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As 2019 comes to a close, we would like to wish all members, partners and other industry professionals a safe and happy holiday season. As we reflect on the past year for the industry, throughout the holiday season, we would like to provide the readers a look at some of the most accessed articles from the year. Our regular publication will resume Thursday, Jan. 2.
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Winston-Salem Journal
From Aug. 27: Expanding Medicaid coverage in the state would provide a $335.2 million annual revenue boost to hospitals in the Triad and Northwest North Carolina, according to a report from a left-leaning advocacy group. Authors of the N.C. Budget & Tax Center report, titled "Strong medicine," said Medicaid coverage expansion for between 450,000 and 650,000 residents "is not just a moral imperative."
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The Advocate
From Aug. 29: Louisiana's health department was blocked from moving forward with a new round of multibillion-dollar Medicaid contracts while protests from losing bidders move forward, over objections from health officials who said such a delay could disrupt health care for more than a million people.
The state procurement office, which is considering protests from two losing bidders for the new round of Medicaid managed care contracts, decided late Wednesday the new contracts will be put on hold until it sorts out the challenges.
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Piatt County Journal-American
From June 20: Illinois lawmakers took several steps this legislative session to increase efficiencies in the state's Medicaid managed care system, which has been widely panned by high-volume Medicaid providers since its inception in 2011.
The negotiations included insurers, health care providers, government regulators and lawmakers, and all sides expressed optimism about a bill which was approved unanimously in both chambers and awaits action from Gov. J.B. Pritzker.
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Health Affairs
From May 30: On May 24, the Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) issued a new proposed rule to dramatically revise the agency's prior interpretation of Section 1557 of the Affordable Care Act (ACA), the ACA's primary anti-discrimination provision. The latest proposal from OCR rewrites an Obama-era regulation that was issued in 2016 that has been the source of ongoing litigation.
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- PMPM Increase Per Conversion
- Millions In New Revenue, Risk Free
- Tax-Free Monthly Income for Members
- Directly Impacts SDoH
- Healthier Members, Healthier Bottom Line
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First Report Managed Care
From March 12: Lacking stable housing, access to nutritious food, transportation to medical appointments, or just plain isolation or loneliness are factors that often set people up for poor health conditions. Whether it is not adhering to prescribed medications or relying on emergency rooms to manage chronic conditions, lack of access to the basic social needs of living makes it difficult and sometimes impossible for people to manage chronic illnesses, much less prevent them. The impact on individual health and increase in health care costs are the inevitable consequences of ignoring these nonclinical or social determinants of health.
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The Hill
From Aug. 15: Thirteen states led by Washington Attorney General Robert Ferguson (D) filed a lawsuit Wednesday over the Trump administration's new "public charge" rule.
The states are suing the Department of Homeland Security over the new rule that expands the government's ability to deny entry or green cards to legal immigrants based on their use of public services like food stamps and Medicaid.
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MHPA
From June 11: The Medicaid Health Plans of America (MHPA) and HealthTech4Medicaid (HT4M) has announced an exclusive partnership to accelerate the adoption of innovative technologies that enhance access to comprehensive, quality and cost-effective care for Medicaid enrollees.
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Chicago Tribune
From March 12: The Trump administration is proposing a sharp slowdown in Medicaid spending as part of a broad reduction in the government's investment in health care, calling for the public insurance for the poor to morph from an entitlement program to state block grants even after a Republican Congress rejected the idea.
The budget released by the White House on Monday also calls for a sizable reduction for Medicare, the federal insurance for older Americans that President Donald Trump has consistently vowed to protect. Most of the trims relate to changing payments to doctors and hospitals, and renewed efforts to ferret out fraud and wasteful billing — oft-cited targets by presidents of both parties.
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A commercial Medicaid plan in Nevada leveraged MCG solutions in its community health program and reduced ER visits by 20% and hospital readmissions by 30%. Click here to learn more about how MCG can support improved member outcomes and cost control.
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CNBC
From July 11: The Trump administration has withdrawn its proposal to eliminate rebates from government drug plans, a key component of the president's blueprint to lower prescription drug prices, a White House spokesman confirmed.
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TIME
From March 19: A federal judge heard legal challenges Thursday to a Trump Administration policy that allows states to implement work requirements in order for residents to qualify for Medicaid.
U.S. District Judge James Boasberg heard oral arguments in two separate cases challenging plans in Arkansas and Kentucky that require Medicaid enrollees to either have a job or meet "community engagement" requirements to receive their health benefits.
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