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Tuesday, Nov 17 2015

Full Issue

Study: Philadelphia-Area Medicaid Programs Denied Coverage For Nearly Half Of New Hep C Prescriptions

Meanwhile, Iowa Gov. Terry Branstad accuses some of the state's health care providers of using scare tactics to undermine Iowa's Medicaid privatization effort.

State Medicaid programs in the Philadelphia region denied nearly half the coverage requests for the most effective - and expensive - treatments for chronic hepatitis C, according to a University of Pennsylvania study that will be presented on Monday. The findings, based on prescription data for Pennsylvania, New Jersey, Delaware and Maryland, appear to confirm widespread concerns that state budgets are effectively limiting treatment for a potentially fatal condition. (Sapatkin, 11/14)

Gov. Terry Branstad expressed concern Monday that some health-care providers are using 鈥渟care tactics鈥 and misinformation to undermine his administration鈥檚 effort to begin the transition to a privately managed Medicaid service delivery system beginning Jan. 1. Some providers in mental-health, assisted living and other service areas that rely on Medicaid for treatment have expressed concerns that the state鈥檚 plan to privatize Medicaid services includes a new payment system that could cut their reimbursements enough that it could force smaller organizations to close. (Boshart, 11/16)

In other Medicaid news -

Private Medicaid plans are seizing on the political rancor over prescription drug prices to lobby for an overhaul of how the government insurance program pays for medicine. The Medicaid Health Plans of America, the major Washington-based lobbying organization, is working on a set of proposals to present to lawmakers and hopes to release them publicly by mid-2016, the group鈥檚 president and CEO, Jeff Myers, told STAT. (Scott, 11/16)

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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