CMS Approves California Medicaid Waiver. How Does It Differ From Texas’ Expiring 1115?

California is the latest state to receive federal approval for the renewal of a waiver meant to pay for reforming the Medicaid program by instituting new care delivery strategies and platforms. Modern Healthcare reports that California’s waiver is worth $6.2 billion and will help offset the cost of uncompensated care accrued at its safety net hospitals. Texas has a similar request pending with the Centers for Medicare and Medicaid Services. Known as the 1115 waiver, the state had to request renewal by last September. Texas’ waiver is worth nearly five times as much as California’s ($29 billion over four years) and… Full Story

Meet The Healthcare Lawyer Who D CEO Honored As Outstanding In-House Counsel

When Parkland decided to spin off a healthcare data analytics department, it was entering uncharted territory. Steve Roth, senior vice president and senior deputy general counsel at Parkland, led the effort to create what is now the nonprofit Parkland Center for Clinical Innovation. Roth serves as its chief counsel. Full Story

Alternative Payment Models Look To Help Offset Cost Of Repealing SGR

Earlier this year, Congress repealed the much maligned Sustainable Growth Rate cost-control scheme used by the Centers for Medicare & Medicaid Services (CMS). If you are like I am, you are celebrating this legislative victory—the SGR Repeal and the Medicare Provider Payment Modernization Act—which took too many years to achieve. The estimated cost of repealing SGR is $150 billion over 10 years because, in the simplest terms, the SGR law attempted to control growth in Medicare costs by reducing the reimbursement rate for each “unit of service” provided by physicians. But, as Joel White, president of the Council for Affordable… Full Story

Another Resignation At The State’s Top Health Agency

The former chief of staff to the state’s top health agency’s highest lawyer has resigned, The Texas Tribune reports. Cody Cazares voluntarily put in his resignation on August 7. He was chief of staff to Jack Stick, the former deputy inspector general of the Texas Health & Human Services Commission who resigned amid an investigation that he helped steer a contract to an Austin firm without undergoing the proper bidding process. In January,  he was placed on leave for six months and saw his salary cut from $112,000 to $55,000. Cazares was placed on leave while the investigators dug into the situation. A spokeswoman for… Full Story

Inside The Medicaid Waiver Standoff, And What It Means For Texas

For the last four years, Texas healthcare providers have received billions of dollars from the federal government for treating the uninsured while implementing programs to keep them healthy. The state will need to ask for a renewal this year if it wants that money once the funds’ authorization expires in September 2016. And there’s no guarantee Texas will be given more money. Full Story

On The Interconnectivity Of Medicaid Expansion, 1115 Waiver Renewal, And Access To Care

A study released late last week declared that the percentage of Texan adults without health insurance dropped more than 7 percentage points from September 2013 to last March, a free-fall that is “almost entirely attributable to a rise in individually purchased health plans” through the Affordable Care Act. The Health Reform Monitoring Survey, written and researched by Rice University’s Baker Institute and the Episcopal Health Foundation, found that enough uninsured Texans bought coverage through President Barack Obama’s insurance exchanges to drop the state’s uninsured rate by a third during the two open enrollment periods, descending from 24.6 percent to 16.9… Full Story