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Nursing homes urge CMS to revisit Medicaid managed care oversight; states request flexibility
Inside Health Policy
States say recent CMS guidance on incorporating long-term care into managed care reviews is a good step forward, though a provider stakeholder suggested the guidance is too vague in certain areas. CMS released detailed guidance on how to include manged long-term care and support services in external quality reviews last month, urging states to take a wider view of medical records in certain situations and consider avoidable hospitalizations when looking at improvements within a managed care program.
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Actuaries warn about consequences of delaying ACA's individual mandate or extending open enrollment period
PRNewswire via Yahoo News
Delaying the implementation of the Affordable Care Act's individual mandate or extending the open enrollment period for obtaining coverage could have negative consequences for health insurance coverage and costs, the American Academy of Actuaries' Health Practice Council warned in a letter sent to members of Congress on Nov. 5.
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Sebelius on offense, tells Senate panel she won't delay Obamacare
Los Angeles Times
VideoBriefHealth and Human Services Secretary Kathleen Sebelius said that she had considered shutting down the problematic Obamacare website but has no intention of delaying implementation of the nation's new healthcare law.
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Kathleen Sebelius hearing takeaway: More bad news
Politico
Kathleen Sebelius got through a recent Obamacare hearing, but her message to Senate Democrats was a bit of a downer: Expect more bad news. The Health and Human Services secretary told the Senate Finance Committee that the Obama administration is on track to fix the sputtering federal enrollment website. Well, maybe not on track exactly — "not where we need to be."
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Insurer backs 'pause' on Obamacare rollout
The Hill
A top health insurance company urged government officials to "push the pause button" on Obamacare and shut down the troubled HealthCare.gov until it could be completely fixed. "Pushing the pause button right now would be a good thing," Aetna CEO Mark Bertolini said at a recent event, as reported by The Courant.
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Pledging to expand state's Medicaid rolls, McAuliffe elected Virginia governor
The Associated Press via The Washington Post
Terry McAuliffe won the governors office over Ken Cuccinelli, capping a campaign driven by a crush of negative advertising, nonstop accusations of dodgy dealings and a tea party-backed nominee who tested the limits of swing-voting Virginia.
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GOP: Virginia results boost 2014 Obamacare attacks
Politico
At a time when not much is going right politically for the Republican Party, one thing certainly is — Obamacare. And the Virginia governor's race this week, party hands say, is the best evidence yet.
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Rural Medi-Cal managed care effort begins
California Healthline
Californians in 28 rural counties now have access to Medi-Cal managed care plans, bringing state-linked managed care plans to all 58 California counties. The expansion will affect roughly 274,000 residents in rural areas, according to Toby Douglas, director of the Department of Health Care Services, which is coordinating the effort.
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Less than 60 days remain: Officials prepare for next phase of KanCare
Kansas Health Institute
With fewer than 60 days remaining before the second major phase of KanCare is scheduled to start, state and managed care company officials say they continue to lay groundwork for as smooth a launch as can be managed, though there are important details and major tasks that remain to be worked out or completed.
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In Dallas, Obama urges Medicaid expansion as he scoops up cash
The Dallas Morning News
In Dallas to raise cash for Senate candidates, President Barack Obama took a side trip to pressure Texas Gov. Rick Perry to expand Medicaid and thank volunteers working to help uninsured Texans. He called it a "no-brainer" that Texas could provide coverage immediately to 1 million working poor for little state investment — if only Perry would go along.
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GOP lawmakers in Ohio under fire for supporting Medicaid expansion
Los Angeles Times
Ohio Rep. Barbara Sears is the kind of Republican the party would want to highlight these days — a woman and former business owner, fluent in health insurance issues, who has managed to repeatedly win reelection in a district where Republicans and Democrats are almost evenly divided. But this year, the popular legislator with a strong conservative voting record has found her photo on door hangers throughout her district, pictured as the conductor of the Obamacare train to disaster.
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Missouri governor calls meeting of legislative panels to discuss Medicaid
St. Louis Beacon
After months of lying low on the topic of Medicaid expansion, Missouri Gov. Jay Nixon appears to be resurrecting the issue with an invitation to General Assembly leaders to join him "for a discussion about reforming our state's healthcare system to provide better outcomes for patients and better returns for taxpayers."
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Medicaid enrollment surges ahead of ACA signups
Politico
HealthCare.gov may be limping along to full viability, but Medicaid is flying off the shelves. New Medicaid enrollment is far outpacing new insurance customers under Obamacare so far, a subtle sign that the program could play a greater role in the law's coverage expansion than first anticipated.

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Sebelius on healthcare law rollout: 'Hold me accountable for the debacle'
The Washington Post
The battle over the government's problem-plagued healthcare website recently escalated as Republicans attacked the Obama administration over an array of emerging issues involving the health law, including potential security vulnerabilities on the site and complaints from Americans facing cancellations of existing policies.

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CMS mantra: It'll work by December
Politico
November's shaping up to be a major test of Obamacare functionality. That's when new features of the health law's enrollment system — some of which have been put off repeatedly because of insufficient testing — are slated to go online. Among them: Online enrollment in the marketplace for small businesses, a Spanish-language enrollment website and the transfer of Medicaid applications from the feds to the states.

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AmeriHealth Caritas honored with Innovate+Educate HIRE Award
AFRO
AmeriHealth Caritas Family of Companies, a national leader in Medicaid managed care and other healthcare solutions for those most in need, was recently recognized for its innovative approaches to building and developing its workforce with a HIRE Award from Innovate+Educate. AmeriHealth Caritas, one of five recipients of the inaugural award, accepted the honor at Innovate+Educate's Close It Summit on Nov. 6 at the Capitol Hilton Hotel in Washington, D.C.
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Why new Medicaid enrollment is soaring
The Pew Charitable Trusts via Kaiser Health News
States are reporting far higher enrollment in Medicaid than in private insurance since the Affordable Care Act exchanges opened Oct. 1. In Maryland, for example, the number of newly eligible Medicaid enrollees is more than 25 times the number of people signed up for private coverage. Even some Medicaid experts say they are surprised at the early numbers.
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Michigan's approach to Medicaid expansion and reform
The New England Journal of Medicine
A cornerstone of the Affordable Care Act is the expansion of Medicaid coverage in 2014 to adults with incomes up to 133 percent of the federal poverty level (approximately $15,500 for a single adult in 2014). The proportion of these low-income adults under 65 years of age who are uninsured exceeds 40 percent nationally. Individual insurance is prohibitively expensive for most adults with low incomes, and employer-sponsored insurance is often unaffordable or not offered to the members of this population who work.
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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Medicaid enrollment surges ahead of ACA signups (Politico)
Florida adds Medicaid managed care contracts (Health News Florida)
Avalere: Duals demo delays expected as plans eye 3-way negotiations (Inside Health Policy)
Obama health official apologizes for broken HealthCare.gov (The Hill)
Plans seek mergers, Medicaid business to remain competitive (Managed Healthcare Executive)

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


MHPA 2013: Your feedback is important to us
MHPA
If you went to MHPA 2013, please complete the short online attendee survey. Updated presentations are also available on the app and MHPA's website here.
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Johns Hopkins HealthCare LLC via FurstGroup
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Sign up for a free trial to Health Exchange Alert, a news service from InsideHealthPolicy.com
Inside Health Policy
The Affordable Care Act's mandated health exchanges are on the front burner for policymakers and should be for you, too. Stay on top of the evolution and implementation of health exchanges with Health Exchange Alert, the news service from InsideHealthPolicy.com. Act now by clicking here to activate a no-obligation, four-week free trial to gain immediate access to InsideHealthPolicy.com and Health Exchange Alert.

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Recent webinar presentations from PwC, SCA Personal Care, Lilly, First Quality, Millennium Labs and others available free on MHPA website
MHPA
View PDFs or listen to audio for the following webinars: Additional webinars can be viewed here.
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MHPA on Twitter, LinkedIn and Facebook
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