Medicaid Archives - Mediarabe

Supreme Court declines to hear South Carolina attempt to block Medicaid funding from Planned Parenthood

October 13, 2020

a large white building: Supreme Court declines to hear South Carolina attempt to block Medicaid funding from Planned Parenthood

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Supreme Court declines to hear South Carolina attempt to block Medicaid funding from Planned Parenthood

The Supreme Court on Tuesday declined to hear an appeal of a lower court ruling that blocked the South Carolina Department of Health from cutting off Medicaid funding to Planned Parenthood.

The high court’s rejection means that last year’s ruling from the Fourth Circuit Court of Appeals will remain in effect, prohibiting the state from terminating Planned Parenthood as a Medicaid provider.

While it takes four justices to approve a petition, the court doesn’t publish the vote totals and it declined to hear the case without comment.

South Carolina Gov. Henry McMaster (R) signed an executive order in 2018 prohibiting abortion clinics from participating in Medicaid.

Video: ACA unlikely to be struck down; Roberts and Kavanaugh are expected to support severability: Turley (FOX News)

ACA unlikely to be struck down;

The Health 202: Republican-backed ACA lawsuit also threatens Medicaid as enrollment grows during pandemic

October 9, 2020

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| Health Center

But the health-care law’s Medicaid expansion played a bigger role in extending health coverage – and is now enrollment is surging amid the coronavirus pandemic. Coverage for Americans enrolled in this program is also threatened by the lawsuit, a detail getting far less attention on the campaign trail.

Nearly 4 million more people enrolled in the health insurance program for the low income between February and June.

Medicaid enrollment grew 6.2 percent over the spring and early summer, the Centers for Medicare and Medicaid Services reported this week.

It’s an abrupt reversal of the direction enrollment had previously been moving as it trended downward over the last several years. Yet the surge isn’t terribly surprising, given the nation’s widespread job losses during the first wave of the pandemic and subsequent lockdowns. More than one in five Americans – about 75 million – now rely on Medicaid or the Children’s

Medicare vs. Medicaid: What Is the Difference? | Health Insurance

October 8, 2020

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| Health

ALTHOUGH THEY WERE BORN ON THE SAME DAY, Medicare and Medicaid are not identical twins. And even though they have been around for 55 years, many people still confuse these government-backed two healthcare programs.

On July 30, 1965, President Lyndon Johnson signed the laws that created Medicare and Medicaid as part of his Great Society programs to address poverty, inequality, hunger and education issues. Both Medicare and Medicaid offer health care support, but they do so in very different ways and mostly to different constituencies.

According to the Medicare Rights Center:

Medicare is a federal program that provides health coverage to those age 65 and older, or to those under 65 who have a disability, with no regard to personal income.
Medicaid is a combined state and federal program that provides health coverage to those who have a very low income, regardless of age.

Some people may be eligible

Kentucky launches kynect website for Medicaid access, benefits

October 5, 2020

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CLOSE

FRANKFORT, Ky. — “Kynect” is back, repurposed as a one-stop, online shop for people to apply for Medicaid and a host of other resources such as food and child care assistance, job training and help for the elderly and people with disabilities.

Gov. Andy Beshear announced the launch of the state website Monday, initially created under his father, former Gov. Steve Beshear, as a state-run site where people could shop for health insurance plans under the Affordable Care Act.

Kynect won’t feature commercial insurance plans in time for this year’s open enrollment for health coverage in November.

Background: Beshear says restoring Kentucky’s health insurance exchange will save more than expected

But Andy Beshear, a Democrat, said kynect will include it by next year as part of his plan to restore the site shut down by his predecessor, Gov. Matt Bevin, a Republican. Meanwhile, people can find a link to

8th Congressional District candidates discuss Social Security, Medicare / Medicaid, health care and COVID-19 | Election

October 4, 2020

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| Health Facts

The 8th Congressional District race pits incumbent U.S. Rep. Matt Cartwright, a Moosic Democrat, against management/communications consultant and former Trump administration official Jim Bognet, a Hazle Twp. Republican, in the Nov. 3 election.

The district includes all of Lackawanna, Pike and Wayne counties and parts of Luzerne and Monroe counties. Representatives serve two-year terms and earn $174,000 a year. The Sunday Times asked Bognet and Cartwright their positions on various issues. Their positions on Social Security, Medicare, Medicaid, health care and COVID-19 appear today. Their positions on the economy and policing will appear in Monday’s edition.

Social Security

Facts: The main Social Security trust fund and a separate fund that pays disability benefits will hit zero by 2035, triggering a 21% benefit cut, according to the Social Security trustees’ 2020 report. Last year, about 64 million people received benefits.

The most-discussed solutions center on raising the payroll tax or the

Wellness, quality of health care centerpiece of new Ohio Medicaid plan

October 1, 2020

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| Health Benefits

Catherine Candisky

| The Columbus Dispatch

Gov. Mike DeWine’s administration has unveiled plans for a long-awaited overhaul of the $28 billion Medicaid health-care program covering more than 3 million poor and disabled Ohioans.

The Ohio Department of Medicaid seeks to update its managed-care setup with a focus on wellness and improving the health of beneficiaries, meeting the needs of children with complex needs, and reducing administrative hurdles for patients and health-care providers.

The stakes are huge: The five current managed-care organizations received a combined total of more than $15 billion from the state.

It was the managed-care organizations that hired pharmacy benefit managers, which have grown controversial in Ohio during recent years for charging excessive rates and under-reimbursing pharmacies. But the Medicaid department, under a measure state lawmakers passed in July 2019, is moving to a single PBM next year hired by the state agency to keep closer watch over

Expanded Medicaid begins in Nebraska after years of dispute

October 1, 2020

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| Health News

OMAHA, Neb. (AP) — Nebraska will officially offer expanded Medicaid coverage to low-income people starting Thursday after years of wrangling over it in the Legislature, a statewide ballot campaign that led voters to approve it and a nearly two-year rollout that left some people in health care limbo.

The state will provide coverage to 10,288 residents who have signed up so far, a number roughly in line with the state’s projections. State officials expect expanded enrollment to rise to about 90,000 within a few years.

“This expansion is an excellent opportunity” for people who are now eligible, said Dannette Smith, executive director of the Nebraska Department of Health and Human Services.

Nebraska was among several conservative states where state lawmakers and governors declined to expand Medicaid, only to see the issue go to voters. Republican Gov. Pete Ricketts and his GOP predecessor, Dave Heineman, both argued that expansion would be

Ohio’s Medicaid program to expand behavioral-health services for high-need children, Gov. Mike DeWine says

September 29, 2020

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| Health Issues

COLUMBUS, Ohio—Ohio’s Medicaid system is set to expand access to behavioral-health services for thousands of children as part of the state’s first overhaul of the health-care program in 15 years, Gov. Mike DeWine announced Tuesday.

The governor, speaking during a televised briefing, also announced the state will begin accepting applications Wednesday for Medicaid managed-care plans for both adults and children.

The changes have been in the works for more than a year for the state’s Medicaid program, which provides health care for low-income, pregnant and disabled Ohioans.

Under DeWine’s new “Ohio Rise” program, the state’s Medicaid program will work to improve coordination of care and improve access to treatment programs for substance abuse, severe mental illness, developmental disabilities, and other complex behavioral-health issues, according to the governor.

A significant portion of children with such issues who are enrolled in Medicaid are in foster care, DeWine said, adding that nearly two-thirds

Molina To Buy Affinity Health Plan For $380 Million In Medicaid Deal

September 29, 2020

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| Health Plans

0602-Center Piece Molina Healthcare — Molina Healthcare has entered into a definitive agreement to acquire substantially all of the assets … [+] of Affinity Health Plan for $380 million. A Molina Healthcare facility is shown on Wednesday, June 3, 2020, in Long Beach, Calif. (AP Photo/Ashley Landis)

ASSOCIATED PRESS

Molina Healthcare said it will buy Affinity Health Plan for $380 million in cash, expanding the health insurer’s Medicaid government health benefits businesses deeper into New York.

Affinity, a Medicaid health plan with more than 280,000 subscribers in New York City, Westchester, Orange, Nassau, Suffolk, and Rockland counties in New York, has $1.3 billion in annual premium revenue.

“The acquisition of Affinity provides us with a stable base of membership and revenue and will deepen Molina’s service offerings in New York, allowing us to meet the needs of hundreds of thousands of additional Medicaid members,” Molina chief executive officer Joe Zubretsky said. “The transaction provides added

Multi-billion-dollar Medicaid contract at stake in legal filing by Aetna Better Health. Insurer asks for review of DHHS selection process. | Local News

September 28, 2020

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| Better Health

“The state also has failed to fulfill its own well-documented commitments to the federal government and the public.”

Moving ahead

The main launch challenge is getting the four statewide PHPs operational by the enrollment date.

Managed care is a system under which people agree to see only certain doctors or go to certain hospitals, as in a health maintenance organization, or HMO, or a preferred provider organization, or PPO, health-insurance plan.

Under the current Medicaid system, providers are paid on a fee-for-service model administered by DHHS.

By contrast, the PHPs will pay health-care providers a set amount per month for each patient’s costs. There will be a limited number of special-needs individuals who will remain with fee-for-service providers.

The next big rollout step for DHHS is formulating the per-patient rates for providers by November and submitting them to CMS.

DHHS will reimburse the PHPs, and people will be able to

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