Medicaid Reform for Patients and Doctors
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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
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California and Federal Government Locked In Debate Over Billions In Medicaid Funding

California and Federal Government Locked In Debate Over Billions In Medicaid Funding | Medicaid Reform for Patients and Doctors | Scoop.it
Delays in reaching an agreement on $7.25 billion in Medicaid funding for reforms in California has public hospitals and other providers worried.
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Medicaid Spending Soars — Mostly In Expansion States

Medicaid Spending Soars — Mostly In Expansion States | Medicaid Reform for Patients and Doctors | Scoop.it
New report finds the annual increase in Medicaid spending is the largest in at least two decades, spurred by the federal health law expansion.
Texas Medical Association's insight:

"Most of the growth in Medicaid enrollment has been from people who became eligible under the health law and therefore totally paid for by the federal government. States that expanded the program saw their share of costs increase by 3.4 percent compared to nearly 7 percent in states that did not expand. Much of the growth in the non-expansion states was from increased enrollment among previously eligible parents and children."

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Proposed Medicaid Expansion in Montana

Proposed Medicaid Expansion in Montana | Medicaid Reform for Patients and Doctors | Scoop.it
This fact sheet describes Montana’s Section 1115 and briefly describes Montana’s Section 1915(b) waivers, together called the Health and Economic Livelihood Partnership (HELP) Program, that expand the state’s Medicaid program under the ACA.
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

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State indifference on health care baffling

State indifference on health care baffling | Medicaid Reform for Patients and Doctors | Scoop.it
Together, these two reports help flesh out a nasty portrait of Texas health policy. [...] the state’s failure to set up its own ACA exchange and to expand Medicaid as an option under the act have contributed to the state, despite the drop in the rate of those without insurance, still having both the largest percentage and number of uninsured in the nation. Texas doesn’t care. Because subsidies are involved, it decries the ACA as socialized medicine, though the coverage is offered by private i
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. 

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Law Could Bring Remote Doctor Visits to Schools, by Alana Rocha, Justin Dehn and Edgar Walters

Law Could Bring Remote Doctor Visits to Schools, by Alana Rocha, Justin Dehn and Edgar Walters | Medicaid Reform for Patients and Doctors | Scoop.it
A new law will allow physicians to get paid for seeing children over a sophisticated form of video chat, as long as the patient is at school and enrolled in the state’s Medicaid program for the poor and disabled.
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Medicaid: Key Issues Facing the Program

Medicaid: Key Issues Facing the Program | Medicaid Reform for Patients and Doctors | Scoop.it
Texas Medical Association's insight:

GAO report on access, oversight, program integrity, and federal financing issues. With accompanying podcast. Worth the listen

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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. 

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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...
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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. 

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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. 

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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. 

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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. 

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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. 

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The North Carolina Experiment: How One State Is Trying To Reshape Medicaid

The North Carolina Experiment: How One State Is Trying To Reshape Medicaid | Medicaid Reform for Patients and Doctors | Scoop.it
With legislation that passed last month, North Carolina is trying to build a hybrid managed care, accountable care model – with doctors, hospitals and insurance companies all sharing some risk. Advocates worry it could eclipse gains made by Medicaid in the state in the past.
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How to make Medicaid expansion work for physicians

How to make Medicaid expansion work for physicians | Medicaid Reform for Patients and Doctors | Scoop.it
For primary care physician Doug Curran, MD, seeing Medicaid patients comes at a price—literally.

The Athens, Texas-based doctor’s only new Medicaid patients are children who leave the
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; andContinue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General
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Why Expanding Medicaid Doesn't Always Make People Healthier

Why Expanding Medicaid Doesn't Always Make People Healthier | Medicaid Reform for Patients and Doctors | Scoop.it
New research shows that having affordable health insurance can improve people's health -- but only if a state’s health-care system actually works.
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.

 

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North Carolina providers, insurers may compete for managed Medicaid

North Carolina providers, insurers may compete for managed Medicaid | Medicaid Reform for Patients and Doctors | Scoop.it
A political and philosophical brawl among providers, insurers and policymakers in the Tar Heel State is reaching a possible resolution as North Carolina's Legislature attempts to coalesce around a bill that would overhaul the state's Medicaid...
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Arkansas governor proposes changes to Medicaid expansion

Arkansas governor proposes changes to Medicaid expansion | Medicaid Reform for Patients and Doctors | Scoop.it
Arkansas Gov. Asa Hutchinson supports keeping the state's first-in-the-nation hybrid Medicaid expansion, he said Wednesday, but only if the federal government provides the state with more flexibility to impose limits on the program.
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. 

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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.
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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.

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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.
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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.
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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.
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$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. 

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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.

 

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