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STAT (Subscription required)
Thanks to a combination of falling prices and litigation, more state Medicaid programs have eased restrictions on hepatitis C medications, according to a new analysis by the Center for Health Law and Policy Innovation. But the group, which is funded by drug industry money, also leveled criticism that "far too many states have retained their discriminatory insurance practices."
Francis Rienzo, who heads Medicaid Health Plans of America, explained that "unsustainable prices ... should change with the entry of multiple generics, but until then, offering unrestricted access to hepatitis C drugs will decimate Medicaid budgets in many states. This evolution of the hepatitis C market is Exhibit A in the argument for much-needed reform of the Medicaid Drug Rebate Program which perpetuates misaligned incentives."
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The Hill
A leading advocacy group is launching a six-figure ad campaign pressuring Congress to act to lower drug prices.
The TV and digital ads from the Campaign for Sustainable Rx Pricing, a coalition of insurers, hospitals and other groups, come at a time when hopes are high for action on drug prices.
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The Hill
The Trump administration is loosening restrictions to allow states to better treat patients with serious mental illnesses.
Health and Human Services Secretary Alex Azar wants states to apply for waivers to allow Medicaid to pay for long term mental health at inpatient facilities. The waivers have previously been used to provide more flexibility on substance use disorders.
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Kaiser Health News
Voters on Election Day gave control of the U.S. House to the Democrats but kept the U.S. Senate Republican. That will mean Republicans will no longer be able to pursue partisan changes to the Affordable Care Act or Medicare. But it also may mean that not much else will get done that does not have broad bipartisan support.
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Project Transition
Learn how one provider is challenging the status-quo in behavioral healthcare and advocating for society’s most vulnerable members to discover their life worth living by providing a recovery experience like no other. Individuals with serious mental illness (including dual diagnosis) are empowered and able to realize a life in the community, on terms they define with the right treatment and services. In Philadelphia, PA and Nashville, TN, a unique extended behavioral support program has been proven to reduce cost and increase positive outcomes, by combining apartment-style community living with intensive, daily, evidence-based programming. This setting helps minimize stigma and create normalized social expectations and consequences.
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Arkansas Times
A nonpartisan legislative agency tasked with analyzing Medicaid sent a letter to the Trump administration on Thursday saying it was "highly concerned" about Arkansas's termination of insurance for almost 8,500 beneficiaries in recent months as a result of the state's work requirement for certain beneficiaries.
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Kern Health Systems (Kern) is overcoming numerous care management challenges using Jiva, the industry’s leading PHM platform. Learn how the powerful end-to-end platform is helping Kern consolidate data, streamline workflow, manage compliance, create holistic assessments, improve overall health outcomes, and plan for future expansion into new lines of business.
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The Hill
Medicaid expansion advocates are looking to capitalize off their midterm victories by potentially adding Kansas and Wisconsin to their list of recent wins.
Voters in three deep-red states voted to extend coverage to low-income adults, and those wins could spur expansion efforts next year in Wisconsin and Kansas, where Democratic candidates won governor's races on Tuesday.
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ZeOmega
Deborah Murr, director of health services at Kern Health Systems, describes why she “LOVES” Jiva, the industry’s leading PHM platform. Learn why seamless integration and single sign-on are improving the way the large organization does business, and how the attentiveness of the Jiva team gave rise to a successful implementation.
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The Washington Post
Voters in deeply red states elected some deeply conservative politicians in this week's midterm elections. But they also approved a litany of progressive ballot initiatives, from restoring felon voting rights to raising the minimum wage and expanding Medicaid.
The electoral dissonance underscored that the issues people vote on at the ballot box don't always align with the candidates they vote for. The outcomes also highlight the approach advocates took in trying to get the ballot measures passed — namely, by not associating them with either party.
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Deseret News
With a Friday projection from The Associated Press that Proposition 3 will have enough votes to pass, full Medicaid expansion is set to become the law in Utah, and Department of Health officials have asked the federal government to cancel the agency's request for a more limited form of expansion that state lawmakers set into motion earlier this year.
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HFI’s mission is to partner with healthcare clients to improve their fiscal health by advocating for their most vulnerable members. HFI helps members get necessary benefits and income affording them access to important social determinants of health.
We effectively identify and reclassify eligible super-utilizers from TANF/ACA to ABD.
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North Carolina Health News
Now that some of the dust has settled after Tuesday's election, the big question for many in the state’s healthcare community is whether North Carolina will expand Medicaid.
Here's the unsatisfactory answer: Maybe, maybe not.
Tuesday's elections brought significant change to the balance of power in the N.C General Assembly. Republican lawmakers, who started the 2013 legislative session by rejecting the expansion made possible by the Affordable Care Act, are still very much in power. But Democrats appear to have to picked up enough seats Tuesday in both chambers to break Republican super-majorities, meaning they can uphold any vetoes from Gov. Roy Cooper, also a Democrat.
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Managing complex populations can be an uphill battle with manual processes. Learn how you can automate authorizations and referrals while driving CMS compliance and reducing costs.
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Maine Public
Maine Gov.-elect Janet Mills says improving health care will be a top priority when she takes office in January. Mills made an appearance Wednesday morning at Becky’s Diner in Portland, where she also said she would follow through on promises to address the opioid epidemic and climate change.
Inside Becky's Diner, Mills got a warm greeting from former state legislator and political strategist Pat Eltman, who hugged Mills as she passed by.
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Kaiser Health News
A ballot initiative that would have continued funding Montana's Medicaid expansion beyond June 2019 has failed. But advocates say they'll continue to push for money to keep the expansion going after that financial sunset.
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