Iowa: Governor Approves Medicaid Managed Care Oversight

Governor Terry Branstad (R) approved a measure that will require MCOs to publically report information on enrollment, health outcomes, access to care, and program integrity, and will also add an ombudsman to provide assistance related to long-term care. Governor Branstad noted that there will be “nearly 1,000 measurable results tracking the outcomes of Medicaid patients,” making the program one of the “most transparent, outcome-focused and accountable .” Iowa's Medicaid program transitioned to managed care in April after several delays.

Missouri: State Senate Forms a Panel to Reduce State’s Medicaid Prescription Drug Costs

A new State Senate panel aimed at curbing the State’s $1.8 billion in Medicaid prescription drug costs plans to present recommendations to the General Assembly in January 2017. Senator David Sater (R), the chair of the panel, suggested the panel will consider cost-saving measures such as step therapy, preferred drug lists and monthly prescription limits, and believes that some ideas the panel will discuss may require a federal waiver. The Department of Health proposed having a clinical pharmacist review the needs of Medicaid recipients who are on 12 or more long-term medications, noting to the panel that this measure would save an estimated $8 million to $10 million in its first year. The panel is expected to meet three to four times before sharing recommendations.

North Dakota: Legislators Likely to Review Medicaid Expansion as 2017 Sunset Nears

Representative George Keiser (R), chairman of the Interim Health Care Reform Review Committee, cited budget concerns when he announced that the State will likely re-examine Medicaid expansion in its current form as the 2017 sunset provision nears. The State currently contracts with Sanford Health Insurance to administer the program. Representative Keiser has suggested that modifications to the contract may be required, such as changes to provider reimbursement, or that the State Human Services Department may take over the program. More than 20,000 North Dakotans are enrolled in the Medicaid expansion program.

Oklahoma: Budget May Prevent Major Medicaid Provider Rate Cuts

The Legislature's approval of a FY 2017 budget that increases funding for the Oklahoma Health Care Authority (OHCA) by 2% could prevent the 25% Medicaid provider rate cuts that were under consideration, OHCA CEO Nico Gomez said. Governor Mary Fallin (R) is expected to sign the budget legislation.

South Carolina: State Proposes Streamlined Family Planning-Only Medicaid Application Process

The Department of Health and Human Services announced a proposed Medicaid State Plan amendment to streamline the application process for limited-benefit Medicaid coverage of family planning services. Prior to the ACA, South Carolina permitted individuals to use a family planning-only application if they were not seeking full Medicaid benefits, which also permitted applicants to report their own income and not that of other household members. The State proposes to reinstate their previous family planning-only streamlined application process, which the State says will allow for a more prompt decision than the current process.