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Arizona, May 26, 2022

What They're Watching: Les Ybarra, Anthem

| May 18, 2022 | California

In furtherance of its implementation of CalAIM Community Supports, Anthem is developing a data analytics engine to identify health disparities within its patient population, says Les Ybarra, President of Anthem's California Medicaid Plan. The plan is focused on partnering with local organizations to connect members to Community Supports services.  ...[ Read More ]

5 Things Texas: Roe v. Wade, Rural hospitals, Surprise billing

| May 12, 2022 | Texas

Late last month, CMS dropped its challenge of Texas's 1115 Medicaid waiver, ending a year-long dispute between the Biden administration and HHSC that held the future of Texas Medicaid in the balance. HHSC's original waiver, granted by the Trump administration in January of 2020, is now reinstated, securing the state's...[ Read More ]

What They're Watching: Gary Seguin, Beacon Health Options

| May 10, 2022 | Texas

Beacon Health Options is creating "peer support" roles in its Medicaid contracts, which include parents with children in the Medicaid program, to help members navigate their experience with Medicaid behavioral health care. Gary Seguin, Clinical Quality Director at Beacon, explained that parent advocates embedded into the Medicaid managed care contracts...[ Read More ]

Effort to require health plans to share PBM rebate savings with enrollees moves forward in California Legislature

| May 10, 2022 | California

California legislators are considering a bill that aims to make the cost-savings from rebates negotiated between pharmacy benefit managers (PBMs) and prescription drug manufacturers directly available to consumers at the point of sale.  Sponsored by Sen. Sydney Kamlager (D - Los Angeles), SB 1361 would require a health plan enrollee’s...[ Read More ]

5 Things Colorado: Health billing legislation, Q&A w/ Morgan Medlock, Support for older Coloradans

| May 10, 2022 | Colorado

The Colorado Legislature is set to adjourn on Wednesday after a busy session largely focused on the development of the Behavioral Health Administration, health care support for older Coloradans, and health care billing and payment reform. See our coverage of some of this legislation, as well as an insightful conversation with...[ Read More ]

5 Things California: Q&A w/ Sen. Eggman, Kaiser contract bill, Primary care investment

| May 5, 2022 | California

Happy Thursday! In today's newsletter, we bring you a Q&A with Democratic Sen. Susan Talamantes Eggman that you won't want to miss, an overview of two contentious bills moving through the California Legislature, and data that associates higher investment in primary care with positive quality and cost outcomes. Thanks for reading!...[ Read More ]