ENHANCED FMAP STILL ON HOLD AS AUGUST RECESS LOOMS

Extending the ARRA’s enhanced FMAP rates appears to be one of Congress’ orphan children. After public and media outcry regarding Congress’ inability to extend jobless benefits for the long-term unemployed and the appointment of a new Senator to fill that of the late Robert Byrd, Senate Democrats were finally able to muster the 60 votes necessary to pass the extension of UI. Unfortunately, Senate Democrats have fallen consistently two votes short of those needed to extend FMAP relief to states. Among the Senators most closely identified with the possibility of supporting such an extension are Senators Collins and Snowe (R-ME), Voinovich (OH), and Brown (MA). Senator Nelson (D-NE) is considered a lost cause. States all over the country are increasingly skeptical that a sharply divided Congress will be able to produce any kind of state assistance and many of the states whose budgets had accounted for the extension are going back to the drawing board to find ways to cut millions from their Medicaid program. The lack of support in Congress was even noticed by Wall Street as analysts began suggesting that the lack of fiscal relief to the states could cause states to lay off tens of thousands of state workers, further hindering the economic recovery and placing prolonged pressure on the safety net. Whether that will be enough to move FMAP extension opponents off the dime remains to be seen.

Two points of note for ACAP plans with regard to relationship building with your Members of Congress. First, the House of Representatives will be adjourning for their August recess on August 2 and returning September 13. The Senate will be adjourned from August 9 through September 10. ACAP encourages all members to reach out to your Congressional offices (and particularly their District offices) to schedule a meeting or site visit with your member of Congress and use that time to build up support for your safety net health plan and the work you do. Second, remember that ACAP’s fall fly-in is scheduled for September 13-14 – A LITTLE OVER SIX WEEKS AWAY! We urge you to start calling now to arrange for your DC meetings by calling the office scheduler and request a meeting with the Member of Congress DIRECTLY. The Congressional switchboard line is (202) 224-3121.

ACAP HONORS CHAIRMAN WAXMAN AND ANDY SCHNEIDER

ACAP honored House of Representatives Committee on Energy and Commerce Chairman Henry Waxman and his Chief Health Counsel Andy Schneider for exemplary leadership on health care reform with its legislator award. It was given at ACAP’s annual CEO Summit, where following the award presentation, Andy Schneider discussed health reform and the future of health legislation.

SENATOR MCCASKILL SUBMITS REMARKS HONORING ACAP ANNIVERSARY

Senator Claire McCaskill from Missouri submitted an extension of remarks for the Congressional Record in honor of ACAP's 10th Anniversary. In the remarks, she thanked ACAP and its members for their service to our nation’s underserved populations, as well as congratulated them on their 10th anniversary of supporting the nation’s nonprofit Safety Net Health Plans.

MLR DEFINITION STILL NOT FINALIZED

The National Association of Insurance Commissioners continues to work on its long-overdue recommendations to CMS on the definition of Medical Loss Ratio (MLR). Reports from the recent conference calls hosted by NAIC indicate that at this time ICD-10 expenses, fraud and abuse expenses and accreditation fees will not be included as healthcare costs in the MLR calculation. Although the Financial Committee developing the recommendations is continuing to carry out discussions with CMS, it appears that they are not defining any of the three areas as quality of care expenses. The Committee is also reported to be ready to adopt a resolution that would maintain capitated payments as 100% medical expenses, which would be included in MLR calculations.

ACAP submitted comments on the definition of MLR to CMS and NAIC in mid-May. The comments are available on the ACAP website.

CARESOURCE DOLES OUT FUNDS TO NONPROFITS

CareSource Foundation has doled out nearly $400,000 in grants to 26 organizations in Ohio and Michigan. The foundation said the majority of the funds went to support a new health care initiative in Montgomery County.

A Signature Grant of $210,000 was given to support the launch of Montgomery County Care, a pilot health services program that targets uninsured adults in the Dayton region. Through the program, up to 1,000 uninsured adults in Montgomery County will have access to cost-effective primary care and prescriptions, according to a press release. Montgomery County Care is a partnership with Montgomery County and the Community Health Centers of Greater Dayton.

"While everyone has felt the effects of the high unemployment rate and difficult financial conditions in our community, the population that CareSource touches has felt the recession deeply," said Cathy Ponitz, executive director of CareSource Foundation. "We are committed to finding health solutions in the communities where we live and work. The Signature Grant that supports the Montgomery County Care initiative is an example of our commitment."

STEPHEN COX PROMOTED TO SENIOR PROGRAM ASSOCIATE at acap

Stephen Cox has been promoted to Senior Program Associate at ACAP. As part of Stephen’s new duties, he will perform:

• Survey development and tabulation
• Quantitative analysis of Medicaid and Medicare managed care issues
• Factsheets writing on policy issues
• Legislation tracking
• Grant opportunities tracking for ACAP and managing the proposal development process
• Research on Medicaid managed care issues, payment reform, health IT, quality and others.
• Responding to member inquiries and developing various sessions for ACAP meetings.
• Support the website

Congratulations to Stephen!

COMMUNITY HEALTH CHOICE ANNOUNCES NEW VICE PRESIDENT – MEDICAL AFFAIRS

Dr. Fred Buckwold has assumed the role of vice president – Medical Affairs (senior medical director) at Community Health Choice, Inc. In this position, Dr. Buckwold is responsible for executive oversight of all CHC clinical programs, including care management and clinical quality improvement.

“We are very excited to have Dr. Buckwold join CHC. As a seasoned managed care medical director in the Houston area, he is well known and respected by the hospital and physician community as a person of integrity who is willing to work collaboratively to improve outcomes while managing the cost of care,” says Ken Janda, CHC’s CEO.

Dr. Buckwold is board certified in Internal Medicine, Infectious Diseases and Quality Assurance/Utilization Review. He earned his M.D. from McMaster University in Hamilton, Ontario, Canada. He is from Vancouver.

Press Release: “Community Health Choice Announces New Vice President – Medical Affairs”

AMERIHEALTH MERCY HEALTH PLAN AWARDS SCHOLARSHIPS TO ITS MEMBERS

Seventeen Medical Assistance members recently received $2,000 educational scholarships at an awards banquet sponsored by AmeriHealth Mercy Health Plan. The Member Scholarship program is part of the company’s Mission Partnership program and these funds are generated through monetary contributions from employees of AmeriHealth Mercy Health Plan. Each year, employees from AmeriHealth Mercy Health Plan are asked to contribute funds that will allow its members to receive a scholarship for college or vocational school.

“We are excited to be able to award our members scholarships to help them further their education. All of our recipients are smart, courageous and hard-working and they will make great contributions to their communities and this country,” explained Marge Angello, RN, Executive Director of AmeriHealth Mercy Health Plan.

This program helps members pay for additional education past high school. The award winners, who reside in York, Berks, Lancaster, Northampton or Lehigh county, include non-traditional students and recent high school graduates. Many of these recipients have overcome significant personal challenges, including disadvantaged backgrounds and illnesses, in order to pursue higher education.

“Education is the key to a better life. It is inspiring to know that although many of these members have experienced major challenges in their lifetime, they are continuing their education to enrich their lives and the lives of their loved ones,” explained Jay Feldstein, DO, Interim Regional President, Northeast, and Corporate Chief Medical Officer, which includes AmeriHealth Mercy Health Plan.

In 1988, AmeriHealth Mercy Health Plan created the Member Scholarship program to provide scholarships to its members enrolled in college or vocational school. For the past 22 years, more than 700 scholarships have been awarded to members in the Lehigh/Capital and Philadelphia regions. Almost $2 million has been awarded to members.

ACAP SEEKS DIRECTOR OF MEDICAID POLICY

ACAP is seeking a Medicaid Policy Director for a variety of activities, including policy and lobbying, management, and member relations. If interested please refer the job announcement below and contact contact Meg Murray at 202.204.7509 or mmurray@communityplans.net.

Job Announcement: “Director of Medicaid Policy”

ACAP SEEKS PROGRAM ASSOCIATE

ACAP is seeking a Program Associate to provide policy, research and administrative support on projects related to Medicare and Medicaid managed care. This position offers an excellent opportunity to be a part of a leading organization committed to increasing access to quality health services for vulnerable populations. Position requires excellent verbal, computer, organization, writing and interpersonal skills, and the ability to perform independently in a fast-paced environment under general supervision. If interested please refer the job announcement below and contact contact Stephen Cox at 202.204.7516 or scox@communityplans.net.

Job Announcement: “Program Associate”

HUDSON HEALTH PLAN'S MARGARET LEONARD APPOINTED TO NEW YORK STATE BOARD OF NURSING

Margaret Leonard, Senior Vice President of Clinical Services at Hudson Health Plan, has been appointed to a five-year term on the New York State Board of Nursing, which oversees Registered Nurses, Nurse Practitioners and Licensed Practical Nurses, with the charge to advise and assist the Board of Regents and the State Education Department on matters of professional regulation.

"It's wonderful to have a seat at the table where some of the most important health care issues facing our state and nation are being discussed and addressed," explains Ms. Leonard. "Our health care delivery system is changing dramatically, creating new opportunities for nursing. As a member of the New York State Board of Nursing, I believe I can help strengthen the role of nursing in the new delivery models that are taking shape under reform, and this will benefit everyone."

Ms. Leonard plans to address the critical issue of nursing education, including the state's acute shortage of qualified nursing faculty. "In most cases, bedside nurses make more money than teachers, so there is little incentive for nurses to teach," she explains. "We need to explore imaginative ways to attract nurses to teaching, such as offering scholarship money and loan forgiveness programs."

Press Release: “Hudson Health Plan's Margaret Leonard Appointed to New York State Board of Nursing”

NETWORK HEALTH RECOGNIZED FOR HAVING TOP LEADERSHIP TEAM IN HEALTH CARE

Network Health, a Massachusetts health plan that provides high-quality health care coverage to Massachusetts residents through its Network Health Together® (MassHealth) and Network Health Forward® (Commonwealth Care) plans, recently learned HealthLeaders Media, through its Top Leadership Teams in Healthcare program, named Network Health’s senior leadership team the top-performing health plan management team. The Top Leadership Teams in Healthcare program annually recognizes the best leadership team work at acute-care hospitals, health plans, and medical group practices, with the goal to discover and share new teamwork best practices.

MEETINGS

ACAP HOSTS SUCCESSFUL SUMMER BOARD MEETING AND CEO SUMMIT

ACAP held its 8th annual, invitation-only CEO Summit on July 13 & 14, 2010 in Washington, DC. This meeting brought together over 150 CEOs of Medicaid-focused health plans, their senior staff and and representatives of the Washington policy community to discuss the role that Medicaid managed care is playing in state and federal health reforms. Thank you to all the speakers and attendees for making it such a successful event. The agendas and presentations are all available on the CEO Summit page of the ACAP website.

SAVE THE DATE: SEPTEMBER LEGISLATIVE FLY-IN

ACAP'S next legislative Fly-In will take place on September 13 & 14, 2010. It will kick off with lunch and a lobbying briefing at 12:30 pm which will conclude by 1:45 pm. Plans will then go to their scheduled hill meetings on Monday afternoon. On Tuesday morning there will be breakfast and a brief check-in before plans will go back to the hill for their scheduled legislative meetings. If you have not already started doing so, the time is now to set up meetings with your Senators and Representatives. Registration and more detailed information will be available shortly.

You can reserve your room now by calling the Hotel George at (800) 576-8331 and stating that you are with the “ACAP Fly-In Meeting” to receive the special room rate. Please note that ACAP cannot guarantee hotel and group rate availability and that the last day to reserve rooms at the group rate will be August 16, 2010. If you have any questions please contact Stephen Cox at scox@communityplans.net.

The Hotel George
15 E Street, NW
Washington, DC 20001
(202) 347-4200

SAVE THE DATE: FALL BOARD MEETING

Please hold the date for ACAP’s Fall 2010 Board Meeting which will be hosted by the Monroe Plan for Medical Care in Rochester, NY. The Board Meeting will take place all day Thursday, October 14th and continue through mid-day Friday, October 15th. In addition, ACAP and Monroe Plan would like to plan a golf and/or wine event beforehand for those that are interested on Wednesday afternoon, October 13th. Registration and more detailed information will be available shortly. The meeting will take place at the Woodcliff Hotel, you can reserve your room now by calling the hotel. State that you are with the "ACAP group" to be eligible for the group rate. Please note that ACAP cannot guarantee hotel and group rate availability.

Woodcliff Hotel & Spa
199 Woodcliff Dr – E. Rochester, NY 14450
Phone: (585) 248-4810
Reservations: (800) 3653065
www.woodcliffhotelandspa.com