Texas Covered Weekly by TAHP | 08.16.2024
A weekly roundup of the news you need. ??
?? TAHP Welcomes Lynn Ramsey, CHA as Director of Medicaid Operations
?? Must know info: We are pleased to announce the newest addition to our team, Lynn Ramsey, CHA , who will be joining us as the Director of Medicaid Operations starting Monday, August 19. Her email address is [email protected].
??♀? Hitting the ground running: Lynn brings with her an extensive background in Medicaid and CHIP policy, with over five years of experience in navigating complex regulatory environments and leading operational excellence.
?? Lynn’s background: Her most recent role as Director of Regulatory Operations at DRISCOLL HEALTH PLAN has honed her expertise in compliance, process improvement, and stakeholder collaboration—skills that are crucial to our ongoing efforts in advocating for affordable health care across Texas. Lynn’s leadership and knowledge will be invaluable as we continue to coordinate Medicaid operations with Medicaid MCOs and Texas Health and Human Services .
?? Please join us in welcoming Lynn to the TAHP team. We are confident that her contributions will greatly enhance our mission and further strengthen our commitment to all of you.
?? #TxLege Update: Doc Anderson Resigns
Republican State Rep. Doc Anderson Resigns: A press release from Anderson’s office said he moved to retire early “to help bolster the legislative seniority of his replacement.” He urged Gov. Greg Abbott to call a special election on Nov. 5 — Election Day — to pick a successor to serve out his term, which ends in January.
The Texas Association of Business Calls for Protection of Employer Health Benefits: TAB’s recent op-ed highlighted a “concerning trend where certain state lawmakers have disregarded federal ERISA law” which is the cornerstone of employer health plan regulatory flexibility. Check out TAB’s advocacy from last session opposing efforts to add burdensome regulations to employer coverage.
Former Houston Mayor Sylvester Turner narrowly won the Democratic nomination for Jackson Lees’s Congressional seat, securing 41 votes from a committee of Democratic party officials.
Upcoming #TxLege Hearings:
?? Texas Regulatory Roundup
The Texas Pharmaceutical Initiative (TPI) board held its 7th meeting on August 8th, 2024 and featured insights from the Texas Pharmacy Association, Express Scripts, 3 Axis Advisors, and McKinsey & Company. Discussions focused on refining the strategic plan for managing Texas Medicaid’s prescription drug coverage as the October 2024 deadline for the business plan nears. View TAHP’s recap here.
Texas APCD Rule Amendments: TDI proposes updates to the APCD Common Data Layout, enhancing data submission timelines and revising advisory committee roles, implementing HB 3414 (88R, 2023). TAHP has developed a summary of the proposal, which you can view here. Comments are due September 16, 2024.
Medicaid cost containment comments are due by Aug. 31. The 88th Legislature included a cost containment rider in the General Appropriations Act directing HHSC to achieve $450 million in savings by focusing efforts on reducing fraud, waste, and abuse, maximizing flexibilities, and making programs more efficient. Submit your ideas to [email protected].
Texas Women’s Health Programs Report: HHSC released a report providing a summary of program enrollment, service utilization, and cost savings for Healthy Texas Women, the Family Planning Program, and Breast and Cervical Cancer Services.
??? Upcoming Meetings:
?? Mark Your Calendar: TAHP Events
?? November 4-6 | Austin, TX
?? December 11 | Austin, TX
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?? January 29 | Austin, TX
The bottom line: Don't miss these opportunities to engage with industry leaders and shape Texas health care.
? Two crucial Texas Covered panels you need to attend—register today!
?? Get your ticket today for these essential conversations about Texas health care trends and challenges.
Why it matters: Understanding the latest developments in Texas health care is crucial for staying informed and making impactful decisions in the industry.
?? A Conversation with Texas Commissioners Hear from Texas Health and Human Services Commissioner Cecile Erwin Young and Texas Insurance Commissioner @Cassie Brown as they discuss the pressing challenges in Texas health care. This session provides insights into the policy and regulatory directions that will shape the state's health system.
?? Fighting the Maternal Health Crisis in Texas Learn how virtual care is being used to address the maternal health crisis in Texas. Isabelle Von Kohorn MD PhD from Pomelo Care will cover the innovative approaches that are improving outcomes for mothers and newborns across the state.
?? Stay Ahead: TAHP's Innovative Member Spotlight
?? Blue Cross Blue Shield of Texas Maternal and Infant Health Initiative Serves Nearly 50,000 Texans in Year One.
?? Wellpoint -TORCH Partnership Generates $1 Million in Rural Texas Clinic Improvements.
?? Texicare Selects CirrusMD to Provide Access to On-Demand Virtual Care for Small Employer Groups in Texas.
?? SCAN Group Named to Modern Healthcare ’s Diversity Leader Organizations List
?? Capital Rx Tackles High-Cost Therapies in Latest Podcast
??Latest Podcast: Casey Stockman, PharmD , shares practical strategies for managing the financial and regulatory challenges of covering high-cost gene and cell therapies (CGTs) and GLP-1s.
??Why it matters: With rising costs, understanding how to manage these therapies is crucial for health plans to maintain compliance and ensure effective patient care.
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