Much of the hotly debated health care reform legislation won't actually be implemented for months or years, but an expanded drug rebate program is an important exception. States can collect additional rebates right away, which may help some with severe budget shortfalls.
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Like many state Medicaid directors, Elena Nicolella says that her biggest fiscal challenge is responding to an ever-increasing need for services with an ever-decreasing amount of revenue.
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Athos Alexandrou, director of Maryland's Medicaid pharmacy program, says the state will benefit fiscally from the health care reform legislation's drug rebate program, by getting a share of rebates for pharmaceuticals dispensed by managed care organizations (MCOs). On the other hand, money will be lost on the fee-for-service side.
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Medicaid managed care plans currently serve 21.6 million people, and this number is expected to increase significantly as a result of the health care reform legislation.
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As of 2014, Medicaid will cover everyone below 133% of the federal poverty level, including childless adults and others who are currently ineligible. However, the new health care reform law gives states the option of covering additional low-income adults right away.
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With an estimated 16 million additional Americans coming onto the Medicaid program as of 2014, having enough providers to ensure good access to care is certainly a legitimate concern.
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A "master planning" approach is needed to effectively leverage all of the incentives and resources for building statewide Health Information Exchange (HIE) capacity, says Lynn Dierker, RN, project director for the Chicago-based AHIMA Foundation's state-level HIE Consensus Project.
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This story is the second of a two-part series on improving care of high-risk youth enrolled in Medicaid. This month, we examine the impact of improved quality on subsequent contacts with the juvenile justice system.
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