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The state of implementation: Health reform and the 2012 elections
Health Affairs Blog    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Affordable Care Act is not on the ballot this election, but its fate is very much up for grabs. The law likely will survive if President Barack Obama is re-elected and Democrats maintain control of the Senate, but otherwise is vulnerable. Republican leaders have threatened to use the same parliamentary tactics to repeal the law that Democrats used to pass it, including a budget-reconciliation process requiring only 51 votes in the Senate instead of the filibuster-proof 60. At least five alternative paths have been identified that Republicans could pursue to halt the law's implementation through regulatory and budgetary means should full repeal fail. More



Election will decide health law's future
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The highest court in the country upheld most of the Affordable Care Act in June. But everybody knew it was only an overture. The law "will fall in November by a vote of the American people," Mississippi Gov. Phil Bryant pledged that day, speaking for many other Republicans. Democrats were more reluctant to paint the election as a referendum on what even they came to call "Obamacare." But privately, they admitted the stakes. More

Post-election flood of 'Obamacare' rules expected
POLITICO    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The bottled-up rules to set up President Barack Obama's healthcare reform law are going to quickly start flowing right after Election Day. But how long will that last? That depends on who wins the presidency. The once-steady stream of regulations and rules from the Obama administration — instructions for insurance companies, hospitals and states on how to put the law in place — has slowed to a trickle in recent months in an attempt to avoid controversies before the election. Many states, too, have done little public work to avoid making the law an election issue for state officials on the ballot. More

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CMS Issues final rules on Medicaid, Medicare provider payment rates
California Healthline    Share    Share on FacebookTwitterShare on LinkedinE-mail article
CMS has issued a final rule for a provision of the Affordable Care Act scheduled to take effect in January that temporarily increases Medicaid's payment rate for primary care physicians to match Medicare payment rates, Modern Healthcare reports. The rule specifies that the federal government pay 100 percent of the difference between the Medicaid state rates and the applicable Medicare rate as of July 1, 2009. The rule applies only in calendar years 2013 and 2014. More

OB-GYNs, ER docs excluded from health law's Medicaid pay hike
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Obstetricians, gynecologists and emergency room physicians won't be eligible for higher Medicaid pay rates for primary care doctors that start in January under the Affordable Care Act, the Obama administration ruled. Instead, the higher Medicaid rates, which will be in effect for two years, are reserved for family doctors, internists and pediatricians, because those specialties are specifically listed in the 2010 law, the Centers for Medicare and Medicaid Services said. More



'Who's there?' A free webinar by LexisNexis answers this question in 'Why Identity Management Matters to Medicaid' | 1 p.m. EST Nov. 8
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The challenges of identity risk management can be boiled down to these two words: "Who's there?" At its core, this is the essence of security. Government efforts are driving much of the focus on identity management — a primary concern for the healthcare industry. Medical identity theft or improper access to sensitive records, as well as liability issues, are of paramount concern. Patients want to know what steps are being taken to ensure their privacy. As a Medicaid plan, you should not just be addressing the "what" of identity management — the technical side — but also the question of "who?" How do you know people are who they claim to be and what risks do they pose for the environments and systems they are attempting to enter? Please join us Thursday when Clint Fuhrman, director of Government Health Care Programs for LexisNexis Risk Solutions, addresses these issues in a FREE 60-minute webinar. More

From Texas to Vermont, state elections decide healthcare's future
NBCNews.com    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As Mitt Romney and President Barack Obama pack in some last-minute campaigning before the election, polls show voters are split just about down the middle on who they prefer: Romney, who has promised to do everything he can do repeal the 2010 health reform law, and Obama, who says its benefits are just beginning to take hold. But although the presidential race gets most of the attention, the choices voters make to fill governor's mansions and state legislatures may have just as big an effect on what kind of health coverage they will have in coming years. More

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GOP raises specter of Kansas Medicaid expansion as campaign issue
The Associated Press via Lawrence-Journal World    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Sam Brownback's allies have raised the potential expansion of the state's Medicaid program as a campaign issue in the days before the election decides races for the Kansas Legislature, with conservative Republicans seeking to bind Democrats to President Barack Obama and the federal healthcare overhaul. The federal law enacted in 2010 contemplates an expansion of Medicaid to cover millions of uninsured Americans, and it promises that the federal government will pick up the full cost until 2016 and most of it afterward. A U.S. Supreme Court's decision in June said states could refuse to expand their programs, which provide health coverage for the poor, the disabled and elderly. More

Georgia eyes major change in Medicaid
Georgia Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Georgia officials, in an abrupt shift, are moving toward creating a case management system for hundreds of thousands of Medicaid beneficiaries who are "aged, blind and disabled." This summer, the Department of Community Health, citing the uncertainty about Medicaid's future, stepped away from a proposal to place beneficiaries residing in nursing homes, as well as those with disabilities, into managed care plans. But now, the Medicaid agency appears to envision a lighter form of managed care for those beneficiaries. Medicaid covers 1.7 million Georgians who are poor or disabled. The majority of Medicaid recipients are children, who, along with pregnant women, already are in managed care plans. The state's decision may be at least partly linked to the financial crunch that Medicaid faces. More



As California prepares to expand Medicaid, only the poorest will benefit in Sacramento
Capital Public Radio/Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
California's Sacramento County has closed all but one of its six health clinics in recent years. But this month, the county rolls out the Low Income Health Program, known as LIHP, with state support and an infusion of federal funds that officials hope will help provide better service. Sacramento will contract with Molina Healthcare to connect 12 existing, independent community clinics as a network. Still, Sacramento lags behind most of the rest of California in implementing LIHP, and it will be serving only the poorest of the poor in the county. More

Illinois moves ahead on health insurance exchange
The Associated Press via The Washington Examiner    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Illinois officials are reviewing five bids to build the state's health insurance exchange — a required component of the federal healthcare overhaul that Gov. Pat Quinn intends to implement regardless of who wins the presidency. By 2014, each state must have a working exchange where people and small businesses can comparison shop online for commercial health plans based on quality and cost. The concept has been described as Travelocity for health insurance and it's intended to make buying insurance simpler and more affordable. More


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WellCare Community Foundation donates $75,000 to Hurricane Sandy relief efforts
WellCare Health Plans via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
WellCare Health Plans Inc. announced that the WellCare Community Foundation has donated $75,000 to the American Red Cross to support Hurricane Sandy relief efforts in New York, New Jersey and Connecticut. WellCare also will match employee contributions to the American Red Cross. In addition, WellCare is working with other agencies to provide resources and coordinate local volunteer efforts, fundraisers and blood drives. It also will establish a relief fund for employees affected by Hurricane Sandy. More

Asthma management program from Nurtur wins URAC 2012 Best Practice Platinum Award for consumer health improvement
PRWeb    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The URAC 2012 Best Practices in Health Care Consumer Empowerment and Protection Awards recognize premier healthcare management programs that demonstrate quality improvements in healthcare delivery. Nurtur is proud to join with its parent company, Centene Corporation, in receiving the URAC 2012 Best Practice Platinum Award for its Asthma Solutions Program for a Managed Medicaid Population. More



New Keeping You Healthy Video: 'Reduction of ER Visits'
Horizon NJ Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Improper utilization of hospital emergency facilities by members enrolled in managed care plans continues to be an issue for health plans nationwide. Dr. Brian Bastecki and Dr. Philip Bonaparte discuss how Horizon NJ Health developed and implemented an initiative focused towards reducing member visits for nonemergency issues.

Watch now: 'Facilitating Care Coordination' by Truven Health
Truven Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the final video of this series, Bob Kelley, senior vice president of Truven Health, discusses How health plans can help providers and facilitate care coordination. Watch it here.

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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

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Free webinar: 'Exchange Health Plan Management Functions: URAC Accreditation & Quality Measures for Health Insurance Exchanges' | 2 p.m. EST Nov. 14
URAC    Share    Share on FacebookTwitterShare on LinkedinE-mail article
This complimentary webinar in which 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, will be held at 2 p.m. EST Nov. 14. For more information and to register, click here.

Submissions for Diabetes Care Best Practices Compendium due Nov. 16
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. More



Free webinar: 'Medication Adherence & Identifying Nonadherent Patients' by Merck | 1 p.m. EST Nov. 27
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Merck cordially invites you to a medical education program for healthcare professionals only. Merck is sponsoring this program, and the speaker is presenting on behalf of Merck. The program is a non-CME event. The information presented in this program will be consistent with FDA guidelines. The format is an interactive live webcast titled A Profile of the Concept of Medication Adherence and Strategies to Identify Nonadherent Patients Learning Objectives:
  • Define medication nonadherence and understand its prevalence among patients with chronic disease
  • Recognize the drivers of nonadherence and understand the importance of appropriate communication
  • Use the 10 Tenets model of medication adherence and the Adherence Estimator screening tool
Click here for more information or register here for the live webcast.




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

Insights webinar: 'Reduce Outsourcing Risk' | 11 a.m. EST Dec. 20
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Details here.

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