This message contains images. If you don't see images, click here to view.
Advertise in this news brief.




Text Version    RSS    Subscribe    Unsubscribe    Archive    Media Kit October 21, 2014

Home   About   Policy & Advocacy   Education & Resources   Events        

 



GOP governors don't see 'Obamacare' going away
The Associated Press via The Washington Post
While Republicans in Congress shout, "Repeal Obamacare," GOP governors in many states have quietly accepted the law's major Medicaid expansion. Even if their party wins control of the Senate in the upcoming elections, they just don't see the law going away.
   Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE  




Gov. John Kasich: Repeal Obamacare, but not all of it
Politico
Ohio Gov. John Kasich wants to be very clear: He wants to repeal Obamacare. Just not the part he likes. A political firestorm broke out Oct. 20 when the The Associated Press quoted Kasich as saying that Obamacare repeal was "not gonna happen." That view is almost unheard of — at least in public — among most Republicans, let alone those who might run for the White House in 2016.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Kasich: I 'don't back Obamacare' and I 'want it to be repealed'
The Washington Post
Ohio Gov. John Kasich is pushing back on reports that he'd said Obamacare was here to stay, saying Oct. 20 that he opposes the federal healthcare law and believes it could be repealed and replaced under a Republican president and GOP-controlled Congress. "I don't back Obamacare. I never have. I want it to be repealed," he told The Washington Post in a telephone interview.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


SPONSORED CONTENT


How will Medicaid plans cover specialty drugs? MHPA comments
Bloomberg BNA
According to a recent survey from the Kaiser Family Foundation, almost every state Medicaid plan is concerned about the rising cost of specialty drugs — specifically Sovaldi. Sovaldi is a hepatitis C drug from Gilead Sciences which costs $1,000 a pill, or $84,000 for a 12-week treatment — prices which the plans have balked at. But the drug has a cure rate up to 92 percent. In early October, Gilead received FDA approval on its next-generation hepatitis C drug, Harvoni. That drug delivers cure rates of 94 to 99 percent, but comes with a similarly high price tag of $31,500 a month.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


Binding arbitration proposed as fix to expensive Rx prices in Part D
Inside Health Policy
Congress could allow for binding arbitration to help plans negotiate lower prices for unique specialty drugs, Harvard professors wrote in a January 2008 Health Affairs article that is getting new attention in light of the $94,500 price of a 12-week course of the newly approved hepatitis C drug Harvoni. The Center for a Responsible Federal Budget drew attention to the old proposal to help advance the debate over how, or whether, steps should be taken to control the price of specialty drugs.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


SHOWCASE
 
Your One Set of Data Gives You Access to Superpowers

Complex Clinical Reviews. Dependent Audits. And More.

Contact HMS today!
 


Senate lawmaker eyes hearing on the cost of hepatitis C treatments
The Wall Street Journal
Responding to the ongoing controversy over the prices for new hepatitis C treatments, U.S. Sen. Bernard Sanders will probably hold a hearing — possibly before the year ends — to examine how the cost is affecting the U.S. Department of Veterans Affairs, according to his spokesman. Sanders is chairman of the Senate Committee on Veterans' Affairs.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


mhpa2014 is almost sold out!
MHPA
We are almost at capacity at mhpa2014, the premier event for Medicaid MCOs. If you work in the Medicaid managed care industry and you haven't registered yet, what are you waiting for? Register for mhpa2014 today. For more info, please visit bit.ly/mhpa2014.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article




New Medicaid patients in West Virginia 'come in with baggage'
The Charleston Gazette
With 155,000 people added to West Virginia's Medicaid program following a major expansion, the state's family practice doctors are seeing more patients whose medical care requires a complete overhaul, a state Medicaid official recently told lawmakers. "The problem is patients who come from an uninsured status to a suddenly insured status frequently come in with baggage," said Dr. James Becker, medical director for West Virginia's Medicaid program.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


SPONSORED CONTENT


Supporters of Utah Gov. Herbert's health plan hold vigil
The Associated Press via The Charlotte Observer
About 100 people rallied in Salt Lake City to urge the Legislature to pass Gov. Gary Herbert's alternative plan to Medicaid expansion. Holding lights and candles on the steps of the Capitol, they observed a moment of silence for those who died because they couldn't afford medical care. Utah filmmaker Paul Gibbs, who organized the vigil, said it's time for state legislators to stop playing political games with people's lives.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE




CoOportunity pulling out of Iowa Medicaid expansion plan
The Des Moines Register
The insurance carrier CoOportunity Health is pulling out of an Iowa program that provides government-financed coverage to moderate-income residents. The Iowa Department of Human Services recently announced that CoOportunity has decided not to continue covering participants in the Marketplace Choice Plan next year. The program is an integral part of Iowa's version of Medicaid expansion under the federal Affordable Care Act.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE




Georgia candidates are ready for a runoff ... but not happy about it
The Atlantic Journal-Constitution
If you needed any proof that Republicans are worried about a looming runoff, look no further than the recent gubernatorial debate. That's when Gov. Nathan Deal, instead of lobbing a softball at his Libertarian rival, unloaded a double-barreled attack questioning his support for a Medicaid expansion and criticizing the millions of dollars in federal grants his technology firms accepted.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE


FEATURED ARTICLE
TRENDING ARTICLE
MOST POPULAR ARTICLE
In states that don't expand Medicaid, who gets new coverage assistance under the ACA, and who doesn't?
Urban Institute
This research provides more evidence that state officials' decisions against expansion adversely affect already disadvantaged residents. While 5.9 million adults with moderate incomes in nonexpanding states qualify for financial assistance to purchase insurance through the new marketplaces, nearly 6.3 million uninsured residents with lower incomes remain ineligible for help because the state's Medicaid program was not expanded.

Share on FacebookTwitterShare on LinkedinE-mail article
read more
CMS clears the air about Medicaid tax; MHPA's Myers comments
Government Health IT
The Centers for Medicare & Medicaid Services has issued answers to some frequently asked questions regarding payment of the Affordable Care Act's health insurance fee in Medicaid, with the main clarification being that it should be reimbursed by the states, in accordance with the Balanced Budget Act of 1997. "By issuing this guidance, CMS is saying to states that they should pay the fee in accordance with actuarial soundness requirements," MHPA President and CEO Jeff Myers said.

Share on FacebookTwitterShare on LinkedinE-mail article
read more
Panel backs requiring Arkansas to provide drug
The Wall Street Journal (Subscription required)
An advisory board recommended that the Arkansas Medicaid program eliminate restrictions on the use of an expensive cystic fibrosis drug made by Vertex Pharmaceuticals Inc. that are the subject of a legal battle in federal court. Members of the state's Drug Utilization Review Board, which is made up of Arkansas doctors and pharmacists, recommended that the state adopt a revised set of criteria for prescribing the drug, called Kalydeco, that wouldn't require that patients seeking the drug first prove their health worsened after taking two older, less-costly treatments.

Share on FacebookTwitterShare on LinkedinE-mail article
read more


Accreditation Association for Ambulatory Health Care approved to accredit Qualified Health Plans
Accreditation Association for Ambulatory Health Care
The Accreditation Association for Ambulatory Health Care has been approved to accredit Qualified Health Plans by the Secretary of the Department of Health and Human Services. Under the Affordable Care Act, an insurer must be designated as a QHP to be included in a state or federal exchange, and accreditation is a requirement of this designation.

One of the most powerful ways to demonstrate that a health plan is meeting industry standards — AAAHC QHP accreditation includes on-site peer review by highly experienced surveyors who are healthcare professionals who come from the primary care and health plan environment. Personal peer reviewers understand the challenges a health plan and its providers face and offer a deep working knowledge of the environment as well as a consultative approach.

AAAHC has been accrediting health plans since 1983 and has been recognized by CMS for Medicare Advantage plans since 2007. AAAHC offers accreditation to HMOs, prepaid health clinics, physician sponsored networks, behavioral health plans, dental health plans and PPOs/POS. For questions or to apply for AAAHC accreditation, visit www.aaahc.org or call 847-853-6060.

Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article


IIR's FDA/CMS Summit for Payers featuring MHPA's Jeff Myers | Dec. 11-12, Washington, D.C.
Institute for International Research USA
Hear from the FDA and CMS under one roof, along with C-level executives from top health plans, at the FDA/CMS Summit for Payers. The entire healthcare continuum is coming together to understand how to better interact with the government to remain compliant, adaptive, and successful as our landscape evolves to become more patient-centric. Collaborate with the most influential people in health care, including speakers MHPA's president and CEO Jeff Myers and Janet Woodcock, M.D., director of the Center for Drug Evaluation and Research, FDA. Click here for more information.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article


Did you miss our Webinar Wednesday, 'Strategies for Developing a Successful Member Conversion Strategy'?
MHPA
For a copy of the Oct. 15 Webinar Wednesday "Strategies for Developing a Successful Member Conversion Strategy" by Human Arc, please email Linda Roman. Get info on other past webinars here.
Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article


TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Read 'The Sovaldi Squeeze: High Costs Force Tough State Decisions' (MHPA)
As pricey hepatitis pill Harvoni joins Sovaldi, states erect Medicaid hurdles; MHPA's Myers comments (Forbes)
Mars and Venus on Medicaid (Forbes)
Inside Health Policy on Harvoni: MHPA/Viohl & Associates report cited (Inside Health Policy)

Don't be left behind. Click here to see what else you missed.


Aetna job opportunities
Aetna
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.

Share this article:   Share on FacebookTwitterShare on LinkedinE-mail article
READ MORE
Follow MHPA on social media!
 

Sponsored by ...


 

 

 

 

 

 

 


 

 


 

 

 


 

 

 


 

 

 


MHPA's Industry NewsBrief
Colby Horton, Vice President of Publishing, 469.420.2601
Download media kit

Damon Sayles, Content Editor, 469.420.2662   
Contribute news

This edition of MHPA's Industry NewsBrief was sent to ##Email##. To unsubscribe, click here. Did someone forward this edition to you? Subscribe here -- it's free!
Recent issues
Oct. 16, 2014
Oct. 14, 2014
Oct. 9, 2014
Oct. 7, 2014



7701 Las Colinas Ridge, Ste. 800, Irving, TX 75063