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Bloomberg
Public and private sector decision makers are turning their attention to ways to trim Medicaid's pharmaceutical costs, including shaking up how the program covers drugs. In the private sector, managed care plans also want to take on Medicaid drug spending — but with a totally different approach. Medicaid Health Plans of America is finalizing a policy proposal in the coming weeks to overhaul the Medicaid drug rebate program and essentially create a Medicare Advantage-style prescription drug plan within Medicaid managed care.
Jeff Myers, president and CEO of MHPA, told Bloomberg Law the proposal would give rebate savings to plans (rather than states), which now run the benefits for around three-quarters of Medicaid enrollees. "By allowing plans to use the same tools they use in commercial or other segments of healthcare, you end up getting better results at lower cost," Myers said.
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Kaiser Health News
The nation's most influential science advisory group was set to tell Congress on Tuesday that the U.S. pharmaceutical market is not sustainable and needs to change. "Drugs that are not affordable are of little value and drugs that do not exist are of no value," said Norman Augustine, chair of the National Academies of Sciences, Engineering and Medicine's committee on drug pricing and former CEO of Lockheed Martin Corp.
The report, "Making Medicines Affordable: A National Imperative," identifies eight steps to cut drug prices. It also provides a list of specific "implementation actions" for various federal agencies, including Congress, the Federal Trade Commission and the U.S. Departments of Justice and Health and Human Services.
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CBS News
Pharmaceutical companies on Friday sued to block a new California law that would require them to give advance notice before big price increases. The law was approved this year in response to consumer outrage over a rise in drug spending and high costs for some prescription treatments, including new hepatitis C medications and EpiPens to control allergic reactions.
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The Hill
A bipartisan group of governors is urging Congress to act quickly to reauthorize funding for the Children's Health Insurance Program. In a letter led by Ohio Gov. John Kasich and Colorado Gov. John Hickenlooper, the governors said their states are running out of money, and urged lawmakers to find a bipartisan solution.
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USA Today
Like father, like son — Jimmy Kimmel and his son, Billy, both charmed Kimmel's viewers Monday night. Billy arrived in April with a serious congenital heart defect that required surgery immediately after his birth to repair a blocked pulmonary valve. Last Monday, he had a successful second surgery and Kimmel took a small hiatus from his late-night show.
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The Hill
Nearly 100 House Democrats are urging congressional leaders to pass a bipartisan extension of the Children’s Health Insurance Program (CHIP). In a letter sent Friday, 99 House Democrats urged leaders of the House and Senate to reject the House-passed CHIP extension and instead work on a bipartisan solution. The letter dismissed the House effort as a "highly partisan bill" that "seeks to provide healthcare for some at the expense of others, undermining CHIP's mission."
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ABC News
Virginia is now the latest state to start informing families enrolled in the Children's Health Insurance Program (CHIP) that their coverage will be terminated unless Congress reauthorizes the popular health insurance program soon. On Tuesday, the Virginia Department of Medical Assistance Services will be sending out a letter to 1,114 pregnant women and parents of the 68,495 Virginia children currently enrolled in FAMIS, the name for the state’s children’s insurance program.
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Georgia Health News
Georgia could run out of federal funding for its PeachCare for Kids program as early as next month, state officials say. Federal funding for the Children's Health Insurance Program (which includes PeachCare) expired Sept. 30, putting the future of the popular insurance program in limbo. CHIP covers almost 9 million children nationally. Through PeachCare, it covers roughly about 130,000 children in Georgia.
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The Arizona Republic
It took media inquiries in late October to figure out Arizona Gov. Doug Ducey's position on whether Congress should renew funding for a children's health-insurance program. The short answer: He supports kids. But a records request by The Arizona Republic filed before talking to the governor found Ducey wasn't doing much outreach to the folks who could make a difference — at least not until reporters started asking about it.
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The Dallas Morning News
Three-year-old Zachary Ogletree doesn't speak. But after two years of therapy, he’s learned other ways to communicate with his family. Zachary, who was diagnosed with severe autism as a baby, is one of 8,000 Denton County kids enrolled in the Children's Health Insurance Program. It covers 9 million children, including over 400,000 in Texas, whose parents make less than 200 percent of the federal poverty level but too much to qualify for Medicaid.
Zachary's mother depends on CHIP to pay for the 20 hours a week he spends in therapy. He’s learning to communicate beyond sign language and picture cards and to master basic life skills such as holding a fork and spoon. Without CHIP, each session would cost $410. Ogletree said regular therapy is crucial for his development. Parents like the Ogletrees have been on edge about their children’s health care since Congress allowed CHIP funding to expire Sept. 30. The House passed a bill in early November that funds the program for five years, but the Senate has yet to act.
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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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The Associated Press via San Francisco Chronicle
A study released Monday finds roughly half of those enrolled in Michigan's Medicaid program since its expansion have jobs and another quarter who are unemployed are likely to be in poor health, raising concerns about potential work requirements for enrollees.
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Portland Press Herald
Maine Gov. Paul LePage repeated his demands for funding a voter-approved Medicaid expansion in a forceful letter to legislative leaders Monday, emphasizing that the estimated $60 million a year cost be paid for without any tax increases.
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