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House to vote on Medicaid funding cuts, ACA repeal measures to avert sequester    Share    Share on FacebookTwitterShare on LinkedinE-mail article
House Republicans have scheduled a floor vote on legislation to avoid the fiscal cliff by cutting back Medicaid funding and repealing several health reform law measures — including defunding the insurance exchanges, defunding the prevention fund, taking back insurance subsidy overpayments, rescinding unobligated balances for the CO-OP program and lifting constraints on Medicaid called maintenance of effort. The bill also would cut Disproportionate Hospital Share funding, limit states ability to tax providers, cut federal pay to states for Medicaid and repeal bonus payments to states for Medicaid and CHIP enrollment. More

Advocates: Shield Medicaid from 'fiscal cliff' cuts
The Hill    Share    Share on FacebookTwitterShare on LinkedinE-mail article
A coalition of health and social justice groups is urging Congress to not allow Medicaid cuts in a deal to reduce the deficit and avoid the so-called "fiscal cliff." The 165 national groups sent a letter to lawmakers asking them to shield Medicaid, which provides health insurance to low-income people, including millions of children. Liberal lawmakers have made the same case in recent weeks. More

States scramble to cover Medicaid costs, some face overruns
Reuters    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Rising healthcare costs are pushing up the amounts states must spend on the Medicaid insurance program for the poor, sending some scrambling to find funds, according to a report released by the National Conference of State Legislatures. The report found that spending on Medicaid and other public healthcare programs currently is over budget in 10 states, compared to six states at the same point last year. In contrast, only five states report that education, which has traditionally taken up most spending, is over budget. More

23 states receive bonuses for enrolling children in health coverage
CMS News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The Centers for Medicare & Medicaid Services has awarded performance bonuses to 23 states for improving access to children's health coverage and successfully enrolling eligible children, CMS Acting Administrator Marilyn Tavenner announced. The performance bonuses are authorized under the Children's Health Insurance Program Reauthorization Act of 2009, one of the first pieces of legislation signed into law by President Barack Obama. More

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New report embraces Medi-Cal expansion
Los Angeles Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Gov. Jerry Brown's top healthcare official appeared to embrace an expansion of the state's Medi-Cal system as California moves to implement the healthcare overhaul signed by President Barack Obama in 2010. A new report from the Let's Get Healthy Taskforce, co-chaired by Diana Dooley, Brown's secretary for Health and Human Services, says "expansion of coverage through the Health Benefit Exchange and Medi-Cal will be an important step" that can particularly help African-American and Latino populations, who together comprise nearly half of the state's estimated 8 million residents without health coverage. More

Health insurance executive: 'Incorporating all the new regulations' will be challenge in 2013
Kaiser Health News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As chairman and CEO, Bruce Bodaken led Blue Shield of California to become one of the fastest growing health plans in the state — currently it has more than 3 million members. But after 12 years of service, the 61-year-old recently announced his plans to retire at the end of 2012. More

O'Malley joins effort to dissuade lawmakers from cutting Medicaid provider taxes    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Maryland Gov. Martin O'Malley is urging the president and congressional leaders to maintain the current threshold for Medicaid provider taxes that most states use to help fund their programs but is a tool that has long been eyed for change by both parties as a way to cut federal Medicaid spending. As fiscal negotiations heat up, O'Malley says maintaining the provider tax threshold is crucial to ensuring adequate compensation for nursing homes, which along with other health care groups also are lobbying lawmakers to avoid cutting the threshold. More

Report: Medicaid, other costs threaten New York state and local budgets
Reuters    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Costs for Medicaid, education and employee retirement benefits are threatening to overwhelm state and local government budgets in New York, a report by a national task force has found. "Healthcare costs and retirement costs are rising a lot faster than revenue. And unless one sees something on the horizon that will change that essential dynamic, then that means we're not on a sustainable path," said former New York Lieutenant Governor Richard Ravitch in an interview. More

Opinion: To prevent massacres like Newtown's, expand Medicaid
Bloomberg Businessweek    Share    Share on FacebookTwitterShare on LinkedinE-mail article
It's too soon to know what drove Adam Lanza to massacre 26 children and adults at Sandy Hook Elementary School in Newtown, Conn. But early signs suggest that serious mental illness played a role. If so, that — alongside another arsenal — would be a thread connecting the atrocity with the recent mass killings in Aurora, Colo.; Phoenix; and Blacksburg, Va. Since then, a wave of outrage and a renewed desire for gun control laws have swept the country, including Washington, D.C. More

PwC sees risk, opportunity in newly insured
Healthcare Payer News    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Researchers from global consulting company PwC say providers and insurers have ample opportunities, but also significant challenges in serving the roughly 30 million people who will become newly insured through Medicaid expansion and via the health insurance exchanges in the coming years. But a key to serving the population is to have an understanding of who the newly insured will be, their employment status and their health status, as well as how well they understand and are able to navigate the healthcare system, said PwC researchers in webinar titled, "Health reform re-elected: The Sprint is on in 2013." More

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Cognosante appoints Dennis A. Dworman to lead company's health transformation business
Marketwire via Pharmacy Choice    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Cognosante, a provider of IT services to healthcare organizations, has appointed Dennis A. Dworman as vice president and general manager of the company's Health Transformation Solutions business. Dworman, who joined Cognosante in November, has more than three decades of experience in the health and insurance IT in the private and public sectors. Prior to joining Cognosante, Dworman served in senior roles at HP for more than 29 years. More

New Keeping You Healthy video: CentAccount by Centene
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The CentAccount program promotes personal healthcare responsibility in Centene's membership by offering financial incentives. A consumer-driven incentive program designed to strengthen the relationships between Centene health plan members and their medical home, it increases the utilization of preventive services, reduces reliance on the ER, and increases continuity of care, resulting in better health outcomes for members. Rewarding members for targeted healthy behaviors increases the likelihood that such behaviors will be continued through positive reinforcement. Centene Senior VP Aparna Aburri discusses this innovative program with the MHPA Center for Best Practices. More

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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

Free webinar: 'Medicaid Managed Care Program Management: The Next Generation' | 11a.m. EST Jan. 16
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
There has been "skepticism" about managed care in the policy process and in the public at large. Medicaid Health Plans need to help policy makers understand the value of MCOs and be able to design delivery systems where MCOs can be innovative and valued leaders in delivery and management of Medicaid services. The webinar will cover what MCOs need to do to be ready for the next generation of Medicaid managed care, emphasizing the need to use value-based purchasing to drive for improvement and achievement. Presented by Anne Jacobs, managing director, Navigant Consulting. More

Insights webinar: 'Proper Capitation Rates for Hemophilia Patients' | 11 a.m. EST Jan. 23
Baxter    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The webinar will cover the uniqueness of the hemophilia disease state and the difficulties to apply an appropriate capitation for this disease. Also on the agenda: considerations for managed healthcare plans to ensure that states understand this unique disease state and that adequate reimbursement is received for hemophilia patients to receive the needed care. For details, click here. More

Free webinar: 'The Fiscal Cliff, ACA, and Medicaid Managed Care' | 2 p.m. EST Jan. 29
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In 2013, Medicaid managed care will be affected in a variety of ways — from the shakeout of the 2012 elections and the fiscal cliff negotiations to the continued implementation of the Affordable Care Act. This presentation will address the current status and implications of many outstanding state and federal decisions affecting Medicaid managed care, including: state Medicaid expansion, Health Insurance Exchange decisions and level of integration, and CMS regulatory guidance on Medicaid reforms. Presentations by Jim Hardy and Sarah Wiley of Deloitte Consulting LLP. More

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Watch, listen to the Sept. 18 webinar, 'Importance of Coordinated Care in the Management of Members with Hemophilia,' free on MHPA's website
MHPA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The presentation on coordinating care in hemophilia and how to improve outcomes and reduce costs by Jeff Januska, PharmD, pharmacy director at CenCal Health and Dr. Steven Pipe, associate professor, Department of Pediatrics and the Department of Pathology, University of Michigan, now is available on MHPA's website.

Free webinar: 'Optimizing Pharmaceutical Care and Measuring Outcomes in a Collaborative Drug Therapy Management Program' | 2 p.m. EST Jan. 30
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. More

Free webinar: 'Getting to know the 30 million newly insured: New patients equals new challenges' | 2 p.m. EST Feb. 6
PwC    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the wake of the Supreme Court's ruling to uphold the Affordable Care Act, approximately 30 million uninsured Americans under age 65 stand to gain coverage under the law. States are making two crucial decisions: Whether to expand Medicaid coverage, and which type of health insurance marketplace to create — state-run, state-federal run, or federally facilitated. As decisions are made and plans put in place, one thing is certain: When the exchange population is combined with the new Medicaid beneficiaries, the result will be a distinctly different customer base for the health sector, bringing with it many new challenges and opportunities. 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, click here.

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