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Large Mass. Health Care System Drops Out Of Networks Being Planned For Medicaid

KHN Morning Briefing

UMass Memorial Health Care said it will continue to care for MassHealth patients but it won’t join in the accountable care organizations being formed as the state revamps Medicaid. Meanwhile, a California health care system is moving some of its Medicaid patients to clinics instead, and Utah formally submits a request to the federal government for a limited Medicaid expansion for some homeless people.

Settlement Finalized Between Mylan, Feds Over Epipen Overcharges To Medicaid

KHN Morning Briefing

The $465 million settlement announced Thursday by the Department of Justice resolves claims that Mylan avoided paying rebates to the government by improperly classifying the EpiPen as a generic drug. Mylan and its auto-injector product have been at the center of the national debate over prescription drug costs.

Feds Want Texas To Pay $18.9M Back To Medicaid For Improper School Health Services Bills

KHN Morning Briefing

Reimbursement requested by the Texas Health and Human Services Commission between 2010 and 2011 were not “reasonable, adequately supported, and otherwise allowable” for some school-based health services, according to an Inspector General’s report. Meanwhile, Kansas’ privatized Medicaid sytem ranks last in a customer satsifaction survey among the 36 states that offer managed care programs.

Funding For N.H.’s Medicaid Expansion Now In Jeopardy

KHN Morning Briefing

The federal Centers for Medicare & Medicaid Services informed New Hampshire Gov. Chris Sununu that a fund helping to pay expansion costs, which is partially supported by voluntary donations from hospitals, violates federal law. Meanwhile, federal officials approved changes that will allow Nebraska to continue its Health Insurance Premium Program, through which the state’s Medicaid program helps people pay the costs of private health insurance. Also, Mississippi’s Medicaid director is in the hot seat.

Illinois Halves Number Of Insurers In Overhaul Of Medicaid Managed Care Program

KHN Morning Briefing

The more than 500,000 state residents who were in the six plans that are no longer participating will have to switch insurers. Also in Medicaid news, an Iowa woman ties changes in the program there to her husband’s death, complaints about Mississippi’s program and Maine prepares for a referendum on expanding the program.

House Expected To Hold Hearings On ‘Right-To-Try’ Bill That Senator Tied To FDA Funding

KHN Morning Briefing

The Senate quickly passed the bill that would allow dying patients access to experimental drugs after Sen. Ron Johnson (R-Wis.) had threatened to slow down consideration of a separate bill to renew the FDA’s fee-collection authority. In other drug industry news, the FDA is implementing new rules about hiring foreign scientists, industry tightens controls to keep out counterfeit drugs, cancer trials are low on patients and costs of old drugs rising quickly for Medicaid.

With ‘Brutal’ September Looming, Trump Braces For ‘Thorny Issues’ On Capitol Hill

KHN Morning Briefing

With a number of must-pass legislative items on the agenda, there are also few working days on the congressional calendar — and a possibility that GOP lawmakers may make another attempt at an Obamacare repeal. All the while, news outlets examine how President Donald Trump’s Twitter and verbal attacks on Senate Majority Leader Mitch McConnell could further complicate the days ahead. Meanwhile, during the August recess, Republicans faced a lot of health care questions at town hall meetings. And Democrats use the GOP’s failed repeal-and-replace measures to formulate their talking points and political strategies. Abortion politics, though, continue to complicate their message.

Republican Candidates For Colo. Governor Say Medicaid Costs Are Unsustainable

KHN Morning Briefing

Three candidates seek to make Medicaid’s budget a key campaign issue. In other Medicaid news, talks between Iowa officials and the managed care companies there appear to have bogged down but no one is talking about what the problem is, and two insurance companies have filed suit in Mississippi over how the state awarded the managed care contract.

HHS Watchdog Says Iowa Failed To Collect $700,000 in Medicaid Drug Rebates

KHN Morning Briefing

The inspector general for the federal Department of Health and Human Services says that between March 2012 and December 2014 Iowa’s Medicaid program did not invoice drugmakers for the rebates that the state and federal government were entitled to. Also, California groups file suit to help some Medicaid patients stay out of managed care networks if the patients want to keep their doctors and specialized providers.