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Senate Democrats divided over cuts to benefit programs, raising roadblock to any fiscal deal
The Associated Press via The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
It's not just about taxes. There's another big obstacle to overcome as Congress and President Barack Obama work to skirt the fiscal cliff: deep divisions among Senate Democrats over whether to consider cuts to popular benefit programs like Medicare and Medicaid. Much of the focus during negotiations seeking an alternative to $671 billion in automatic tax increases and spending cuts beginning in January has centered on whether Republicans would agree to raising taxes on the wealthy. Obama insists that tax increases on the wealthy must be part of any deal, even as White House officials concede that government benefit programs will have to be in the package, too. More

Democrats to GOP: Stop stalling and name your entitlement cuts
NationalJournal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Senate Democrats are blaming Republicans for the slow pace of the fiscal cliff negotiations, arguing that Republicans have failed to lay out the entitlement spending cuts they want to see as part of a deal. Instead, Republicans are trying to force Democrats into negotiating with themselves and in the process take on the political burden of proposing both tax increases on the wealthy and spending cuts that could hit the middle class, a Senate Democratic leadership aide said. For their part, Republicans argue that they have passed a budget that included significant entitlement reforms and now it's up to the president to say what cuts he will support. More

Montana senator: Coverage expansion delay off table; he hedges on drug rebates    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Sen. Max Baucus, D-Mont., says delaying the health reform law's coverage expansions will not be on the table as part of a deal to reduce the deficit but the Senate Finance Committee chair hedged when asked by Inside Health Policy if he believed extending Medicaid drug rebates into Medicare Part D — a highly controversial policy strongly opposed by the drug industry but backed by Senate Budget Committee Chair Kent Conrad, D-N.D. — should be discussed. More

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Federal officials say they hope to act soon on KanCare waiver request
KHI News Service via Kansas Health Institute    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The federal official in charge of reviewing 1,115 Medicaid waiver requests recently sat in on an hourlong conference call to hear Kansans' views on Gov. Sam Brownback's proposed Medicaid makeover plan. Only about 20 people had time to comment but none of them expressed support for KanCare, which would move virtually all the state's 380,000 Medicaid beneficiaries into managed care plans run by three insurance companies. Most people who called in questioned the need for KanCare and expressed concern that they or family members would lose services or their case managers. Others called for a delay, saying the program's planned Jan. 1 launch date would come too soon. More

Health plans air concerns amid changes to children's coverage in California
California Watch    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Under a budget-paring plan crafted by California Gov. Jerry Brown and approved by lawmakers, 870,000 children who were covered by the Healthy Families program will be moved to Medi-Cal in phases beginning Jan. 1. But it remains unclear whether a health plan serving Sacramento, Fresno, San Diego and Los Angeles counties will have enough doctors to accept the children. Health Net, which covers about 86,000 children, notified the state that it can't say how many of its doctors will continue to see children after they are moved from the better-paying Healthy Families program to Medi-Cal, a Medicaid program that pays some of the nation's lowest reimbursement rates. More

Missouri governor backs Medicaid expansion
The Associated Press via Journal Sentinel    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Jay Nixon announced his support for expanding Medicaid eligibility in Missouri, calling it both "the smart thing" and "the right thing to do." Nixon's endorsement of the Medicaid expansion comes after months of pre-election silence on the subject and could give a significant boost to an effort by hospitals and other medical groups to persuade state lawmakers to embrace the change. But it won't be an easy sell for the Democratic governor. Republican legislative leaders responsible for passing a state budget generally have expressed opposition to a Medicaid expansion, citing concern about the future cost to the state. More

University economist touts Medicaid expansion; legislator says Montana solution needed
Missoulian    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Expanding Medicaid to cover thousands of low-income Montanans should be an economic boost for the state, as it will bring billions of federal dollars into Montana, a University of Montana economist said. Yet, Gregg Davis of the UM Bureau of Business and Economic Research and others told a healthcare conference that gauging the full effects of any Medicaid expansion in Montana would be difficult, because many variables haven't been determined. More

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Medicaid expansion still uncertain for Colorado
The Associated Press via Ventura County Star    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Colorado health officials won't commit to increasing Medicaid coverage as called for by President Barack Obama's federal healthcare law, saying it's too soon to know whether the state can afford to expand healthcare for the needy. Speaking to a group of healthcare activists, Roxane White, chief of staff to Democratic Gov. John Hickenlooper, said the administration is waiting until after a December tax estimate before deciding how to proceed. "Let me tell you now, we don't have answers for you," White said. More

Report: Florida will benefit from Medicaid expansion
The Bradenton Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Another study is arguing that Florida can save costs if it goes along with a planned federal expansion of Medicaid, as part of healthcare reform. The recently released study follows one with a similar conclusion and argues that while the expansion would mean more people on the rolls, it also would remove many of them from more expensive state and local safety net programs. Florida's Medicaid program currently costs a little more than $21 billion, with the federal government picking up 56 percent of the tab. More

Mississippi Medicaid spokesman: Expanding program shouldn't be about economy
The Associated Press via San Francisco Chronicle    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A spokesman for Mississippi's Medicaid program is questioning the notion that expanding the federal-state health insurance program is the way to spur economic growth. Francis X. Rullan says he's speaking only for himself in this instance. But he says it's not a good idea to base an economic development effort on the dependency of a large group of poor or disabled people. More

South Carolina senators warned about rising Medicaid costs
The Associated Press via The Providence Journal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The director of South Carolina's Medicaid agency told state senators that whether they support or oppose federal healthcare reform, they need to get ready for costs associated with the government health insurance program to rapidly increase. Department of Health and Human Services Director Tony Keck said his agency estimates the changes mean about 200,000 more people will join the 1 million adults and children in the state already using Medicaid. And he warned lawmakers that he can't guarantee the numbers won't be higher. More

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Supporters: Medicaid expansion would benefit Hispanics
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Hispanics — one of Democrats' key voting blocs — will be the biggest beneficiaries if President Barack Obama's healthcare law fully is implemented, the law's supporters said. Jennifer Ng'andu, director of the Health and Civil Rights Policy Project at the National Council of La Raza, said Hispanics would see the biggest gains in healthcare coverage if the law fully is implemented, meaning every state opts in to the optional Medicaid expansion. More

Arizona governor rejects state-based insurance exchange
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Arizona Gov. Jan Brewer is the latest Republican to reject a state-based insurance exchange under President Barack Obama's healthcare law. Brewer joins a slew of high-profile GOP governors who have said their states won't establish state-run exchanges, instead leaving the task up to the federal government. "This has been one of the more difficult decisions of my career in public service," Brewer said in a statement in which she said she had notified the Health and Human Services Department of her decision. More

Survey: Medicaid-level rates could cripple health insurance exchanges
Biotech Week via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
With the results of the presidential election and the fate of state health insurance exchanges decided, a new national survey of hospital executives on the subject finds that talks between providers and payers already are off to a rocky start. Of the 112 hospital executives surveyed, 62 percent said they have begun conversations with payers about participation in the exchanges, 54 percent said those conversations included a discussion of reimbursement rates, and 48 percent of those conversations are "fair to poor." More

WellCare supports heart health with sponsorship of Healthy Family Training Camp
Thomson Reuters via The Boston Globe    Share    Share on FacebookTwitterShare on LinkedinE-mail article
WellCare Health Plans Inc. is showing its support for heart health by joining the American Heart Association and the University of Louisville as a sponsor of the upcoming Healthy Family Training Camp. The company donated $10,000 to help underwrite the event and WellCare employees will be volunteering at the event activities. More

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ProgenyHealth's Dr. Ellen Stang named among Ernst & Young's Entrepreneurial Winning Women for 2012
Ernst & Young    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Dr. Ellen Stang recently was named among Ernst & Young's Entrepreneurial Winning Women for 2012. These women entrepreneurs join an elite network of the country's best high-growth companies and now will participate in the customized leadership program designed to connect them with the advisers, resources and insights they need to scale their businesses. ProgenyHealth provides care management solutions for insurers and employer groups, managing the treatment of premature infants admitted to a neonatal intensive care unit. 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.

Free webinar: 'PCMHs within a Medicaid MCO's Provider Network' | 3 p.m. EST Dec. 11
Qualis Health    Share    Share on FacebookTwitterShare on LinkedinE-mail article
For details, click here. More

Insights webinar: 'Proper Capitation Rates for Hemophilia Patients' | 11 a.m. EST Dec. 17
Baxter    Share    Share on FacebookTwitterShare on LinkedinE-mail article
For details, click here. 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

MHPA CEO Thomas Johnson to speak at Strategic Solutions Network's 4th Annual 'Medicaid Innovations Forum' | Feb. 5-7 | Orlando, Fla.
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Medicaid Innovations is designed to be the meeting place for all participants in the Medicaid universe who want to participate, share and learn about innovations that promote quality improvement, cost reduction and transformation in the face of reform. Use discount code MHPA when registering to receive a $200 discount off the current rate. For complete agenda and to register, visit

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