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Costly hepatitis C treatments help drive 12 percent drug spending jump
Kaiser Health News
After several years of modest increases, American spending on medications is projected to shoot up by 12 percent this year, pushing the nation's drug bill to between $375 billion and $385 billion, according to a report by the IMS Institute for Healthcare Informatics.
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Most Illinois Medicaid patients denied new hepatitis C drugs
Chicago Tribune via Kaiser Health News
Revolutionary new drugs are curing hepatitis C, halting a disease that can corrode the liver to the point of cirrhosis, cancer and death. But state restrictions in Illinois on who can get the costly drugs are keeping them out of reach for some of the poorest patients.

For more on state coverage decisions, please read MHPA's "The Sovaldi Squeeze: High Costs Force Tough State Decisions" by Viohl and Associates.

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Report: US states get more, spend more on Medicaid under Obamacare
Reuters
One part of the Affordable Care Act is going according to plan, with U.S. states receiving and spending more money on the Medicaid health insurance program, a report released by the National Association of State Budget Officers showed.
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New Medicaid rule could challenge state shift away from nursing homes
The Pew Charitable Trusts
For more than 30 years, states have been finding new ways to care for aged and disabled Medicaid beneficiaries without confining them to nursing homes. In fact, the number of people living in skilled nursing facilities has declined significantly over the last decade, despite a marked increase in the ranks of the elderly in the U.S. Starting this year, a new federal rule will require states to ensure that long-term care alternatives to nursing homes — such as assisted living facilities, continuing care retirement communities, group homes and adult day care — work with residents and their families to develop individual care plans specifying the services and setting each resident wants.
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MACPAC: HHS reports show need for CHIP funding, express lane eligibility
Inside Health Policy (Subscription required)
Congressional Medicaid advisers reiterate calls to extend Children's Health Insurance Program funding for two more years and urges CMS to more closely monitor transfers between Medicaid, CHIP and exchange coverage in letters to HHS, Senate Finance and House Energy & Commerce committees on three HHS reports that were released earlier this year.
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California's managed care project for poor seniors faces backlash
Kaiser Health News
California's experiment aimed at moving almost 500,000 low-income seniors and disabled people automatically into managed care has been rife with problems in its first six months, leading to widespread confusion, frustration and resistance. Many beneficiaries have received stacks of paperwork they don't understand. Some have been mistakenly shifted to the new insurance coverage or are unaware they were enrolled. And 44 percent of those targeted for enrollment through Oct. 1 opted out.
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Roughly 25 percent of possible participants have opted out of the
duals project

California Healthline
About 50,000 Californians so far have enrolled in Cal MediConnect, according to figures released by the Department of Health Care Services, which oversees the program. However, about twice that number — a little more than 100,000 duals — have chosen to opt out of the program. The numbers can be a little confusing because the opt-out numbers seem so much greater than the opt-ins.
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Prospects to expand Medicaid services in North Carolina dim for 2015
News & Observer
Any plan North Carolina Gov. Pat McCrory's administration presents for expanding Medicaid would have a tough time getting through the state legislature. A key House member said it would probably be premature to consider expanding Medicaid next year with the future of the federal healthcare law uncertain.
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Medicaid expansion plan is unveiled by Montana governor
Great Falls Tribune
Montana Gov. Steve Bullock officially unveiled a plan to expand Medicaid in the state in a way he says will provide coverage to nearly 70,000 Montanans in a way that would contract with an insurer in a competitive process to provide coverage through private providers at negotiated rates. The plan is based on the Healthy Montana Kids program, which provides health insurance coverage to children who meet certain guidelines.
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Veterans to push Missouri Medicaid expansion; hospitals hire new lobbyist
St. Louis Post-Dispatch
Though Republican leaders in the Missouri General Assembly have already doused any hopes for Medicaid expansion next year, lobbyist and former U.S. Sen. Christopher "Kit" Bond is rounding up supporters to push for it. Bond teamed up with state Sen. Ryan Silvey to announce that Missouri's military veterans organizations support expanding and reforming the joint state and federal health care program for the poor.
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Medicare, Medicaid get big data chief
The Hill
The Centers for Medicare and Medicaid Services is creating the position of chief data officer to improve transparency, agency officials said. Niall Brennan, the agency official who will take on the role, will be charged with collecting and disseminating information about Medicare, Medicaid, the Obamacare marketplaces, the Children's Health Insurance Program and other initiatives.
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Nov. 26 Webinar Wednesday: 'Why All Medicaid Managed Care Organizations Need an ACO Strategy'
Epstein Becker Green
The growth and persistence of the state ACO movement is being fueled by CMS' State Innovation Model grants and by state implementation of Medicaid accountable care organizations (ACOs) — 17 states have already implemented some form of Medicaid accountable care. Join Clifford Barnes, partner at Epstein Becker Green, PC, and Jenny Gladieux, senior health policy analyst for Health Policy Source, Inc., as they provide the tools to develop an understanding of how Medicaid ACOs affect Medicaid managed care and provide the rationale on why Medicaid managed care needs to develop state-specific ACO strategies.
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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.
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TRENDING ARTICLES
Missed our previous issues? See which articles your colleagues read most.

    Introduction of BTD medications like Sovaldi complicates projections of Medicaid expenses (American Academy of Actuaries)
CMS: Some providers are obstructing dual-eligible demonstration (Modern Healthcare)
Millions of Medicaid kids missing regular checkups (Kaiser Health News)
WellCare questions Medicare ratings (WUSF)
Rate of premature births fall as health law provisions begin to take effect (Kaiser Health News)

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


MHPA's Myers to speak at Sixth Annual Medicaid Innovations 2015 Forum | Feb 3-5, 2015 | Orlando
Medicaid Innovations Forum
Join MHPA President and CEO Jeff Myers at the Sixth Annual Medicaid Innovations 2015 Forum in February 2015. This meeting offers a unique combination of forward-thinking perspectives including first-hand case studies and examples of true innovation from both Medicaid managed care plans and state government agencies. The forum, which gathers hundreds of representatives from states, health plans and solution providers in one room, goes beyond policy to explore the specific strategies these organizations are leveraging to improve quality of care, reduce costs and position themselves for success in serving the rapidly expanding Medicaid population. Use Discount Code MHPA200 to receive $200 off the current rate.
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MHPA's Myers to chair WHCC 4th Annual Medicaid and Medicare Reform Summit | March 2015 | Washington, DC
World Congress
MHPA President and CEO Jeff Myers will chair the WHCC 4th Annual Medicaid and Medicare Reform Summit, a meeting that convenes executives from health plans, hospital systems and policy organizations to share, learn and discuss approaches to improve the quality of government programs and achieve payment and delivery reform. For conference details, agenda and registration, please visit here.
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