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Saying it’s how his administration always has projected the state’s annual Medicaid costs, Gov. Terry Branstad on Monday defended a $51 million estimate for Medicaid savings next year, even though the state has produced no documents showing how it arrived at that figure. The state is transitioning to private management of its Medicaid program. Branstad’s administration said the move will save $51 million in the first year, a figure that was calculated into the current state budget. (Murphy, 10/19)

A key Democratic legislator is pressing Gov. Terry Branstad for details that spell out an estimated $51 million in cost savings for a shift of Iowa's Medicaid health care program from state government oversight to private management. State Sen. Robert Hogg, D-Cedar Rapids, chairman of the Iowa Senate Government Oversight Committee, said Monday he is skeptical about Branstad's plans .... Hogg's inquiry follows statements by Iowa Department of Human Services officials last week that they have no documents or even a list of experts consulted to support their estimates that a controversial plan to hire private companies to manage the Medicaid health insurance program will save taxpayers money. (William Petroski, 10/19)

The CMS has granted California permission to change the hospital admission process for some Medicaid beneficiaries in the state. Under a newly approved waiver, California will launch a two-year process for hospitals to voluntarily transition to a more streamlined process for admitting Medicaid patients. Currently, all hospitals except for public safety net hospitals have to get pre-authorization from the program before admitting fee-for-service Medicaid patients. (Dickson, 10/19)

A federal official initially denied Arkansas' request for records related to a Medicaid application that a Brickeys woman said she submitted more than 10 months ago, a state Department of Human Services official testified Monday. ... In a lawsuit filed Oct. 9, [Anita] Walker, 53, said she's been waiting for word on her eligibility since Nov. 24, 2014, when she applied through the federal healthcare.gov website. Federal rules require the state's Medicaid program to determine eligibility within 45 days of an application being made. Human Services Department officials testified that they never received any records on Walker's application from the federal Centers for Medicare and Medicaid Services, which runs the enrollment website. (Davis, 10/20)

North Carolina is in the process of overhauling its Medicaid program. The governor and state lawmakers are using a mixture of health care models to put the major players — doctors, hospitals and insurers — all on the hook to keep rising costs in check. For many of the Republicans who control the state legislature, the reason for the change is simple: budget predictability. (Tomsic, 10/20)

Lawmakers in some states mulling Medicaid expansion are tacking on a new stipulation: more money from the federal government to serve clients of the Indian Health Service. Republican South Dakota Gov. Dennis Daugaard met with Department of Health and Human Services officials last month to push the federal agency to pick up the full cost of serving Medicaid-eligible Indian Health Service patients who go to non-IHS facilities. (Evans, 10/19)

A new report to Congress on the transparency of Medicaid demonstration waivers is doing little to quell concerns that the CMS needs to beef up its oversight of the policy experiments. Experts say the document fails fully explain how the federal government decides whether to approve or reject a state's application. (Dickson, 10/19)