Kansas: Three Members of House Committee Ousted Due to Support of Medicaid Expansion

Kansas House Speaker Ray Merrick (R) has removed three moderate GOP members from the House Health and Human Services Committee due to their support of Medicaid expansion. The debate over Medicaid expansion has been gaining attention in the wake of a rural hospital closure. According to Representative Merrick, the members' removal was “in the best interests of our caucus and state.” Representative Barbara Bollier (R), a retired physician and one of the three members removed, said that while she would continue to participate in the debate as actively as possible, she was saddened that “three of the most knowledgeable people on health care issues are being removed from all of the policymaking decisions.” The other two legislators pulled from the committee are Representative Susan Concannon (R), the former director of the Mitchell County Regional Medical Foundation, and Representative Don Hill (R), a practicing pharmacist.

Montana: Enrollment in Medicaid Expansion Exceeds Expectations

In the first week after CMS approved Montana's expanded Medicaid program, approximately 5,500 Montanans applied and were approved to enroll in the program, representing nearly one-quarter of the total number of Montanans that Governor Steve Bullock (D) estimated would enroll during the first six months. The Governor stated, "High enrollment in the plan in its first week shows just how critical the need for quality, affordable health care is for Montanans." Coverage through the expansion is set to begin January 1, 2016.

Nebraska: Health Department Moves Toward Integration of Medicaid Services with Managed Care RFP

The Nebraska Department of Health and Human Services released a Request for Proposals for the integration of physical health, behavioral health, and pharmacy services under a new Medicaid managed care initiative called Heritage Health. The State currently works with three insurance companies that manage enrollees’ physical health and two separate entities for behavioral health and pharmacy services. Heritage Health is intended to streamline the delivery model for Medicaid beneficiaries by providing them with a simple, comprehensive package of healthcare benefits. Approximately 230,000 enrollees will be served by Heritage Health, including 41,000 who were previously excluded from the managed physical health care program. Proposals are due December 22, 2015, and Heritage Health is scheduled to begin operations on January 1, 2017.

Virginia: Up to $38 Million in Medicaid Benefits Provided to Ineligible Recipients

An audit by the State’s Joint Legislative Audit and Review Commission found that up to $38 million in Medicaid payments were made in 2014 for services provided to individuals determined Medicaid ineligible during the renewal process whose renewals were processed after payments were made. The audit pointed to overburdened eligibility workers and recommended revising how administrative funds were distributed to regional Medicaid offices to reflect caseloads. Linda Nablo, the Chief Deputy Director for the Department of Medical Assistance Services said new policies to address issues discovered in the audit are expected to be in place by the end of the year.

Over 70% of Medicaid Beneficiaries Are in Managed Care, According to New Report

More than 51 million Americans receive Medicaid benefits through a private managed Medicaid plan, an increase from last year of 7.8 million beneficiaries, according to a new report by PwC. In addition, the number of Medicaid beneficiaries enrolled in fee for service or public managed care programs decreased by 1.4 million over the past year. Forty-one states currently provide coverage through private managed Medicaid, though the proportion of states’ Medicaid populations in these plans ranges from 100% of the Medicaid population in Hawaii and Tennessee to 1% in Idaho. Private managed Medicaid plans are highly local and increasingly consolidated: 90% of the 194 total plans operate in only one state, and of those, the largest 12 plans account for 56% of total membership.