Medicaid Reform f...
Follow
Find
2.1K views | +0 today
 
Scooped by Texas Medical Association
onto Medicaid Reform for Patients and Doctors
Scoop.it!

Medicaid problems hinge of doctor, nurse pay | Latest State headlines from AP | News fro...

The first question many doctors ask when new patients call for appointments is how they intend to pay. If the answer is Medicaid, the doctor can expect to lose money.
more...
No comment yet.

From around the web

Medicaid Reform for Patients and Doctors
Find a way to provide health care to low-income Texans with realistic payment, less stifling bureaucracy, and no fraud-and-abuse witch hunts
Your new post is loading...
Your new post is loading...
Scooped by Texas Medical Association
Scoop.it!

Not Expanding Medicaid Can Cost Local Taxpayers

Not Expanding Medicaid Can Cost Local Taxpayers | Medicaid Reform for Patients and Doctors | Scoop.it
In some states that have declined to expand Medicaid under the Affordable Care Act, the cost of caring for people who would have qualified for Medicaid is being borne by local taxpayers.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Feds unveil long-awaited overhaul of Medicaid managed care

Feds unveil long-awaited overhaul of Medicaid managed care | Medicaid Reform for Patients and Doctors | Scoop.it
The 700-page "uber rule" contains the biggest changes to Medicaid in a decade.
Texas Medical Association's insight:

TMA's Medicaid Managed Care recommendations:

 

✓ Establish a centralized credentialing portal so physicians can apply to participate in all the Medicaid HMOs participating in the service area simultaneously.

✓ Integrate Medicaid/Medicaid HMO application and credentialing processes for physicians applying to the program for the first time.

✓ Improve coordination of benefits between Medicaid and Medicaid HMOs to prevent recoupment of money from physicians after services were provided in good faith.

✓ Require Medicaid HMOs to communicate clearly to physicians and patients the process for obtaining services when an in-network physician/provider cannot be found.

✓ Require the HMOs to establish a dedicated contact person for a physician to call to request assistance in arranging services not available in network.

✓ Establish a Texas Health and Human Services Commission (HHSC) ombudsman to oversee Medicaid HMO network adequacy, respond to patient and physician complaints, and enact physician recruitment initiatives.

✓ Establish a division within HHSC dedicated to recruiting new physicians to participate in Medicaid, and/or allow the HMOs to recruit physicians who are not enrolled in Medicaid but whose specialty is needed in the network.

✓ Monitor HMO network adequacy more stringently. Apply stiffer penalties for plans that fail to maintain adequate networks.

✓ Require the state to publish in-network and out-of-network utilization trends and data about patient/physician complaints.

✓ Protect 2013 legislation that improves due process for physicians who are confronted with a Medicaid fraud or overpayment accusation.

✓ Ensure physicians and providers have a meaningful opportunity to appeal allegations of Medicaid fraud and/or abuse to an independent third party.

✓ Eliminate redundant efforts and expenditure of state funds, employee time, and other resources involved in investigating alleged violations of Medicaid regulations.

✓ Ensure Texas laws and regulations clarify the coordination of responsibilities, authority, and interaction among enforcement agencies regarding the Medicaid program.

✓ Eliminate data collection programs, such as the Texas Health Care Information Council, that don’t provide patients with useful information to make informed health care decisions.

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

New Medicaid Managed Care Rules Could Be ‘Epic’

New Medicaid Managed Care Rules Could Be ‘Epic’ | Medicaid Reform for Patients and Doctors | Scoop.it
As the Baby Boomers age and enrollment surges, the feds will issue regulations for managed long-term care.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Kansas, Texas join Florida Medicaid expansion suit

Kansas, Texas join Florida Medicaid expansion suit | Medicaid Reform for Patients and Doctors | Scoop.it
TALLAHASSEE – Kansas and Texas will file amicus briefs supporting Florida in its lawsuit against the federal government over Medicaid expansion, Gov. Rick Scott announced Monday.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Montana Medicaid expansion on way to governor's desk

Montana Medicaid expansion on way to governor's desk | Medicaid Reform for Patients and Doctors | Scoop.it
HELENA - Saturday morning the Montana Senate gave final approval to Medicaid expansion with a 28-21 vote. The bill now heads to the governor's desk.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

$4 billion in health care for poor Texans at risk as doubts rise about Medicaid agreement

$4 billion in health care for poor Texans at risk as doubts rise about Medicaid agreement | Medicaid Reform for Patients and Doctors | Scoop.it
[...] federal officials signaled last week they may no longer be willing to pay for uncompensated care for people who could be covered by expanding Medicaid under the Affordable Care Act. With Texas lawmakers adamantly opposed to a Medicaid expansion, the waiver expiration creates a potential showdown between state and federal health care officials that, if not resolved, threatens to unravel the state's health care safety net. Coverage rather than uncompensated care pools is the best way to se
Texas Medical Association's insight:

TMA says:

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

States Benefit from Medicaid Expansion

States Benefit from Medicaid Expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Eight states that expanded Medicaid have seen budget savings and revenue gains without reducing services.
Texas Medical Association's insight:

TMA Says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General.

 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Dems Want To Make Obamacare’s Boost To Medicaid Rates Permanent

Dems Want To Make Obamacare’s Boost To Medicaid Rates Permanent | Medicaid Reform for Patients and Doctors | Scoop.it
Two Democratic senators introduced a bill Thursday that would boost Medicaid provider reimbursement rates back to Medicare levels -- part of an Obamacare provision that was supposed to be temporary.
Texas Medical Association's insight:

TMA Says:

 

A Medicaid card does not access make. Inadequate physician payment rates have forced many physician practices to limit their Medicaid and CHIP participation or cease it altogether. Medicaid payments are the least competitive among all insurers, ranging from 48 percent to 87 percent of Medicare and 41 percent to 73 percent of commercial insurance payments. These rates are hardly enticing, particularly when many practices can barely keep up with demand for their services from better paying privately insured patients. 

According to TMA’s biennial physician survey, in 2000 67 percent of Texas physicians accepted all new Medicaid patients. Today, that number is 34 percent. The good news is that increasing physician Medicaid payments actually reverses the decline in participation. From 2012 to 2014, physician participation in Medicaid rose 5 points, a jump attributable to the temporary two-year primary care physician rate increase paid for with federal funds. Similarly, in 2008, physician participation also increased after Texas lawmakers invested new monies to improve the physician Medicaid network.

Unfortunately, the recent federal funding to increase primary care physician payments expired December 31. Without the higher payments, our organizations fear that physician Medicaid participation will again enter free fall. Physicians support Medicaid and want to participate. Yet, as owners of small businesses, facing ever more costly and demanding federal and state regulatory burdens, many just cannot afford to stay in a program that pays less than half their costs. 

- See more at: http://www.texmed.org/Template.aspx?id=32971#sthash.IdCHpIKX.dpuf

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

New Hampshire strikes deal for Medicaid expansion

New Hampshire strikes deal for Medicaid expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Six states have been approved to run their own version of the ObamaCare expansion.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Poor Payouts Endangering Medicaid, Doctors Say

Poor Payouts Endangering Medicaid, Doctors Say | Medicaid Reform for Patients and Doctors | Scoop.it
Physicians’ groups told Texas budget writers on Thursday that the state’s health insurance program for the poor pays doctors so little that it is endangering the health of the program.
Texas Medical Association's insight:

TMA's 2015 Medicaid Reform Agenda:

 

Improve physicians’ Medicaid payments;Cut Medicaid red tape and administrative hassles;Hold Medicaid HMOs accountable for establishing adequate physician networks;Restore funding for Medicaid-Medicare “dual-eligible” patients;Stop unfair and unreasonable fraud and abuse audits; andFind a creative solution to pull down federal dollars to ensure access to health care for working, poor adults.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Medicaid Expansion by Another Name

Medicaid Expansion by Another Name | Medicaid Reform for Patients and Doctors | Scoop.it
State “Alternatives” to Expansion under ObamaCare Allow for No Significant Reforms
Texas Medical Association's insight:

TMA Says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Arkansas Medicaid Plan Offers Mixed Lessons

Arkansas Medicaid Plan Offers Mixed Lessons | Medicaid Reform for Patients and Doctors | Scoop.it
Early on, supporters of Medicaid expansion pointed to Arkansas as an example of how Texas might go about helping insure its poor. But lately, the neighbor's grass doesn't look quite as green.
Texas Medical Association's insight:
Expansion language Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must: • Draw down all available federal dollars to expand access to health care for poor Texans; • Give Texas the flexibility to change the plan as our needs and circumstances change; • Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program; • Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors; • Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and • Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Judge rules Florida Medicaid program violates federal laws

Judge rules Florida Medicaid program violates federal laws | Medicaid Reform for Patients and Doctors | Scoop.it
A federal judge has ruled that Florida's healthcare system for impoverished and disabled children violates several U.S. laws.
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Texas Politicians And Businesses Feud Over Medicaid Expansion

Texas Politicians And Businesses Feud Over Medicaid Expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Texas has turned down federal funds to expand Medicaid under the Affordable Care Act. Hospitals and some business owners want the money, but it's a tough sell in Republican-dominated state politics.
Texas Medical Association's insight:

TMA says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Skyrocketing Medicaid signups stir ACA fights

Skyrocketing Medicaid signups stir ACA fights | Medicaid Reform for Patients and Doctors | Scoop.it
Medicaid enrollment under Obamacare is skyrocketing past expectations, giving some GOP governors who oppose the program’s expansion under the health law an “I told you so” moment. More than 12 million people have signed up for Medicaid under the Affordable Care Act since January 2014, and in some states that embraced that piece of...
more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Georgia Weighs Medicaid Experiment (But Not Expansion)

Georgia Weighs Medicaid Experiment (But Not Expansion) | Medicaid Reform for Patients and Doctors | Scoop.it
State health officials say they will seek increased federal funding and permission to “experiment” with Medicaid to shore up rural and safety net hospitals.
Texas Medical Association's insight:

TMA says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Some States Elect to Pay Higher Medicaid Reimbursement

Some States Elect to Pay Higher Medicaid Reimbursement | Medicaid Reform for Patients and Doctors | Scoop.it
Some states have elected to pay doctors higher reimbursement rates as an incentive to take on Medicaid patients.
Texas Medical Association's insight:

The Texas House of Representatives' budget for fiscal 2016-17 includes $460 million to increase primary care physicians’ Medicaid payments to Medicare rates starting Sept. 1, 2015. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Obama Administration Tells Texas It Could Play Medicaid Hardball There, Too

Obama Administration Tells Texas It Could Play Medicaid Hardball There, Too | Medicaid Reform for Patients and Doctors | Scoop.it
The Centers for Medicare and Medicaid Services holds a call with Lone Star State officials, as the drama in Florida heats up.
Texas Medical Association's insight:

Governor Abbott released a statement today, saying "The Supreme Court made it very clear that the Constitution does not allow the federal government to use these coercive tactics against the States." - see the full statement at http://gov.texas.gov/news/press-release/20776


 

TMA Says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Florida governor again changes course on Medicaid expansion

Florida governor again changes course on Medicaid expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Rick Scott is back to opposing the ObamaCare expansion.
Texas Medical Association's insight:

TMA Says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

The Red State Solution On Medicaid: Georgia’s Not Part Of It

The Red State Solution On Medicaid: Georgia’s Not Part Of It | Medicaid Reform for Patients and Doctors | Scoop.it
The final piece in the Atlanta Journal-Constitution’s series on Arkansas’ privatized Medicaid expansion looks at how several red states are considering such a model as a politically palatable way t...
Texas Medical Association's insight:

TMA Says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Florida Senate to consider Medicaid expansion proposal

Florida Senate to consider Medicaid expansion proposal | Medicaid Reform for Patients and Doctors | Scoop.it
TALLAHASSEE — A Senate committee will consider a controversial plan Tuesday that would extend federally subsidized health insurance to more than 800,000 poor Floridians — but require a waiver from the federal government to pay for it.
Texas Medical Association's insight:

TMA Says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Texas GOP Leaders Say They Won't Expand Medicaid

Texas GOP Leaders Say They Won't Expand Medicaid | Medicaid Reform for Patients and Doctors | Scoop.it
Leading Texas Republicans on Monday asked the Obama administration for greater flexibility to administer Medicaid — a move that has gotten little traction in the past — while reiterating that they would not participate in an expansion of the program under the Affordable Care Act.
Texas Medical Association's insight:

TMA Says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Alternate Medicaid expansion: Crossing the proverbial bridge

Alternate Medicaid expansion: Crossing the proverbial bridge | Medicaid Reform for Patients and Doctors | Scoop.it
While some states are beginning to cross the alternate Medicaid expansion bridge, it is still unclear what the other side will look like. States will likely face many questions as their journey continues.
Texas Medical Association's insight:

TMA says: 

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
4Kirsten Jackson's curator insight, March 9, 9:50 PM

The bureaucracy that is being discussed is Centers for Medicare and Medicaid Services (CMS)

 

I did not realize using the new expansion funds, Iowa created two programs: the Iowa Marketplace Choice Plan and the Iowa Wellness Plan.

 

I agree with actions expansion, whether traditional or alternate, will likely require an overhaul of operation strategies, technology functions and IT enhancements to support enrollment system changes.

Scooped by Texas Medical Association
Scoop.it!

Pa. governor opts for traditional Medicaid expansion

Pa. governor opts for traditional Medicaid expansion | Medicaid Reform for Patients and Doctors | Scoop.it
HARRISBURG - Fulfilling a campaign pledge, Gov. Wolf on Monday moved to dismantle his predecessor's alternative to Medicaid expansion and implement a traditional plan to extend health insurance to hundreds of thousands of low-income Pennsylvanians.
Texas Medical Association's insight:

TMA says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General. 

more...
No comment yet.
Scooped by Texas Medical Association
Scoop.it!

Feds give Arkansas, Iowa more leeway in Medicaid expansion waivers

Feds give Arkansas, Iowa more leeway in Medicaid expansion waivers | Medicaid Reform for Patients and Doctors | Scoop.it
The Obama administration is continuing to compromise with Republican-led states that expand Medicaid, allowing Arkansas for the first time to impose cost-sharing for beneficiaries below poverty level.
Texas Medical Association's insight:

TMA says:

 

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

 

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

 

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General.

more...
No comment yet.