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Medicaid

May 15, 2014 | Daily News

Indiana Governor Mike Pence (R) unveiled a blueprint for the “Healthy Indiana Plan 2.0” to expand the state's Medicaid program with three different options, including premium assistance to help those with the option for employer-sponsored coverage afford it.

May 15, 2014 | Daily News

Senate Finance Committee Chair Ron Wyden (D-OR) said he expects his committee to vote for HHS Secretary-nominee Sylvia Mathews Burwell next week after she received a mostly cordial welcome at her confirmation hearing on Wednesday (May 14).

May 15, 2014 | Daily News

HHS Secretary-nominee Sylvia Mathews Burwell said that if confirmed she hopes to learn more about the states whose insurance exchanges failed to function, and pledged that if she discovers that funds were misused she would advocate using the “full extent of the law” to retrieve the funding from vendors or other parties who failed to live up to promises.

May 13, 2014 | Daily News

Children's advocates are upset with MACPAC's recent decision to recommend Congress extend CHIP funding for only two years instead of five, and argue that many policy decisions need to be made before the administration can even consider ending the program and possibly transitioning children into qualified health plans on the exchanges.

May 13, 2014 | Daily News

Arkansas' surgeon general says the state's decision to let Medicaid-eligible individuals buy private insurance on the state's exchange has improved the risk pool to the point that, on average, it is 10 years younger than the risk pools for every other state.

May 09, 2014 | Daily News

Executives at AbbVie, which has a Hepatitis C drug under FDA review, implied that they don't plan to compete on price with Sovaldi, which could frustrate health plans and pharmacy benefit managers that are counting on brand competition to bring down the $84,000 per-regimen price for curing the infection.

May 08, 2014 | Daily News

HHS Secretary-nominee Sylvia Mathews Burwell on Thursday (May 8) refused to commit to Senate health committee Republicans that she would allow non-ACA compliant policies to be renewed in perpetuity, but the current Office of Management and Budget Director did say she would work with senators on a number of Affordable Care Act issues.

May 08, 2014 | Daily News

Projected spending on major federal health programs has plummeted by a “remarkable” $900 billion over a decade, and Medicare's Part D, the exchanges and Medicaid accounted for the biggest drop in expected spending, according to a budget think tank's analysis of the Congressional Budget Office's latest projections, released last month.

May 07, 2014 | Daily News

FDA's top drug official, responding to criticism about the high price of breakthrough drugs, said the agency is driving toward cures for diseases like cancer and hepatitis, but there will be a transition and possibly “a big down payment” required.

May 06, 2014 | Daily News

Senate Finance Committee Chair Ron Wyden (D-OR) told Inside Health Policy he is monitoring the debate over the high cost of the breakthrough Hepatitis C drug Sovaldi, but said he is holding off weighing in. He noted that his committee has strongly supported the Medicare Part D drug benefit and his “theory is that you really shouldn’t mess with programs that have worked generally,” but the lawmaker didn't signal what direction he may take on Sovaldi.

May 05, 2014 | Daily News

Nonprofit Medicaid managed care plans are asking CMS to immediately increase pay rates to offset the unexpectedly high cost of the breakthrough Hepatitis C drug Sovaldi and to demand state Medicaid directors swiftly take action.

May 02, 2014 | Daily News

States Medicaid officials and health plans grappling with the high cost of the breakthrough Hepatitis C drug Sovaldi are likely to limit the drugs' availability through prior authorization and clinical guidelines -- many of which could recommend limiting the drug to those with advanced liver disease, sources say.

May 02, 2014 | Daily News

Pressure is increasing on CMS to give states a year to adopt Medicaid drug reimbursement changes driven by the Affordable Care Act, as lawmakers and pharmacy groups have added their voices to states' earlier calls for more time, though those following the issue say CMS has not indicated if it would be amenable to the idea.

May 01, 2014 | Daily News

An HHS official on Thursday (May 1) expressed confidence that pricing and markets will be stable in all states going into next year even though some exchanges saw relatively weak qualified health plan sign-ups in 2014.

May 01, 2014 | Daily News

HHS says roughly 28 percent of all enrollees who chose a plan on the exchanges between Oct. 1 and April 19 were in the coveted 18- to 34-year-old age category and young adults came out in full force in the final weeks of the 2014 season, according to the department's latest report analyzing the more than 8 million people who signed up for qualified health plans.

May 01, 2014 | Daily News

Health plans likely knew the Hepatitis C drug Sovaldi was coming to the market this year and should have had a good idea of what it would cost and how broadly it would be prescribed, drug lobbyists said.

April 30, 2014 | Daily News

A model telehealth policy recently approved by the Federation of State Medical Boards that proposes to limit telemedicine to video technologies and exclude telephone consultations has drawn the ire of some in the telemedicine industry as lawmakers prepare to take a deeper dive into the topic this week.

April 30, 2014 | Daily News

Telehealth advocates and providers are poised to push for more robust telehealth benefits and reimbursement within accountable care organizations and other payment models that may include bundled or capitated payment, as such systems could use services that are sometimes held up because of the fee-for-service system.

April 28, 2014 | Daily News

The head of the group representing the nation's Medicaid directors says managed care plans will be paid “appropriately” for the coverage of a new high-cost Hepatitis C drug, Sovaldi, that was approved by the FDA in December after plans had already negotiated their 2014 rates, but notes that the mechanics of this will not be worked out for some time.

April 28, 2014 | Daily News

Medicaid health plans on Monday (April 28) sought reimbursement from state Medicaid agencies for unexpected spending on a high-cost breakthrough Hepatitis C drug approved by FDA after rates were already negotiated with states, laying out their demands in a letter to the National Association of Medicaid Directors (NAMD).

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