From Medicare Advantage News - Recognizing “early signs of progress” from the first three Financial Alignment Initiative (FAI) demonstrations to serve dual-eligible beneficiaries, CMS on Jan. 19 offered the states of Massachusetts, Minnesota and Washington an opportunity to extend the scheduled end dates of their demos for two additional years. This is the second extension CMS has offered to states participating in the duals demos, and will give CMS and the three states the additional time needed to evaluate whether the programs meet certain quality and cost savings goals and should be made permanent. Read more
From Health Plan Week - The goal of Anthem, Inc.’s Pharmacy Home Program (PHP) is to keep members out of it. The program, which launched April 1, 2016, was created to curtail inappropriate opioid use — and improve drug safety — among a small population of commercially enrolled members (see story, p. 1). Anthem’s Medicaid plans have been running similar programs for years. Read more
From Health Plan Week - Leaders from some of the nation’s largest health plans, along with the industry’s two trade groups, turned up at the White House on Feb. 27 to meet with President Trump — and his recently confirmed HHS secretary — to discuss replacing the Affordable Care Act (ACA) and strategies to stabilize the market in the short term. Read more
From Medicare Advantage News - The latest budget estimate from the California Department of Finance concluded that the state’s Coordinated Care Initiative, which includes the CMS-backed Cal MediConnect (CMC) duals demonstration, is not cost effective, meaning CCI will officially end in a year. But the Dept. of Health Care Services (DHCS) this month said it remains committed to the demo and plans to make certain modifications to continue being able to coordinate medical, behavioral health,… Read more
From Drug Benefit News - Carriers participating in the Federal Employees Health Benefits Program (FEHBP) for 2018 should focus heavily on moderating rising prescription drug prices and utilization, the Office of Personnel Management (OPM) told insurers in its annual FEHBP Program Carrier Letter. The annual letter, used by OPM to lay out its priorities for FEHBP each year, is designed to help insurers craft their benefit and rate proposals, which are due by May 31. Read more
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