The Shumlin administration says at least one in eight adults actively using an income-based Medicaid program no longer qualify for state-sponsored health insurance. It's the first empirical estimate the administration has given regarding how many people shouldn't be enrolled in a Medicaid program since the state expanded access in 2014. The income-based program had 78,577 people enrolled as of Oct. 1, according to data from the Department of Vermont Health Access.
This fact sheet provides a look at the Louisiana’s planning efforts to implement Medicaid expansion. Louisiana’s planning efforts include:
The President of the Massachusetts Senior Care Association writes in The Boston Globe that nearly 70% of nursing home residents rely on MassHealth to pay for their care, yet Medicaid reimbursement rates have remained nearly flat since 2008. The best way to ensure improved quality, he writes, is to provide adequate Medicaid funding for nursing homes, and that budget gap deserves more coverage, as many local for-profit and not-for-profit nursing homes are struggling to stay afloat.
This analysis of Medicaid managed care plan changes by Families USA examines updated standards affecting the enrollment process. It suggests the changes, including how information is provided to individuals, significantly improve enrollment and navigation of the Medicaid managed care system. It adds that the updated requirements provide an opportunity for advocates and enrollment assistants to work with their states to secure meaningful investments in outreach, enrollment, and consumer education.
The U.S. approved Louisiana to be the first state to allow food stamp applicants additional enrollment in Medicaid. Those signing up or re-enrolling for SNAP benefits will have information checked for Medicaid eligibility and automatic enrollment. The decision features increased income limits set for the health care program. Residents with a household income below 138% of the federal poverty level will be eligible to obtain health coverage through the state’s Medicaid program.
WellCare Health Plans completed the acquisition of certain assets of Advicare Corp.'s Medicaid business, including the transfer of approximately 30,000 members to WellCare of South Carolina. The financial terms of the transaction were not disclosed. As part of the deal, Regional HealthPlus joined WellCare's provider network in the state, which provides services through three member hospitals: Spartanburg Medical Center, Pelham Medical Center and Union Medical Center, and more than 500 physicians and allied health professionals.
The Texas Legislature suggests a potential change to the states' Medicaid program that may restrict access to epilepsy care by allowing insurers instead of doctors to choose what medications managed care plans would cover. Access to epilepsy medications can lead to greater seizure control and less hospitalizations while savings from restrictive formularies often lead to greater spending on medical complications, according to research.
The governor of Iowa approved plans for increased accountability for the state's newly-privatized Medicaid health care program, while taking final action on 30 bills and the state's $7.35 billion general fund budget for the upcoming fiscal year. "By signing into law every Medicaid modernization oversight item, Iowa’s Medicaid program will be one of the most transparent, outcome-focused, and accountable programs in the country," Gov. Terry Branstad wrote in his letter to the Secretary of State's office.
The Senate Ways and Means Committee included a proposal in its version of the state budget to spend $1 million to create a common application for MassHealth and SNAP (Supplemental Nutrition Assistance Program) benefits by July 1, 2017, and to incorporate subsidized housing benefits a year later. The budget would appropriate $1.9 million for caseworkers to help with enrollment in public benefits programs.
Centene's specialty solutions division, Envolve, was selected by Maryland Care, Maryland Physicians Care MCO to provide health plan management services for its managed Medicaid operations effective July 1, 2017. Maryland Physicians Care is a locally based managed care organization that administers health care services to over 190,000 Marylanders enrolled in the Maryland HealthChoice program. Envolve will provide management services for MPC's over $900 million revenues and associated medical expenses, in turn creating 200 jobs.
Aetna filed an application to participate as a Medicaid managed care organization in Maryland, Aetna Better Health of Maryland. The application is pending review and approval by the state’s Department of Health and Mental Hygiene.
Three-quarters of respondents in a Commonwealth Fund poll said they are satisfied with their health plans, with 71% of people enrolled in marketplace or Medicaid plans saying their health care plans were good, very good or excellent. The high satisfaction among plans comes after many experts warned that Obamacare customers could have a tougher time finding doctors in their area without wait times.
At the Oral Health Integration Project launch, lawmakers, staff and advocates learned about the efforts to integrate oral health with medical care in Massachusetts. An initiative of Health Care For All's Oral Health Advocacy Task Force, the project is based on the idea that incorporating oral health in ACOs and more closely aligning medical and dental care can save money and improve a patient's overall well-being. The project's ultimate goal is to see oral health and dental services included as a requirement in state standards for Medicaid and commercial ACOs.
New Jersey delayed their switch to a Medicaid fee-for-service reimbursement system for mental health organizations, a sign the state is listening to the needs of organizations providing behavioral health to some of the state's poorest residents, according to the CEO of NewBridge, which treats approximately 8,500 patients. The CEO of the New Jersey Association of Mental Health and Addiction Agencies agrees it is a positive move.
According to an issue brief from The Commonwealth Fund changes in benefits and service delivery have been built into several Medicaid expansion demonstrations which seek to alter financial responsibility rules for low-income beneficiaries.