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Study: Medicaid expansion is cheap for states
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Implementing the Medicaid expansion in President Barack Obama's healthcare law wouldn't cost the states much money, according to a new report from the Kaiser Family Foundation. Republican governors are under enormous pressure not to expand their Medicaid programs, as conservatives look for any way to undermine the Affordable Care Act now that it has survived the Supreme Court as well as the 2012 election. Nearly every Republican governor has rejected the expansion, citing the additional costs to state governments that still are recovering from the recession. But according to the new Kaiser analysis, states' additional costs would be small. More

Study: States face increased Medicaid costs even if they don't expand program
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
If state officials think they can escape a fiscal quagmire by refusing to expand Medicaid under the federal health law, they might want to reconsider. State Medicaid costs will jump $76 billion, or nearly 3 percent, over the next decade if all 50 states decide to expand Medicaid eligibility in 2014 under the federal health law. But state spending on the program would still increase to the tune of $68 billion even if not a single one opts for the expansion, according to a study released Monday by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) More

Much talk, little action on 'fiscal cliff' as Congress returns
Los Angeles Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Congress returned to a lame-duck session with no signs of quick compromise to ease the nation's budget deadlock, and the White House rolled out a strategy to marshal popular support for raising taxes on the wealthiest tier of income earners. Closed-door talks by senior aides produced no clear progress despite President Barack Obama's private phone call over the weekend to House Speaker John A. Boehner, R-Ohio, in an effort to forge a deficit reduction deal in the five weeks before current tax rates expire, which would lead to tax increases for most Americans. More

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Horizon NJ Health receives full URAC health plan re-accreditation
Horizon NJ Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Horizon NJ Health, a subsidiary of Horizon Blue Cross Blue Shield of New Jersey, announced that it again has received full Health Plan Accreditation from URAC, a Washington, D.C.-based, national healthcare accrediting organization that establishes quality standards for the healthcare industry. The Health Plan Accreditation recognizes Horizon NJ Health's commitment to providing quality healthcare access, with standards including key benchmarks for network management, provider credentialing, utilization management, quality management and member relations. More

Centene appoints 2 executive vice presidents
St. Louis Business Journal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Nearly six months after joining Centene as chief marketing officer, David Minifie was appointed to executive vice president, effective immediately, the managed care company reports. Minifie will now oversee branding and product management. Keith Williamson also was appointed to executive vice president, secretary and general counsel. Williamson began working for Centene in 2006 as general counsel, where he led the legal and compliance departments. More

Pennsylvania governor: State can't absorb Medicaid expansion costs
PA Independent via Easton Patch    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Pennsylvania Gov. Tom Corbett said that expanding Medicaid in accordance with the Patient Protection and Affordable Care Act would cost the state millions of dollars that it doesn't have. "I don't think there's any way we can absorb this," Corbett said of the expansion costs, while recently speaking to the Pennsylvania Press Club. As multiple states make their announcements on whether to expand Medicaid to more residents, Pennsylvania has yet to come out one way or the other. But Corbett was specific in citing associated costs, adding that Pennsylvania may not have room in the budget to cover them. More

Study: Medicaid expansion not as expensive for New Jersey as other states
NJBIZ    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As healthcare reform implementation continues full steam ahead, a study produced by Kaiser Family Foundation shows New Jersey would not see a moderate increase in state spending if Medicaid coverage is expanded. According to the study, if New Jersey implements the Medicaid coverage expansion, the state will spend an estimated $1.5 billion more than it would without the expansion between 2013 and 2022. More

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Wisconsin governor: No decision yet on Medicaid expansion
The Associated Press via Green Bay Press-Gazette    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Wisconsin Gov. Scott Walker told The Associated Press that he still hasn't decided whether Wisconsin will seek a voluntary expansion of Medicaid services as provided under the federal healthcare overhaul. Walker said earlier this month that Wisconsin would not move forward with implementing its own state-run health insurance exchange under the Affordable Care Act. But Walker has not said whether Wisconsin will expand Medicaid services under the law. More

Kansas governor taking cautious approach to Medicaid expansion
Lawrence Journal-World    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Kansas Gov. Sam Brownback is taking a wait-and-see attitude about whether to opt-in to expansion of the Medicaid program under the federal Affordable Care Act. "We're talking with other states about what they are doing, still reviewing options," Brownback recently said. Currently, Medicaid provides healthcare coverage to about 380,000 Kansans, with the largest portion of them — about 230,000 — being children. The rest mostly are lower-income, pregnant women, people with disabilities and the elderly. The $2.8 billion program is funded with federal and state dollars. More

Missouri Republicans unlikely to expand Medicaid
The Kansas City Star    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Here's how much Missouri Republicans oppose Obamacare: GOP lawmakers are reluctant to spend one dollar in state money for every 19-plus dollars of new federal money if that means expanding Medicaid eligibility in line with the president's healthcare overhaul. The state has no extra money to spare, they say, so any expansion likely will result in cuts somewhere else, like education. It's a stance that's not playing well with their hometown hospitals, though, who say they badly need more Medicaid dollars as money they get from Washington for caring for low-income patients starts to go away. And now those hospitals are issuing a stark warning: Failure to act could result in some hospitals closing their doors for good. More

Florida's Medicaid increases hinge on legislative ruling — now or later?
The Miami Herald    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The first crucial date is a mere six weeks away for Florida to obey a requirement to start paying Medicaid providers higher rates, but even with the recent softening tones of the state's Republican leadership, it's unclear whether the state will approve the payments. Under the Affordable Care Act, Medicaid payments to primary care doctors increase beginning Jan. 1 to the much higher rates paid by Medicare, with the feds picking up the total cost of the increase for two years. More

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Alabama's Medicaid faces new $30 million shortfall
The Anniston Star via InsuranceNewsNet    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Just two months after Alabama voters agreed to raid a state fund for $437 million to patch a hole in the state budget, the state again is facing a Medicaid shortfall. State Health Officer Don Williamson said changes at the federal level will tack an additional $30 million onto the state's Medicaid funding needs for 2014 — a cost state officials didn't know about when voters approved the $437 million budget plug Sept. 18. "With no fundamental change in the program, you're looking at an additional $30 million just to stand still," Williamson said. More

Texas healthcare facing big changes, tough spending decisions
The Associated Press via The Dallas Morning News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Texas Gov. Rick Perry has promised to fight tooth and nail against implementing the Affordable Care Act. But that doesn't mean big changes aren't coming to Texas healthcare, and it won't save lawmakers from facing tough spending decisions. Perry has refused to expand Medicaid, the healthcare program for the poor. And he announced Texas will not set up a federally mandated healthcare exchange. Texas has about 6 million uninsured residents, which comes out to nearly a quarter of its population — higher than any other state. Both Republicans and Democrats agree that's too many, but they disagree on how to get that number down. More

New York to pay Medicaid patients to get healthy
The Journal News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A federally funded program will see whether paying people in New York to go to the doctor and take medication will ultimately save money and promote healthy living. About 16,700 study participants statewide who are smokers, pre-diabetic, diabetic or have high blood pressure will receive debit-card payments of up to $250 each to work toward getting healthier. 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. Drs. Brian Bastecki and Philip Bonaparte discuss how Horizon NJ Health developed and implemented an initiative focused toward reducing member visits for nonemergency issues.

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The Nov. 28 webinar, 'Optimizing Pharmaceutical Care and Measuring Outcomes in a Collaborative Drug Therapy Management Program,' has been postponed
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medication-related problems and medication mismanagement are massive public health problems in the U.S. Experts estimate that 1.5 million preventable adverse events occur each year that result in $177 billion in injury and death. In response to these problems, PerformRx, in collaboration with the AmeriHealth Mercy Family of Companies, successfully have developed a collaborative Drug Therapy Management program that has demonstrated significant reductions in emergency room visits and inpatient admissions, as well as significant costs savings. Stay tuned for new date and time. More

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 by CGS' | 11 a.m. EST Dec. 20
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Refine your outsourcing process and reduce ongoing operational risk by implementing a vendor qualification and review tool. The CGS presentation, "Reduce Outsourcing Risk with a Vendor Qualification and Review Process," demonstrates how to qualify a supplier during the selection process using a defined set of scoring criteria and how to use the same criteria to manage the supplier during ongoing operations. More detail and registration here.

Free webinar by LexisNexis 'Why Identity Management Matters to Medicaid' | 1 p.m. EST Jan. 9
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? Clint Fuhrman, director of Government Health Care Programs for LexisNexis Risk Solutions, addresses these issues in a FREE 60-minute webinar. More

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