDA. We've also added a diabetes disparities workshop Oct 24, free for all conference attendees. "Diabetes Disparities: Innovations in Identifying and Addressing Them in Medicaid Managed Care Plans" will feature Dr. Kasia Lipska from Yale University School of Medicine; Dr. Gary Puckrein of the National Minority Quality Forum; Mary Barton from NCQA; and Dr. Andrea Gelzer, CMO of The AmeriHealth Mercy Family of Companies. See the agenda here. More

New Keeping You Healthy video for National Breast Cancer Awareness Month: 'Gift for Life' mammography outreach program
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Keystone Mercy Health Plan's "Gift for Life," an aggressive mammography outreach and event scheduling program, provides mammography screenings for their members in their own neighborhoods. Through partnerships with mobile mammography vans and local providers, Keystone Mercy arranged accessible locations throughout their five-county service area to engage members who have not had screenings in the past two years. Learn more about this best practice, which was nominated for both the Center for Best Practices 2012 Outreach award and Innovation award, from Veronica Medina, director of the Rapid Response and Outreach Program for Keystone Mercy Health Plan. More

New call for submissions: Diabetes Care Best Practices Compendium
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid Health Plans of America is calling for case studies from our member organizations that will help to highlight real-world examples of best practices related diabetes prevention and treatment. We invite member and partner organizations to submit information to be included in the MHPA Diabetes Care Best Practices Compendium, to be published in January 2013. More

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Watch now: Complexities of alternative payment methods, expert video from Truven Health
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the fourth video of this series, Bob Kelley, senior vice president of Truven Health, discusses the complexities of alternative payment methods. Watch it here. Coming up next week: How health plans can help providers and facilitate care coordination. More

Slides available for Medagate webinar: 'Member Engagement: Communications & Wellness Programs'
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
See last week's presentation from Fred Haumesser from ReadyWireless and Donny Tye from Medagate about communication and wellness strategies that take advantage of Lifeline Medicaid programs to engage members. More

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Insights webinar: 'The Ins and Outs of Encounter Reporting' | 11 a.m. EDT Oct. 29
Altegra Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Health plans have many compliance requirements tied to their state Medicaid contracts, not the least of which is encounter reporting. REGISTER NOW.

Free webinar by MHPA partner LexisNexis: 'Why Identity Management Matters to Medicaid' | 1 p.m. EST Nov. 8
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As a Medicaid Plan you should not just be addressing the "what" of identity management — the technical side — but, more important, the question of "who?" How do we know who the person on the other end is who they say they are and what risks they may pose for the environments and systems they are attempting to enter? More

Take action for World Diabetes Day: Attend MHPA's free webinar by Novo Nordisk on diabetes trends to 2025 and resources for policymakers, patients | noon EST Nov. 14
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In an effort to help confront the epidemic of diabetes, Novo Nordisk commissioned and funded "United States' Diabetes Crisis: Today and Future Trends," the first study to provide detailed diabetes prevalence and cost forecasts individually for all 50 states out to the year 2025. The study not only provides insight into how the growing diabetes epidemic geographically will spread in the U.S., but also highlights how this demographic shift might affect local economies. This webinar will provide an overview of the study from lead researcher Dr. Bill Rowley and will introduce the Novo Nordisk Diabetes Barometer, an interactive tool and comprehensive resource that highlights important research about the current state of diabetes in the United States. Participants also will learn how to use the interactive map portion of the website to benchmark and compare diabetes prevalence and cost forecasts to 2025 for all 50 states. More

Health Insurance Exchanges Summit; MHPA's Thomas Johnson guest speaker | Nov. 29-30 | Las Vegas
Healthcare Education Associates    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Join Healthcare Education Associates Nov. 29-30 at the Tropicana Las Vegas Hotel for the Health Insurance Exchanges Summit. This health insurance exchanges conference will deliver real, actionable takeaways for effective exchange implementation. MHPA members are eligible for a 15 percent registration discount. Mention Priority Code HMP122 during registration to enjoy this offer. More

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