Texas Covered Weekly by TAHP | 08.16.2024

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:

  • August 27th: Senate Committee on Business and Commerce has posted a hearing on AI.
  • August 27th: The House Human Services Committee has posted a hearing. The committee will hear invited testimony on its charge to monitor the implementation of HB 1575 that passed last session and aims to improve health outcomes for pregnant women under the Medicaid program.
  • September 5th: House Insurance is expected to hold a hearing on health care issues.
  • September 5th: Senate Finance has posted a hearing to discuss mental health services and inpatient facilities and the implementation of SB 30.
  • September 18th: Senate Health & Human Services will hold a hearing to hear testimony on Mental Health and Access to Health Care charges (scope of practice issues).


?? 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:

  • The Texas Pharmaceutical Initiative (TPI) will meet again on August 20th to discuss next steps of the TPI business plan.
  • The Statewide Behavioral Health Coordinating Council (SBHCC) will meet on August 21st to receive an update on the Children’s Mental Health Strategic Plan.
  • Comprehensive Hospital Increase Reimbursement Program (CHIRP): HHSC will hold a public hearing on August 21st on proposed SFY 2026 quality metrics and performance requirements.
  • The Policy Council for Children and Families (PCCF) will meet on August 22nd to consider its draft legislative report.
  • Texas Incentives for Physicians and Professional Services (TIPPS): HHSC will host a public hearing on August 28th on proposed SFY 2026 quality metrics and performance requirements.


?? Mark Your Calendar: TAHP Events

?? November 4-6 | Austin, TX

  • ?? Texas Covered 2024 Health Care Conference and Expo: Texas' premier health care event with enhanced networking and learning opportunities. Members register at a discounted rate of $800 and get a 10% discount on sponsorship packages. Register now.

?? December 11 | Austin, TX

  • ?? TAHP Holiday Party: Celebrate the year's successes at our holiday party. Mingle with TAHP members and legislative staff in a relaxed and festive setting. Strengthen community ties and enjoy quality time with influential health care professionals.

?? January 29 | Austin, TX

  • ?? TAHP Legislative Day at the Capitol: Includes Food for Thought lunch with Capitol staffers, legislative office visits, and a networking event for health plan leadership. More details coming soon.
  • ??? CEO and Health Plan Leadership Dinner: TAHP will host a dinner for our health plan leaders at Comedor in Austin, TX following our Legislative Day at the Capitol. Sponsorships for this event are now available, for more information email Patti Doner at [email protected].

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.

Register Today!


?? 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.

Listen Now!


Interested in TAHP Membership?

  • For three decades, TAHP has been a leader on issues that improve the accessibility, value, and quality of health care in Texas. Learn how our plans help keep the state healthy, with over 20 million Texans covered.
  • Membership with TAHP is an invaluable tool for integrating, building relationships, exchanging information and best practices, and promoting your services.
  • Learn more about becoming a member of TAHP, and gain full access to TAHP membership benefits.



要查看或添加评论,请登录

Texas Association of Health Plans的更多文章

社区洞察

其他会员也浏览了