On Tuesday, Feb. 5, former Hacienda Healthcare nurse Nathan Sutherland pleaded not guilty for raping and impregnating a disabled 29-year-old woman in a vegetative state for nearly two decades. Sutherland was arrested last month after the woman unexpectedly gave birth to a baby boy on Dec. 29.
The unprecedented birth in December...National News
According to a state audit released this past week, California’s Medicaid program, Medi-Cal, spent $4 billion between 2014 and 2017 on coverage for beneficiaries that may have been ineligible for Medicaid.
California’s $100B Medicaid program covers 13.1 million residents of the state (one-third of the state) and eligibility is...Arizona News
Anthem individual insurance plans bid goodbye to Affordable Care Act (ACA) markets across the nation to focus on the growth of its Medicare Advantage business, an experience more sweet than bitter; the insurance giant's third quarter profits were up 29 percent, year over year.
Enrollment in Anthem's insurance plans may have taken...National News
A new analysis from the Association for Community Affiliated Plans (ACAP) focuses on new models implemented by safety-net plans and the best way high-quality coordinated care can be provided for individuals with substance abuse disorder (SUD).
Successfully managing the needs of people with SUD requires a high-level of comprehensive...Arizona News
The National Committee for Quality Assurance ranked over 1,000 health plans on measures of quality, member satisfaction and the committee's survey accreditation results. The ratings aim to highlight patient care outcomes and how patients feel toward those outcomes and the care they are receiving.
The highest performing plans...National News
Following last week's decision to reinstate dental and vision benefits to the state's Medicaid recipients, Gov. of Kentucky Matt Bevin's administration has made the call to suspend Medicaid copays priced from $1 to $50 by Aug. 1.
Many Medicaid healthcare providers are being kept in the dark as the agency makes sudden changes, but...National News
Kentucky's Cabinet for Health and Family Services (CHFS) reinstated the dental and vision coverage Gov. Matt Bevin's administration cut suddenly last month after a federal judge rejected Medicaid work requirements in the state.
Approximately 400,000 Kentucky residents were affected by the cuts for the month of July.
A...National News
One of the first states to implement Medicaid beneficiary work requirements has reported more than 7,000 people failed to report at least 80 hours of work for the month.
Consequences are crucial for recipients, as they face the possibility of losing Medicaid coverage if they do not comply for at least three months of a calendar...National News
Gov. of Kentucky Matt Bevin didn’t get the ruling he was hoping for in court for his Medicaid overhaul plan and now his administration is making dental and vision coverage cuts for almost 500,000 residents.
On Friday, U.S. federal judge James E. Boasberg rejected Kentucky’s proposal to enact work requirements in the Medicaid...National News
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patient Communities Act received an overwhelming amount of support from representatives, passing in a 396-14 vote.
This legislation approved by the House on Friday will give various federal agencies the resources they need to combat...National News
Kansas was one of five states that requested lifetime limits, the others are Arizona, Maine, Utah and Wisconsin.
As President Donald Trump took office, his administration announced a willingness to give states more flexibility in how they run their Medicaid programs, funded through a combination of state and federal dollars. The...National News
Currently, researchers have access only to Medicare claims data for the fee-for-service program.
Release of Medicare Advantage data will provide a more comprehensive view of care provided to Medicare beneficiaries, said Verma at last week’s Health Datapalooza conference in Washington. Health Data Management quotes CMS Administrator...
Arizona's Medicaid program, the Arizona Health Care Cost Containment System, has a three-month retroactive eligibility period, which means those applying for Medicaid coverage may receive benefits for services provided three months prior to their application.
The state now seeks to limit retroactive coverage to the month of an...
Effective immediately, Health Net will not be quoting any more new business for small and large business health plans.
Health Net stated in a letter to brokers:
We want you to know that Health Net will honor all current group contracts and continue to provide high quality service to our members. Employer groups and members will...
For patients without smartphones, staffers at participating physicians' offices can schedule their rides for immediate pickup or dropoff up to 30 days in advance.
Rather than operating through an app, Uber Health will send passengers their ride information via text message. Drivers, however, will still locate and pick up riders...
The 2019 budget requests hits insurer and payer hot spots including ACA Medicare risk corridor payments and cost-sharing reductions, uncompensated care payments, Medicare post-acute care costs and even graduate medical education.
Trump’s proposal outlines his administration’s priorities – Congress makes the decisions.
Budget...National News
In a Washington Post opinion piece, the CMS Administrator shares her vision.
Verma begins:
Americans are among the most generous people in the world. While this nation was founded on the pursuit of a shared dream, the moral pledge of the American people has been to never leave behind our most vulnerable fellow citizens.
Our aim is...Arizona News
Kentucky will be offering a novel way to reactivate your medical coverage: a health or financial literacy course you must pass.
The waivers approved by the Trump administration present opportunity for new ways to think about how to empower individuals to improve their health.
The precise content of the courses is not yet worked...National News
Centene is an insurer that offers individual health insurance under its Ambetter brand in 15 states.
The lawsuit outlines a number of instances where Ambetter enrollees have had difficulty finding a doctor, have had to travel for health care, have been denied care that they thought was covered and in-network, or have relied on...Arizona News
Trump administration to permit requirement to work if states seek it.
The Arizona Daily Star reports Arizona is one of 10 states that have submitted applications to add work requirements for the government health insurance program for low-income people.
The state’s Medicaid program, called the Arizona Health Care Cost Containment...
