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Monday, Aug 1 2016

Full Issue

Georgia Official Rejects Insurers' Challenge On Medicaid Contracts

Last year, state officials chose four vendors for the Medicaid program, but other companies appealed the selection. The dispute has set the start of the contract back a year. Also, outlets report on Medicaid news in Minnesota, Alabama, California, Arizona and Pennsylvania.

After months of contract limbo, the head of a state agency has denied health insurers鈥 appeals of the selection of vendors in a multibillion-dollar Medicaid and PeachCare procurement. In a letter dated Friday, obtained by Georgia Health News, the commissioner of the Department of Administrative Services said he concurred with a March decision by an agency official to deny the appeals. (Miller, 7/30)

A federal judge ruled Friday that a class action lawsuit filed by people with disabilities can proceed against the Minnesota Department of Human Services. The four named plaintiffs allege they represent some 5,000 disabled Minnesotans who have been deprived of over $1 billion in services from a Medicaid program managed by DHS. (Ashenmacher, 7/30)

Alabama doctors will be paid less for handling certain cases for the state鈥檚 Medicaid agency. As of August 1st, Alabama will no longer compensate doctors for what are known as 鈥渆nhanced payments鈥 for specific primary care visits and services. The higher than usual fees were paid for by the Federal Affordable Care Act in 2013 and 2014. Alabama chose to continue the higher payments in 2015, but elected to cancel them. (Duggins, 7/31)

Experts estimate that about half of all people turning 65 today will need daily help as they age, either at home or in nursing homes. Such long-term care will cost an average of about $91,000 for men and double that for women, because they live longer. In California and across the U.S., many residents can鈥檛 afford that, so they turn to Medicaid, the nation鈥檚 public health insurance program for low-income people. As a result, Medicaid has become the safety net for millions of people who find themselves unable to pay for nursing home beds or in-home caregivers. This includes middle-class Americans, who often must spend down or transfer their assets to qualify for Medicaid coverage. (Gorman and Feder Ostrov, 8/1)

Thousands of low-income immigrants in Arizona who are eligible for full medical benefits under the state's Medicaid program are being improperly assigned to less robust coverage by a state agency, a federal lawsuit alleges. The lawsuit filed this month in U.S. District Court in Phoenix contends that lower-income refugees, asylum seekers and other immigrants who qualify for Medicaid coverage are being shifted to emergency-only medical coverage even though they qualify for full benefits that pay for outpatient care and prescription drugs. (Alltucker, 7/29)

The financial health of Cedarbrook and Gracedale may be on the path to recovery after state leaders agreed to phase out a debilitating law that's handicapped the county-run nursing homes and cost local taxpayers millions. For about a decade, Pennsylvania law has required county-owned nursing homes to pick up 10 percent of their patients' Medicaid costs. Over that time, public nursing homes across the state struggled to keep up with costs, and many have been privatized. (Shortell, 7/31)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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