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Federal judge halts Calif. plan to cut Medicaid payments for medical transportation

A federal judge issued a preliminary injunction Wednesday to halt a 10% Medi-Cal provider reimbursement cut to medical transportation services. It was the third time the state has lost in court on this issue. State officials said the state will appeal.

13 Jan 2012

Roundup: SEC pursuing managed care execs in Fla.; Minn. emergency medical assistance program ends; Ore. lawmakers consider reforming medical liability laws

The U.S. Securities and Exchange Commission is going after some former WellCare Health Plans executives in federal civil court regarding their alleged actions concerning WellCare's managed-care contracts for behavioral health in the state of Florida. In 2010, WellCare agreed to pay about $334 million to settle legal actions with various entities related to an alleged $40 million, five-year pattern of fraud in those contracts without admitting or denying any wrongdoing.

12 Jan 2012

Medicaid cuts have patient advocates, states considering their options

Stateline reports that new federal rules that limit state options for cutting Medicaid have moved health care providers and patient advocates nearer to testing the legality of the cuts in court. In the meantime, Medicaid cuts and restructuring remain in play in dwindling state budgets as Oregon, Ohio and Kansas look for ways to save money in the state-federal health care program for the poor.

12 Jan 2012

JHM, Healthways partner for innovative weight-loss program

Building on the success of recent Hopkins research showing obese participants were able to lose significant weight and keep it off for two years using telephone coaching and a specially designed website, Johns Hopkins Medicine is collaborating with Healthways to help bring the innovative weight-loss program to many more who could benefit from it.

9 Jan 2012

State governments trying new ways to cope with Medicaid costs

Despite the improving budget news, states still have tough choices to make as they continue struggling to keep up with increased demand for services - particularly for Medicaid, the state-federal health insurance program for the poor.

9 Jan 2012

CCPR completes new specialty behavioral health provider network

Comprehensive Care Corporation, which provides behavioral health, substance abuse and at-risk psychotropic pharmacy management services for managed care companies throughout the U.S. and Puerto Rico, is pleased to announce that CompCare de Puerto Rico (CCPR) has completed its build out of a fully contracted and credentialed specialty behavioral health provider network to better serve its clients and insured Medicare and dual-eligible members across the Island of Puerto Rico.

9 Jan 2012

Brown unveils frugal Calif. budget: Cuts to in-home services, plans for Medi-Cal managed care

Governor Jerry Brown unveiled his proposed state budget today for the next fiscal year, and the event had a familiar look. Brown proposed big cuts to welfare and other safety net programs - and that's assuming voters approve tax hikes slated for the November ballot. ... there is a very small fee increase in this budget that helps fund health care for kids in low-income families.

7 Jan 2012

First Edition: January 3, 2012

In today's headlines, reports that New York seniors are experiencing reduced prescription coverage and more California patients are being added to the health insurance rolls.

3 Jan 2012

Healthcare scheduling exchange solution improves preventive services for managed care organizations

It's well known that many of America's most serious health problems—and their associated cost—can be reduced or eliminated through early detection. Yet after years of effort, more than 95% of every health dollar in the United States still goes to treatment rather than prevention, according to a publication of the Centers for Disease Control. Where is the disconnect?

29 Dec 2011

Romney, Obama on the attack

GOP presidential hopeful Mitt Romney used a TV appearance to take on rival candidate Newt Gingrich regarding a range of policy and political issues. Meanwhile, aides to President Barack Obama blasted Romney for shying away from the similarities between Massachusetts' health reforms and the 2010 health law. Negative ads also flood the Iowa airwaves.

22 Dec 2011

Kansas officials revise plans for reorganizing social services; Wis. study finds problems in Medicaid oversight

Kansas lawmakers grilled state officials about Gov. Sam Brownback's plans to streamline the state bureaucracy. In Wis., the legislative analysis found that private contractors are taking on an increasing share of the work of administering Medicaid programs.

22 Dec 2011

Roundup: Health coverage drops again in Fla.; Calif. wrestles with issue of violence in mental hospitals

Enrollment in commercial health insurance is continuing to decline in Florida. An annual market report adopted Tuesday by the Florida Health Care Insurance Advisory Board shows enrollment dropped by 4.3 percent during 2010. That's the fifth straight year it's gone down.

22 Dec 2011

Viewpoints: If not the health law, then what?; Shifting Medicare costs isn't enough

When President Barack Obama's health care reform was making its way through Congress, Republicans and other opponents registered plenty of criticisms: It was too generous, too inflexible and too centralized. But such concerns were brushed aside in the push to get a bill passed. Today, it's harder to ignore those flaws. Implementation of the program has brought tougher challenges than the administration led Americans to expect. So it has been obliged to make some major concessions to reality.

21 Dec 2011

BAHN to participate as Pioneer Accountable Care Organization

Montefiore Medical Center announced today that its Bronx Accountable Healthcare Network (BAHN), has been selected to participate as a Pioneer Accountable Care Organization (ACO), a transformative new initiative sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center.

20 Dec 2011

IHA, U-M to participate in Pioneer ACO model

The University of Michigan Health System will participate in the Pioneer Accountable Care Organization (ACO) model, in partnership with IHA Health Services Corporation, an Ann Arbor, Mich.-based multi-specialty group practice.

20 Dec 2011

A Texas-sized Medicaid deal

KUHF's Carrie Feibel, reporting as part of a partnership with Kaiser Health News, NPR and KUHF, writes: "The deal that federal regulators struck with Texas this week to expand managed care coverage for the poor allows both Gov. Rick Perry, a Republican presidential contender, and a Democratic White House to claim victory for their very different healthcare agendas."

17 Dec 2011

State roundup: Florida awaits Medicaid waiver news

Now, nurses regularly do everything from give insulin shots to empty urinary catheter bags. At the same time, state budget cuts mean the number of school nurses in California is shrinking. As a result, nurses say, they are responsible for more students every year and are largely consumed with keeping "medically fragile" children in class.

16 Dec 2011

Medicaid spending claims increasingly larger share of state budgets

According to the National Association of State Budget Officers, Medicaid spending by the states has steadily gone up during the last three years, and this trend is likely to continue. Media outlets also report on Medicaid developments in Texas, Florida, New York and California.

15 Dec 2011

First Edition: December 14, 2011

In today's headlines, reports about progress -- or lack thereof -- as the House and Senate work to come to terms on the year's must-pass legislation.

14 Dec 2011

Kansas finds prison clinics help control costs

The Kansas Health Institute News offers a series of stories about caring for the health needs of state prisoners.

14 Dec 2011

Managed Care News and Research

Federal judge halts Calif. plan to cut Medicaid payments for medical transportation

Roundup: SEC pursuing managed care execs in Fla.; Minn. emergency medical assistance program ends; Ore. lawmakers consider reforming medical liability laws

Medicaid cuts have patient advocates, states considering their options

JHM, Healthways partner for innovative weight-loss program

State governments trying new ways to cope with Medicaid costs

CCPR completes new specialty behavioral health provider network

Brown unveils frugal Calif. budget: Cuts to in-home services, plans for Medi-Cal managed care

First Edition: January 3, 2012

Healthcare scheduling exchange solution improves preventive services for managed care organizations

Romney, Obama on the attack

Kansas officials revise plans for reorganizing social services; Wis. study finds problems in Medicaid oversight

Roundup: Health coverage drops again in Fla.; Calif. wrestles with issue of violence in mental hospitals

Viewpoints: If not the health law, then what?; Shifting Medicare costs isn't enough

BAHN to participate as Pioneer Accountable Care Organization

IHA, U-M to participate in Pioneer ACO model

A Texas-sized Medicaid deal

State roundup: Florida awaits Medicaid waiver news

Medicaid spending claims increasingly larger share of state budgets

First Edition: December 14, 2011

Kansas finds prison clinics help control costs

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