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85% medical-loss ratio in final managed Medicaid rule

By Virgil Dickson and Bob Herman  |  April 25, 2016

The CMS has finalized a long-awaited rule that will overhaul managed Medicaid, which has not been updated in a decade. The medical-loss ratios were capped at 85%, and network adequacy issues have been punted to states.

Q&A: Building the business case for achieving health equity

Q&A: Building the business case for achieving health equity

By Modern Healthcare  |  April 23, 2016

Cara James, director of the Office of Minority Health at the CMS, runs the agency's program for addressing racial health disparities. Modern Healthcare reporter Steven Ross Johnson recently explored the agency's efforts to address healthcare disparities.

Data Points for April 25, 2016

Data Points for April 25, 2016

By Modern Healthcare  |  April 23, 2016

Data Points for the week of April 25, 2016, covered the following topics: States cut funds for health centers, mental health, Medicaid and public heath.

Ohio Medicaid waiver could cost hospitals $2.5 billion

By Virgil Dickson  |  April 22, 2016

A provision of the pending Medicaid waiver request submitted by the administration of Republican Gov. John Kasich would eliminate 90-day retroactive coverage. That could cost hospitals as much as $2.5 billion over the course of the five-year waiver, according to an analysis.

Arkansas GOP governor uses veto to save Medicaid expansion

By Associated Press  |  April 22, 2016

Gov. Asa Hutchinson on Thursday effectively saved Arkansas' first-in-the-nation hybrid Medicaid expansion by voiding part of a budget bill that would have ended the subsidized insurance for more than 250,000 poor people.

Pilot program results show promise for new CMS payment model

By Shannon Muchmore  |  April 20, 2016

Warren Clinic in Tulsa, Okla., was able to drop some of its diabetic patients' elevated blood sugar levels by using data, a team approach and plenty of follow-ups. This care was paid for under a pilot program aimed at lowering costs and improving care quality without hurting patient satisfaction.

Feds warn states against defunding Planned Parenthood

By Associated Press  |  April 20, 2016

The director of the federal Medicaid program published a broadside Tuesday over efforts in Arizona and other state legislatures to block funding for Planned Parenthood.

Texas seeks short-term Medicaid waiver in standoff with feds

By Virgil Dickson  |  April 19, 2016

Texas is seeking a 15-month waiver to finance its uncompensated-care pool after the Obama administration appeared to balk at extending special financing for the uninsured who would otherwise be covered if Texas expanded Medicaid.

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