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An advisory committee charged with helping state officials design a system for regulating the use of prescription mental health drugs for Medicaid patients met for the first time Tuesday. The nine-member committee spent nearly two hours discussing the pros and cons of “prior authorization” policies that would allow the three private insurance companies that manage KanCare, the state’s Medicaid program, to approve or disapprove mental health drug prescriptions. (Ranney, 9/1)

Ohio's Department of Medicaid must count live-in spouses as family members when determining whether Medicare beneficiaries qualify for financial assistance with their premiums, a federal appeals court ruled Tuesday. Family "does not mean whatever the State's officials want it to mean," wrote Circuit Judge Raymond Kethledge of the 6th U.S. Circuit Court of Appeals on behalf of a unanimous three-judge panel, ordering the state to reverse its current policy excluding spouses. (Pierson, 9/1)

In a decision that could have far-reaching effects, a federal appeals court ruled Tuesday that Ohio must count an applicant’s spouse as a member of his family when determining eligibility for financial assistance to pay Medicare bills. A three-judge panel of the Cincinnati-based U.S. 6th Circuit Court of Appeals told the state it can’t exclude a beneficiary’s spouse when it comes to income calculations simply because the federal law doesn’t define the word “family.” At issue is a program under Medicaid, the federal-state insurance program for the poor, that helps low-income Ohioans pay their premiums, co-payments, and deductibles under Medicare, the federal health insurance for senior citizens. (Provance, 9/1)

Several Democratic and Republican state senators want DFL Gov. Mark Dayton to delay implementation of 2016 Medicaid and MinnesotaCare contracts out of concern bidding may have been "flawed." At the center of those concerns is the decision by Dayton's Department of Health and Human Services to strip one major provider, UCare, of the vast majority of its customers. (Zdechlik, 9/1)

The chairwoman of a state program that provides health insurance to children of poor families is questioning whether Iowa has acted legally with efforts to privatize management of the system. At issue is a $111.3 million annual program known as hawk-i that provides health insurance for more than 37,000 children from low-income families in Iowa. The program's management will shift to private companies as part of Gov. Terry Branstad's effort to privatize oversight of the state’s annual $4.2 billion Medicaid budget. (Clayworth, 9/1)