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Inside Health Policy (Subscription required)
Lawmakers from both parties, CMS and Medicaid health plans are looking at ways to improve coordination of care for children with high-cost, medical complexities, but they don't always agree on the solutions. The Advancing Care for Exceptional Kids Act of 2015 aims to address the problem by calling for the development of designated children's hospital networks for children with medical complexity and aims to coordinate care among home, primary, ambulatory, acute and post-acute care/providers.
Jeff Myers, president of Medicaid Health Plans of America, said the legislation is bad policy that would cost taxpayers a lot of money. MHPA expressed its discontent with the bill, saying it would create a carve out in a fee-for-service structure that does not have adequate cost and quality controls.
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Energy & Commerce Committee
The national Medicaid improper payment rates for FY2015 are 10.59 percent for fee-for-service and 0.12 percent for Medicaid managed care.
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Kansas Health Institute
A former Kansas Medicaid director has authored a paper proposing ways to streamline Medicaid programs that he says are too fragmented in many states. Andy Allison, who also previously ran the Arkansas Medicaid program, presented the paper last month at a conference of state Medicaid directors.
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The Indianapolis Star
Indiana Gov. Mike Pence says the Obama administration has chosen a biased source to evaluate the state's alternative Medicaid program. In a letter sent Thursday to Health and Human Services Secretary Sylvia Burwell, Pence asks that the federal review be dropped as the state has contracted with an independent evaluator.
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Complex Clinical Reviews. Dependent Audits. And More.
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NPR
One of the first issues Matt Bevin will confront as the new governor of Kentucky is how far to take his pledge to roll back parts of the state's Medicaid expansion under the Affordable Care Act. The effects could be particularly dramatic in places such as Jackson County, one of the poorest counties in Kentucky. Half of the population of 13,000 is on Medicaid, the state and national program that provides healthcare insurance to low-income Americans. According to Census figures, 34 percent of Jackson County's residents live below the poverty line, compared to almost 19 percent of the population statewide.
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The Associated Press via Chicago Tribune
Kentucky Republican Gov.-elect Matt Bevin has chosen a Louisville attorney to lead his efforts to dismantle and replace the healthcare system put in place by his Democratic predecessor. Vickie Yates Brown Glisson will be the next secretary of the Health and Family Services Cabinet, Bevin announced Thursday. The agency operates the state's Medicaid program, which outgoing Democratic Gov. Steve Beshear greatly expanded under the federal Affordable Care Act.
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The Washington Post
Virginia's hospitals reversed their position this week on a controversial bed tax, potentially giving Gov. Terry McAuliffe a path to the top priority of his administration — Medicaid expansion. Members of the Virginia Hospital and Healthcare Association have traditionally resisted efforts to pay additional fees, but a tax on beds — also known as a provider assessment — would draw down a federal match. Together, the money could be used to expand Medicaid under the Affordable Care Act and without state funding.
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The Associated Press via Chicago Tribune
Utah Gov. Gary Herbert will not propose another Medicaid plan and instead will wait to see what, if anything, legislators come up with, his office said Thursday. Lawmakers earlier this year rejected two plans backed by the Republican governor. They intend to tackle the issue again in 2016 after debating it for more than three years and failing to agree.
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Deseret News
House Speaker Greg Hughes outlined more details about the newest Medicaid expansion plan being sought by GOP legislators, explaining that it will focus on the "most vulnerable" Utahns and that lawmakers will look to hospitals — and possibly other Utahns — to fund it.
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With an emphasis on innovative initiatives and data-driven solutions, DentaQuest is partnering with health plans to fundamentally change the way oral health is delivered in America. Integrating preventive oral health programs not only offers members a wider portfolio of choice - it is also a proven driver of cost control.
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Modern Healthcare
The CMS has finalized a rule to permanently retain funding that helps states upgrade the technology they need to allow their residents to enroll in Medicaid. Nearly 25 percent of states are looking to modernize their aging, often very state-specific technology systems, many of which have experienced the stress of Medicaid expansion under the Affordable Care Act.
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The Hill
More than 8 in 10 family doctors in the U.S. say they are not adequately prepared to care for severely mentally ill patients, according to a survey released Monday by the Commonwealth Fund. Just 16 percent of U.S. doctors said their offices had the capacity to care for those with serious mental illnesses, the lowest of any other developed country besides Sweden, according to the annual international study.
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MHPA
"What If We Knew The Future: A Prevention Approach to Safer Use of Prescription Opioids," an RxAnte webinar presented by Michael Ross, M.D., chief medical officer, and Amie Joyce, MPH, vice president of account management at RxAnte, took place on Nov. 18.
Download the presentation.
MHPA
Click on the session names to download select presentations. You may also access them through the online version of the mhpa2015 conference app — just click on the schedule icon for the sessions. The presentations are listed in the documents section.
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