Tag: State News

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New Hampshire Selects Conduent to Provide Medicaid Beneficiaries with Improved Access to Healthcare Information

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Conduent wins new contract expansion in NH to facilitate more member access to their own data.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Company’s solution to help the state coordinate medical services while empowering patients to make more informed healthcare decisions
 

Contract enables New Hampshire to comply with a new federal regulation on Interoperability and Patient Access

FLORHAM PARK, N.J., June 02, 2021 (GLOBE NEWSWIRE) — Conduent Incorporated (Nasdaq: CNDT), a business process services and solutions company, today announced a contract from the New Hampshire Department of Health and Human Services (NH DHHS) to provide Medicaid beneficiaries in the state with improved, secure access to their personal health information, enabling them to make more informed healthcare decisions. The company’s solution will improve how information is exchanged between payers, providers and patients, as well as support efficient care coordination.

Through a web portal developed by Conduent, beneficiaries will have the ability to locate healthcare and pharmacy providers in their network, as well as seamlessly and securely review their information and share it with various providers. The contract also brings New Hampshire into compliance with the Interoperability and Patient Access Final Rule, a federal regulation put into effect by the Centers for Medicare and Medicaid Services. The rule, finalized in 2020, is expected to have a major impact nationally on the future of healthcare, making health information more easily available to patients and allowing them to safely share their data.

The contract marks an expansion of Conduent’s support for NH DHHS, a client since 2013. The company currently provides the department with claims processing and provider services for New Hampshire’s Medicaid program, as well as management of its Medicaid Management Information System (MMIS), which processes more than 15 million claims annually.

“We’re proud to continue supporting New Hampshire with innovative and efficient solutions for its Medicaid program,” said Pat Costa, President, Government Healthcare Solutions at Conduent. “Our team is dedicated to helping both patients and healthcare professionals in the state access critical health information that improves patient outcomes.”

With 50 years of experience in the government health and social services industry, Conduent supports more than 41 million customers annually with various government health programs and other eligibility services. For Medicaid, Conduent supports systems in 23 states, Puerto Rico and Washington, D.C., and it has facilitated federal MMIS certifications in 14 states.

About Conduent
Conduent delivers mission-critical services and solutions on behalf of businesses and governments – creating exceptional outcomes for its clients and the millions of people who count on them. Through our dedicated people, process and technology, Conduent solutions and services automate workflows, improve efficiencies, reduce costs and enable revenue growth. It’s why most Fortune 100 companies and over 500 government entities depend on Conduent every day to manage their essential interactions and move their operations forward.

Conduent’s differentiated services and solutions improve experiences for millions of people every day, including two-thirds of all insured patients in the U.S., 10 million employees who use its HR Services, and nearly 18 million benefit recipients. Conduent’s solutions deliver exceptional outcomes for its clients, including $17 billion in savings from medical bill review, up to 40% efficiency increase in HR operations, up to 27% reduction in government benefits costs, up to 40% improvement in finance, accounting and procurement expense, and improved customer service interaction times by up to 20% with higher end-user satisfaction. Learn more at www.conduent.com.

Media Contact:
Neil Franz, Conduent, +1-301-820-4324, neil.franz@conduent.com

Investor Relations Contacts:
Giles Goodburn, Conduent, +1-203-216-3546, giles.goodburn@conduent.com

Note: To receive RSS news feeds, visit www.news.conduent.com. For open commentary, industry perspectives and views, visit http://twitter.com/Conduent, http://www.linkedin.com/company/conduent or http://www.facebook.com/Conduent.

Conduent is a trademark of Conduent Incorporated in the United States and/or other countries.

Clipped from: https://finance.yahoo.com/news/hampshire-selects-conduent-medicaid-beneficiaries-124500854.html

 
 

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Montana Medicaid Expansion Enrollment Hits Record During Pandemic

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The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

A record number of Montanans are enrolled in the state’s expanded health coverage program for low-income adults. More than 9 percent of the state’s population is enrolled in the program.

Enrollment in Montana’s Medicaid expansion climbed to record levels this spring after rising since early 2020. Nearly 99,000 Montanans were enrolled as of the latest data in April.

The last time enrollment peaked was in the fall of 2018 with 96,656 Montanans enrolled. 

 
 

Representative Ed Buttrey from Great Falls is the main architect of the legislation that established and continued expanded Medicaid in Montana. The Republican says the economic slump during the pandemic has spurred enrollment numbers.  

“The program is responding exactly as it should,” Buttrey says. “When we get into hard times, people get into hard times, this is a safety net measure to make sure that folks are not neglecting their health care and that providers are getting paid for the services they provide.”

According to state health department data, since the start of 2020, Sheridan County saw the greatest growth in Medicaid expansion enrollment with a 40% increase. Counties across the state saw on average a 20% growth. 

Chuck Council, a spokesperson for the state health department, says the state stopped disenrolling people from Medicaid programs during the public health emergency and that’s led to the increase. 

Council says the health department will resume taking people off of the programs if they’re no longer eligible once Montana’s public health emergency ends.

 
 

Clipped from: https://www.mtpr.org/post/montana-medicaid-expansion-enrollment-hits-record-during-pandemic

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Medicaid insurers at heart of Nevada public option plan

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Nevada is close to passing a law that would begin a multi-year process to establish a system for managed care-run public option plans.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

The state will bid out the business to private insurance carriers instead of doing the work in-house. Medicaid managed care organizations will be required to submit a bid.

 
 

 
 

Nevada’s plan to launch a public option health plan hinges on participation from the state’s Medicaid managed care organizations.

After passing both houses of the legislature, Democratic Gov. Steve Sisolak told reporters Tuesday he will sign the bill that will likely crown Nevada as the second state to pass a public option — a government-run plan that promises to lower premiums and increase access to care by creating an additional insurance option for residents.

To achieve its aims, Nevada’s public option plan requires premiums to be 5% lower than the benchmark silver Affordable Care Act plan in each ZIP code and, ultimately, premiums must be reduced by 15% over a four-year period. At the same time, reimbursement to providers must not go below Medicare rates.

Coverage under the public option would begin in 2026. The bill is just the beginning of a process in which Nevada will seek a waiver from the federal government to enact the public option plan. In short, the state is asking to capture the savings it may generate for the federal government.

Similar to other public health programs, the state of Nevada will bid out the public option business to insurance carriers instead of doing the work in-house. The state will rely heavily on Medicaid managed care organizations, at least at first, as it tries to spur participation.

“As a condition of continued participation in any Medicaid managed care program,” Medicaid MCOs will be forced to offer a public option plan if they want a Medicaid contract with the state, according to the bill sponsored by a Democratic state senator and Nevada’s majority leader, Nicole Cannizzaro, which passed the body earlier this week.

The bill says Medicaid MCOs must submit a “good faith proposal,” in response to an eventual RFP.

Sabrina Corlette, a research professor at Georgetown’s Center on Health Insurance Reforms, said she “assumed they wanted a guaranteed pool of potential bidders for the public option. Maybe they were afraid that if they didn’t require some bidders, they might not get any.”

Currently, there are three Medicaid MCOs in the state of Nevada: Centene, UnitedHealthcare and Anthem Blue Cross Blue Shield.

None of the companies responded to a request for comment.

The Nevada bill comes at a time when there is a renewed interest at the federal level for a public option plan, and a push from a handful of other states interested in creating an affordable health plan option for residents who have found themselves ineligible for Medicaid but unable to afford a marketplace plan.

Washington was the first state to implement a public option plan, which went live this year. 

President Joe Biden is a proponent of a public option plan — instead of “Medicare for All” — as it would build on the ACA, a law he helped usher in under former President Barack Obama, instead of dismantle it.

The insurance lobby is strongly opposed to a public option and previously expressed concern over Nevada’s plan via an opposition letter dated May 3 and addressed to Cannizzaro and the state’s Health and Human Services Committee.

AHIP, America’s Health Insurance Plans, took aim at the way in which the bill requires premiums for the public option plan to be lower than certain competitive plans on the exchange. AHIP characterized it as arbitrary “government rate setting.”

The tactic of prodding insurers into offering a separate business line in a specific state is not new.

The exchanges, launched under the ACA, relied on insurers to voluntarily sell plans to a relatively new market. At times, some counties were at risk of having no exchange plan at all. Some states tried to alleviate this problem by creating incentives for Medicaid MCOs if they also offered an exchange plan.

In a more extreme example, New York banned insurers from providing plans to any other program, including Medicaid, if they exited the exchange, according to a 2017 executive order from Gov. Andrew Cuomo.

Over time, the exchanges have become a core business for Medicaid MCOs.

Selling exchange plans is a complementary business for Medicaid MCOs that traditionally contract with states to care for Medicaid-eligible members. By selling exchange plans, Medicaid MCOs attempt to attract the Medicaid members they were serving as they churn off the program as their income fluctuates. It’s a key strategy for players like Centene.

However, if they’re forced to participate in the public option plan they will have to undercut their own premium prices on the exchange.

In Nevada, UnitedHealthcare and Centene command the largest market share on the exchange, according to the Kaiser Family Foundation.

Clipped from: https://www.healthcaredive.com/news/medicaid-insurers-at-heart-of-nevada-public-option-plan/601084/

 
 

 
 

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Former state Medicaid director hired by University of Vermont Health Network

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The quick hiring of the VT Medicaid director by a hospital system has raised a few eyebrows.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

For the past four years, Cory Gustafson oversaw the state’s Medicaid program, which provides funding to doctors and health care facilities. Now, he’s taken a job at Vermont’s largest health care organization. 

Gustafson, whose last day as commissioner of the Department of Vermont Health Access was May 28, started June 1 at the University of Vermont Health Network as network director of strategic and business planning. In his new role, he will develop “long term capital plans and strategies” for the organization, which serves about half of the state’s patients, according to spokesperson Neal Goswami. 

Gustafson said the move from state government to an entity that relies on state funding doesn’t represent a conflict of interest because he will focus on “internal-facing” issues such as business planning, capital planning and increasing efficiency within the six network hospitals in Vermont and New York. The role allows him to abide by ethics rules that prohibit lobbying for a year after leaving state government, he said. 

“This being an internal-facing position, I don’t see that being a problem,” he said of potential ethical conflicts. Upon deciding to leave state government, he said, he looked only for jobs “that would not run afoul of” the rules.

Goswami said Gustafson’s responsibilities “will not involve representing the Network before the state of Vermont, or any public and regulatory bodies.” The network spokesperson highlighted Gustafson’s “deep experience and knowledge in health care” and said that the new employee was “committed to following all state policies.”

It’s not the first time the hospital has recruited former state officials from the Agency of Human Services. In 2019, the Health Network hired Al Gobeille, former chief health care regulator of the Green Mountain Care Board and former secretary of human services, as its executive vice president for operations.

Prior to joining state government, Gustafson represented the health care industry before the legislative and executive branches. From 2011 to 2013, he worked as a lobbyist for the Vermont Association of Hospitals and Health Systems. After that, he lobbied on behalf of Blue Cross Blue Shield of Vermont. 

Gov. Phil Scott appointed him commissioner in January 2017. 

As head of the Department of Vermont Health Access, he was responsible for running the state Medicaid program, which provides health insurance for low-income Vermonters — and pays hospitals for those services. The department also manages the state’s health insurance exchange.

Most of the department’s day-to-day interactions with UVM Health Network were conducted by his subordinates, Gustafson said. However, he worked with the network on its role in the all-payer model, the state’s effort to change the way health care is financed. Vermont’s Medicaid program is a participant.

When it came to speaking with his future employer, “I had health care reform conversations, but that’s about the extent of it,” Gustafson said. He recused himself from those conversations after applying for the job, he said. 

A large hospital’s interest in hiring a well-connected state official makes sense — and often pays off, according to Mike Fisher, Vermont’s chief health care advocate. Fisher said he was speaking generally and not specifically about Gustafson’s or Gobeille’s employment.

“Even if you have to wait a year, you have a person who really knows the ropes and has the relationships,” Fisher said. 

Still, he said, “there’s a problem” with “the general flow from state government into an entity that’s regulated by state government.” 

“There’s a concern about the integrity of the position,” Fisher said. 

As a cabinet member, Gustafson said, he signed the executive code of ethics that bars officials from lobbying for one year after leaving their posts. He said he had no plans to move into a lobbying role even after the requisite time has expired. 

But, he added, “Who knows what the future brings?”

 
 

Clipped from: https://vtdigger.org/2021/06/02/former-state-medicaid-director-hired-by-university-of-vermont-health-network/

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Ohio Senate wants a redo of Medicaid managed care contracts

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Local, losing bidders (Paramount/Promedica) in the OH MCO awards have successfully enlisted legislators to undo the recent awards.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

After a more-than-two-year effort to overhaul Ohio‘s Medicaid managed care system, state senators are asking for what could amount to a redo of the whole thing.

The state in April had finally chosen six companies to handle the governmental health insurance for more than 3 million low-income or disabled residents. But it’s run into hiccups, with at least two of the companies who lost out on contracts filing complaints against the Ohio Department of Medicaid.

Those complaints have turned into legislative action.

Senate Republicans on Tuesday inserted language into the state budget bill requiring the state to complete a new procurement process with a few new rules. The move comes just months after those $20 billion awardees were determined, potentially the largest contract in state government history.

“A couple of the Ohio companies, who for many years have been providing this service, and of course their employees and everyone else are here in Ohio, those folks were concerned what the process was and how it went forward,” said Senate President Matt Huffman, R-Lima. 

Pete LuPiba, spokesperson for the Ohio Office of Budget and Management, defended the administration’s handling of procurement, saying it has had extensive public outreach and has been transparent.

“We will continue to work with the General Assembly on Medicaid as part of the budget process,” he said. “It would be unfortunate to lose the momentum that we have to transform Ohio’s Medicaid at this late stage in the process.”

Preference for Ohio-based companies

The budget language stipulates that contracts with Medicaid managed care organizations have to include those based in Ohio, and so do parent companies. 

The proposed requirement echoes a complaint filed by Paramount Advantage, owned by Toledo-based ProMedica, the only current Medicaid managed-care contractor that lost out on a contract. A question as to whether it played a role in requesting the legislation was ignored.

“Out-of-state, for-profit, multi-billion-dollar Fortune 500 companies appear to have been favored over mission-driven, not-for-profit managed care organizations headquartered in Ohio,” the company said in a statement to the USA TODAY Network Ohio Bureau. “We are encouraged that it appears our state lawmakers understand the importance of the issue and the need to protect Ohio jobs from being lost.”

ProMedica called the bidding process “systemically flawed and unfair” and said it was grateful that lawmakers were trying to ensure a fairer method.

The one other major Ohio company, Dayton-based CareSource, said through a spokesperson it did not request that preference language. CareSource was able to get a contract.  

If that component stays in the budget and becomes law, the consequences would be “disastrous,” said Loren Anthes, who chairs the Center for Community Solutions‘ Center for Medicaid Policy.     

For one, he isn’t a fan of requiring the procurement process be geared toward Ohio-based companies, as it flies in the face of using free-market, competitive principles to get the most efficient health care outcomes.  

“We… are creating a provision that would guarantee direct economic benefit to existing businesses with taxpayer money,” he said. “I’m not saying that if you’re domiciled in Ohio, that you are underperforming, but all I’m saying is that it means that you don’t have as much of an incentive to do better with my money.”

Furthermore, forcing a redo could put in jeopardy other parts of the budget that rely on the current procurement process, such as the entire Medicaid budget, as well as around $416 million in savings from current and previous procurements.   

“If you take a segment out, you pull a piece out of the wrong part of the Jenga stack, it all is going to come tumbling down,” said Anthes. 

Awardees might not be too happy as well to see the promised contracts yanked away, which could result in litigation.

Frustration with the DeWine administration

The motive behind putting this in the budget, however, seems to come more out of frustration with Gov. Mike DeWine’s administration. Lawmakers haven’t been able to get information on why certain parts of the bidding process played out the way it did, said Huffman.

For example, there was one Ohio company that received “0” points on their oral presentation during the bidding process.  

“They gave a presentation, but I’m not sure how you can receive zero. I suppose that happens somewhere,” he said. “Things like that are mystifying when you ask the question, ‘How did someone get a zero? How badly did they do to get a zero?’ And the answer is, ‘We can’t tell you anything, we’re in litigation.’ That’s concerning.”

That’s likely in reference to ongoing lawsuits the state has against at least three of the applicants for Medicaid contracts. The main one against health care company Centene was cited as a reason for putting its bid on hold.     

Huffman said he agreed with arguments that companies shouldn’t get the contracts simply because they’re from Ohio.

“But certainly there should be special preference, as we do in many other situations,” he said. “These are Ohio jobs.”

Nothing is final until after the Ohio House and Senate work out their differences in the budget bill. For now, the Senate is plunging forward on this issue.

“We have to do something. We can’t simply accept that we’re not going to get any information,” said Huffman. “Until this is resolved… until this information is forthcoming… this is what we’re going to do.”

Titus Wu is a reporter for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.

 
 

Clipped from: https://www.dispatch.com/story/news/healthcare/2021/06/03/ohio-senate-wants-redo-who-gets-states-medicaid-money-mike-dewine-budget-paramount-advantage-lawsuit/7504416002/

 
 

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State officials drop plans for 2-tier Medicaid system

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Medicaid beneficiaries in the new Nebraska expansion group will get dental, vision and OTC drug coverage without having to meet any volunteer or wellness requirements.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

LINCOLN, Neb. — State officials are dropping plans for a two-tier system to cover voter-approved Medicaid expansion in Nebraska.

The Nebraska Department of Health and Human Services (DHHS) announced Tuesday that all Nebraskans covered by the expansion will get a full range of benefits starting Oct. 1, the Omaha World-Herald reported. The announcement is a change from the earlier plans of Gov. Pete Ricketts’ administration to offer a two-tier system that would include a “basic” plan covering physical and behavioral health care services and a “prime” plan that would also cover dental, vision and over-the-counter drugs.

The two-tiered system would not have applied to those who receive benefits through the traditional Medicaid program, only those who qualify for the expanded coverage.

To qualify for prime coverage, recipients would have been required to meet work or volunteer benchmarks or participate in educational or job-training programs. They also would have had to meet with a health care provider for a wellness assessment.

Tuesday’s announcement means the state will provide the full range of benefits without the additional requirements.

The Trump administration approved Ricketts’ two-tier plan last year, prompting a lawsuit by advocacy group Nebraska Appleseed. But President Joe Biden’s administration made clear early this year that it would not approve the system.

It’s unclear how Tuesday’s announcement will affect Nebraska Appleseed’s lawsuit, but a hearing in the lawsuit was set for Monday.

Voters expanded Medicaid through a 2018 ballot measure, but the state Health and Human Services Department stalled implementation of it for nearly two years — the longest delay in the nation among states that have expanded the program. Activists placed the measure on the ballot after years of failed attempts to expand Medicaid in the Republican-dominated Legislature and strong opposition from the state’s GOP governors.

The expansion extends coverage to able-bodied, working-age adults who earn too much to qualify for regular Medicaid but too little to be eligible for tax credits to help them buy health insurance under the Affordable Care Act.

 
 

Clipped from: https://nebraska.tv/news/local/state-officials-drop-plans-for-2-tier-medicaid-system

 
 

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Gov. Stitt’s plan to privatize Medicaid lacks required legislative authorization, Oklahoma Supreme Court says

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A court ruling means the state will now expand Medicaid but under a fee for service model, making this the first example of this combination.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

OKLAHOMA CITY (KFOR) – The Oklahoma Supreme Court delivered a blow to Gov. Kevin Stitt’s plan to privatize the state’s Medicaid program, ruling in favor of medical associations that challenged the constitutionality of his plan.

Governor Stitt and Oklahoma Health Care Authority announce managed care organizations to assist with Oklahoma Medicaid, despite pushback from lawmakers

The Oklahoma State Medical Association, Oklahoma Dental Association, the Oklahoma Osteopathic Association, the Oklahoma Society of Anesthesiologists, Inc., and Oklahoma Chapter of American Academy of Pediatrics, Inc., challenged the Oklahoma Health Care Authority (OHCA) and the State of Oklahoma’s effort to outsource management of the state’s Medicaid program to for-profit companies, awarding those companies $2.2 billion in contracts.

The Supreme Court ruled in a 6-3 decision that the State and OHCA went beyond their authority by implementing an entirely new capitated managed care program, SoonerSelect, following the passage of State Question 802.

Oklahoma State Medical Association to seek motion for injunction against Gov. Stitt’s Medicaid managed care plan

“In effect, the OHCA moved ahead without the required legislative authorization,” the Supreme Court’s conclusion states.

 
 

Oklahoma Supreme Court

The website OKPolicy.org describes SQ 802 as “an initiative petition that gave Oklahoma voters the chance to expand Medicaid to cover low-income adults in Oklahoma beginning no later than July 1, 2021.” SQ 802 was passed on June 30, 2020.

Oklahoma’s top physician & health groups file motion for injunction against Gov. Stitt’s Medicaid managed care plan

The court determined that SQ 802 does not allow the governor and the OHCA to outsource Oklahoma’s Medicaid program to private insurance companies.

The Supreme Court’s full conclusion is as follows:

“The provisions of SQ 802 in no way authorize this course of action. The OHCA, through an RFP [Request for Proposal] process and competitive bidding, awarded contracts to MCOs [Managed Care Organizations] without legislative authorization or required rules in place. In effect, the OHCA moved ahead without the required legislative authorization. This Court assumes original jurisdiction and grants declaratory relief to the Petitioners. We find the actions of the OHCA are invalid under Oklahoma law. Having determined the Respondents did not have legislative authority to implement the SoonerSelect program, there is no need to issue a writ of Mandamus for OHCA to promulgate any rules. A writ of prohibition is also not appropriate in this matter. In addition, having determined declaratory judgement in favor of the Petitioners, we need not address whether the provisions proposed in the RFPs and model contracts are unconstitutional in and of themselves.”

OKLAHOMA SUPREME COURT

Gov. Stitt criticizes House Public Health Committee’s challenge to his Medicaid privatization effort

 
 

Gov. Kevin Stitt

Stitt announced SoonerSelect, his plan to revamp the state’s Medicaid program, on Jan. 29.

Selected Managed Care Organizations include Blue Cross Blue Shield of Oklahoma, Oklahoma Complete Health, Humana Health Horizons and UnitedHealthcare – each established in the state and serving Oklahomans. Stitt’s office estimates 1,500 new jobs will be created.

Stitt said the new program will improve health care outcomes for Oklahomans.

Oklahoma governor battles with members of own party over Medicaid privatization plan

Physicians across the state and several lawmakers, both Democratic and Republican, opposed privatizing Medicaid, wanting to keep the Medicaid expansion brought on by SQ 802 in the hands of the state.

“The Supreme Court today agreed that the Managed Care contracts were awarded without legislative input and contrary to the plan approved by the voters through State Question 802,” said Lynn Means, executive director, Oklahoma Dental Association. “Medicaid expansion will provide coverage for more than 200,000 of Oklahoma’s most vulnerable citizens. The managed care plan would’ve jeopardized health care for all Oklahomans by driving out providers of general health care, as well as dentists and specialists across the state. This lawsuit was one part of a physician-led effort to ward off privatization to insurance companies and keep Oklahomans in charge of health care in Oklahoma.”

Oklahoma lawmakers seek to put ‘guardrails’ on privatized Medicaid expansion

Stitt was on the cusp of succeeding in privatizing Medicaid, as legislators who opposed the privatization effort instead began focusing last month on putting guardrails on privatization to prevent problems experienced by 42 other states that enacted some form of managed care.

Sen. Greg McCortney, R-Ada, spoke with KFOR on May 19 about rewriting Senate Bill 131 to insert guardrails that would ensure Managed Care Organizations keep up their end of the deal.

Supreme Court Managed Care Decision by KFOR on Scribd

Gov. Stitt released the following statement:

“The Supreme Court’s ruling will unnecessarily delay Oklahoma’s efforts to improve health outcomes through managed care, which the Legislature confirmed is the right path forward for our state through Senate Bill 131. I will continue to work with the Oklahoma Health Care Authority to determine the next steps in the process.”

The Oklahoma Health Care Authority released the following statement:

“Improving health outcomes in Oklahoma will continue to be a top priority for the Oklahoma Health Care Authority. While we are disappointed in the Supreme Court ruling, we respect their decision and continue to focus on providing quality care to the more than one million Oklahomans we serve through SoonerCare. We are excited to welcome our newest population of Oklahomans now eligible for benefits through Medicaid expansion. This will allow us to serve an estimated 200,000 more people who deserve health care benefits.”

 
 

Clipped from: https://kfor.com/news/oklahoma-legislature/gov-stitts-plan-to-privatize-medicaid-lacks-required-legislative-authorization-oklahoma-supreme-court-says/

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Bill cutting procedural roadblocks for kids with Medicaid picks up steam in Texas legislature

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Texas lawmakers are working to make it easier to sign up and stay enrolled for Medicaid kids.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

AUSTIN (Nexstar) — A bill that aims to keep eligible children from getting kicked off Medicaid due to procedural roadblocks is picking up steam at the Capitol.

House Bill 290, authored by State Rep. Philip Cortez (D-San Antonio), has already passed in the House and had its first hearing in Senate committee on Friday.

Right now, Texas Health and Human Services sends requests for Medicaid eligibility verification to families within eight months of qualifying and only gives them limited time to respond.

The clock starts ticking as soon as HHSC mails the paperwork, and families only have 10 days to get the necessary documents and mail it back or lose their child’s coverage.

Dr. Lindy McGee, representing the Texas Pediatrics Society, has been fighting for the bill to help patients like hers.

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“This current process is just burdensome and unnecessary at best and harmful to the child’s health and well being at worst,” Dr. McGee said. “They would qualify for Medicaid, they need Medicaid, and they need the services Medicaid offers. But because of paperwork and mail and this process, they end up losing their coverage.”

She explained many times a family doesn’t even realize they missed a deadline.

“The patients show up, they may not realize that they don’t have coverage. They may end up having to pay out of pocket, which can be extremely expensive. Or if we do catch it, it’s a missed appointment, and that they then have to try and get their coverage rescheduled appointment,” Dr. McGee said.

She explained this can lead to even more severe problems for those needing early development specialists.

“I could easily have a two-and-a-half year old come in for a checkup; I’m concerned that patient may have autism. We know that early services makes a huge difference in autism,” Dr. McGee said. “It takes a while to get into the developmental pediatrician. So I make that referral and make speech therapy referrals. But then by the time the appointment comes up the patient, the family has inadvertently lost Medicaid, and so they’re unable to get those important follow up appointments. They have to come back to see me. We start the process all over again.”

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The bill also aims to knock these mid-year checkpoints from four to one.

“Ensuring that fewer of these vulnerable children cycled on and off the program or were forced to go without health insurance,” Republican Senate sponsor of the bill Lois Kolkhorst of Brenham said during Friday’s hearing.

The bill has bipartisan support, with only 16 Republican lawmakers voting it down in the 150-member House earlier this session. That opposition could be related to mere partisan policy.

“The fact that the bill has to do with Medicaid, it’s kind of a hot button issue, but the fact of the matter is, this has to do with kids covered by Medicaid and it doesn’t have anything to do with Medicaid expansion,” Katie Mitten, a health policy associate with Texans Care for Children, said.

She said she hopes the bill will continue to get support from both sides of the aisle.

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“This bill is really important for making sure that kids are healthy, making sure that they’re able to go to the doctor and get any sort of care that they might need,” Mitten said.

The bill still awaits a vote in committee. If approved, it heads to the Senate floor.

 
 

Clipped from: https://www.kxan.com/news/texas-politics/bill-cutting-procedural-roadblocks-for-kids-with-medicaid-picks-up-steam-in-texas-legislature/

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Texas Senate passes bill extending Medicaid coverage for new moms

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TX added extended maternity coverage to its Medicaid program this week.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

AUSTIN (Nexstar) — After a marathon day debating legislation with the end of session deadlines looming, the Texas Senate approved a measure early Thursday morning to increase Medicaid coverage for new mothers.

The committee substitute to House Bill 133 would raise Medicaid coverage for new Texas moms to six months after the birth of her baby. Currently, two months are covered.

The bill passed out of the Senate in a 30-1 vote.

“We will become one of the first states in the nation to extend it beyond two months,” State Sen. Lois Kolkhorst, R-Brenham, who chairs the chamber’s Health and Human Services Committee, said during the bill layout after 3:00 a.m. Thursday. She noted Illinois has 12 months, Georgia has six months and Missouri only allows 12 months for substance abuse and mental health. According to Kolkhorst, four states have pending waivers with the federal government.

“We are one of only two states that have state-funded 12 month postpartum services— us and California,” Kolkhorst said.

The version passed by the House proposed a full year. The bill’s author, State Rep. Toni Rose, D-Dallas, hoped her legislation would be approved with the full year intact, but was optimistic about its movement earlier in the session.

“There are some concerns but we’re working them out,” Rose acknowledged in April, explaining that she had already been working with Senators to compromise at that point.

“Women without comprehensive health care is the number one cause of death amongst women after pregnancy,” Rose said last month. “This legislation will save lives.”

During the pandemic, federal waivers allowed new moms to remain on Medicaid longer than two months. HB 133 would make permanent some of the changes granted by the waivers.

HB 133 was part of a legislative healthcare package supported by Speaker Dade Phelan, R-Beaumont.

Supporters of HB 133 believe it would help cover finances for critical care. Opponents of the bill expressed concerns about the cost to fund the extended coverage.

The legislation returns to the House for approval before it can advance to the Governor’s desk.

 
 

Clipped from: https://www.conchovalleyhomepage.com/news/texas-politics/texas-senate-passes-bill-extending-medicaid-coverage-for-new-moms/

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Centene CEO: Missouri Medicaid decision an ’embarrassment’

MM Curator summary

Centene CEO takes the gloves off and adds to rumors of the MCO giant moving HQ out of the state.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

JEFFERSON CITY, Mo. (AP) — The CEO of Centene Corp. has called Missouri an “embarrassment” after Republican Gov. Mike Parson and the GOP-controlled Legislature failed to approve funding for voter-approved Medicaid expansion.

The St. Louis Post-Dispatch reported Wednesday that Centene chief Michael Neidorff made the comments to Health Payer Specialist, a health industry trade publication.

“As the largest provider of Medicaid in the United States and a Fortune 42 company I have to ask myself, ‘Why am I in this state?'” Neidorff said. “This is a state that frowns on this business — what am I doing here?”

“It’s an embarrassment,” he added.

The comment raised further concern about Centene’s future in the St. Louis area, where it is among the region’s largest employers. Centene announced it June it would add thousands of jobs in North Carolina, rather than St. Louis County, with Neidorff citing worries about crime in St. Louis.

Medicaid expansion, approved by voters in August, would bring health coverage to 275,000 low-income adults starting in July. But without funding, it is expected to end up in court.

In an emailed statement, Parson said Medicaid expansion can’t proceed without a revenue source or funding from the Legislature. He said he is “grateful for Centene’s investments in Missouri.”

 
 

Clipped from: https://apnews.com/article/michael-brown-business-medicaid-5f25a838b47176263c377522a6c6d0d5