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North Carolina Medicaid leaders revealed new details Tuesday about their plans to overhaul health systems that covers more than 1.9 million people. They'll rely on commercial insurers and medical provider networks to keep patients healthier and control costs — doing what legislators and Gov. Pat McCrory already agreed upon. Meeting their first deadline set in Medicaid overhaul legislation approved last September, top officials at the Department of Health and Human Services filed a status report on the project with a General Assembly oversight committee. (Robertson, 3/1)

The effort to privatize North Carolina's Medicaid program made its first substantive deadline Tuesday, but Department of Health and Human Services officials warned lawmakers that putting the plan in place will face at least one big obstacle: presidential politics. ... President Barack Obama is in his last year in office, and as the election approaches, [DHHS Secretary Rick] Brajer said he expects work to slow on the plan. Depending on who is elected next, he said, the federal government could do anything from accepting North Carolina's plan as is to demanding major changes or scrapping it entirely. (Binker, 3/1)

Legislators were given an overview of the plan to open the state’s $13 billion Medicaid business to insurance companies and “provider-led entities” – hospitals, doctor groups or other health care providers who would offer health care plans to Medicaid patients.The federal government, which pays most of the state’s Medicaid costs, must approve the plan. The legislature required the state Department of Health and Human Services to submit a proposal to the federal government by June 1. (Bonner, 3/1)

[Stephanie] Azar has been part of Alabama Medicaid for 17 years, serving as general counsel before becoming acting commissioner in May 2012. ... Aside from the political and daily managerial tasks, Azar is working on an overhaul for how the program cares for patients. And other states are watching. On Feb. 9, the federal Centers for Medicare and Medicaid Services approved a waiver that allows Alabama to create 11 regional care organizations to help Medicaid beneficiaries with primary care, behavioral health and specialty care. (Evans, 3/1)

Democratic Gov. John Hickenlooper's proposal to reclassify a Medicaid-related fee to balance the state budget and avoid taxpayer refunds is legal, Republican Attorney General Cynthia Coffman said in an opinion issued Monday. Debate over the arcane fee has dominated the legislature this year. Hickenlooper and Democrats who control the House want to remove about $750 million generated by the fee from constitutional spending limits that otherwise would require refunds. At stake, they say, is long-term investment in roads and schools in the fast-growing state. (Anderson, 3/1)

A government-run hospital on an Indian Reservation in South Dakota where federal health inspectors found serious deficiencies leading to people receiving substandard care — to the extent that the lives of emergency room patients were at risk — will no longer be able to bill the government for services provided to those eligible for Medicare and Medicaid. The Centers for Medicare and Medicaid Services notified the administration of the 35-bed hospital on the Rosebud Indian Reservation on Tuesday that the funding cutoff will take effect March 16. The move, which comes after the November findings and a follow-up inspection in February that found remaining problems, is a blow to an already-underfunded facility operated by the federal Indian Health Service. (Cano, 3/1)