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AIS Health
In her first major speech on the Medicaid program, CMS Administrator Seema Verma on Nov. 7 informed attendees of the National Association of Medicaid Directors fall conference that the agency is streamlining its approach to reviewing and approving Section 1115 demonstration requests to test innovations in states' Medicaid programs. And in discussing the various changes, she emphasized the interest of CMS in waiver proposals that promote "community engagement" among working-age, able-bodied Medicaid recipients and encourage them to "rise out of poverty."
"The work requirement and to a lesser extent, drug testing and other items all go with this idea of community involvement. The plans are fiduciaries of state and federal taxpayers, so if the state wishes to enforce a work requirement or other items, the plans will do their level best to make sure that that is as effective as possible," Jeff Myers, president and CEO of Medicaid Health Plans of America (MHPA), told AIS Health. "Having said that, I think there are some real concerns about linking the two that the states should really consider."
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The Hill
The legislation to fund the government for two weeks could also provide some short-term relief to help states keep their Children's Health Insurance Programs (CHIP) afloat. The bill, which would fund the government through Dec. 22, would temporarily lift certain spending constraints to allow states to get more money for CHIP from the federal government. Without action from Congress, the government will run out of money Friday.
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Marketplace
Funding for the Children's Health Insurance Program ran out at the end of September, meaning millions of kids and pregnant women won't have coverage in the new year. There are bills in Congress that would fund the program, but nobody can agree where to get to money to do it. The $15 billion program funnels federal money to states, which they use to subsidize healthcare for some families. Now some states are sending notices to CHIP recipients that their coverage may go away next year.
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The Sacramento Bee
The Children's Health Insurance Program provides low-cost coverage to children in families that earn too much to qualify for Medicaid. But it has become caught up in a political stalemate over how to fund it. Congress failed to reauthorize the program before it expired in September. Several states are expected to deplete their remaining funds for it by next month. The uncertainty has left states scrambling — and causing worries for families that depend on the program.
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Kaiser Health News
Last week, Colorado became the first state to notify families that children who receive health insurance through the Children's Health Insurance Program are in danger of losing their coverage. Nearly 9 million children are insured through CHIP, which covers mostly working-class families. The program has bipartisan support in both the House and Senate, but Congress let federal funding for CHIP expire in September.
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The Texas Tribune
Hey, Texplainer: With the Children's Health Insurance Program funding in jeopardy, is there a way to see how much money Texas spends per child per month through the health insurance program and how that compares to other states?
The short answer is yes — and no. But first: Let's talk about why CHIP is back in the headlines. It's because Congress failed to renew the program's authorization before it expired on Sept. 30.
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Health News Florida
More than 20 managed-care organizations are seeking state Medicaid contracts that could be worth up to $90 billion over a five-year period. A review of state records shows that a total of 21 managed-care organizations are seeking to be part of Florida's Medicaid program, which provides health coverage for the poor.
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KCUR-FM
Republican legislators have temporarily sidetracked an effort to block the Brownback administration from obtaining federal approval to renew KanCare, the state’s privatized Medicaid program. Democrats on a joint committee that oversees KanCare wanted the panel's report to the full Legislature to recommend keeping the current program in place until a newly elected governor takes office in January 2019.
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Read the latest blog post on Eliza Engage to learn why it’s essential to look beyond claims data and engage members in conversations to identify and address social determinants of health. Read Now→
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Governing
Prior to last month's elections, no polling had been done on Maine’s first-of-its-kind ballot initiative to expand Medicaid. Considering how controversial the healthcare debate in Congress has been all year and the fact that the state elected a Republican governor, health policy experts were expecting a nailbiter. But to their pleasant surprise, the vote was quickly called in their favor.
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STAT
Arizona has become the latest state to seek permission from the federal government to limit the number of medicines that would be covered by its state Medicaid program, which is currently required to provide coverage for all treatments.
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A KLAS Leader in the delivery of actionable population health, i2i Population Health’s integrated Population Health Management and Analytics solutions have proudly served healthcare organizations for over 17 years. The company offers a depth of experience gained from over 2,500 healthcare delivery sites across 34 states, supporting 20+ million lives.
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STAT
Amid ongoing criticism that some states continue to curb access to hepatitis C drugs, Colorado officials have lifted restrictions that determined when patients could receive treatment. Going forward, Medicaid beneficiaries will no longer have to demonstrate an advanced stage of liver disease to be treated.
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MHPA
Health care education company to offer exclusive online training to MHPA members
Medicaid Health Plans of America has announced a new strategic alliance with Relias, trusted partner in online analytics, assessments and learning for the health care market. This partnership will help deliver meaningful, uniform, accredited training to health plan network providers to improve their productivity and performance. We chose Relias as its preferred partner because the company’s wide range of easily accessible, quality, online education solutions around compliance and care management are well-suited to meet the needs of MHPA members' networks of providers. As a result of this partnership, they will receive exclusive discounts on Relias products, including the industry-leading online Relias Learning Management System (RLMS).
"MHPA is excited to offer Relias's best-in-class educational programming to our members," said Jeff Myers, president and CEO of MHPA. "Together, MHPA and Relias will support health plan network providers' needs in challenging areas facing our industry, such as the opioid epidemic. This important relationship strengthens the commitment of both of our organizations to bringing quality health care to the people who need it the most — our nation’s underserved."
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