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Strategies for Navigating the New Medicaid

Omni Shoreham Hotel
Washington, DC

June 4 - 6, 2006

State Medicaid programs are undergoing fundamental transition. States are reshaping their Medicaid programs and their entire health systems by developing new models of providing benefits. The federal government continues to place Medicaid reform at the top of its agenda as it seeks broader cost savings. With the advent of the new Medicare prescription drug benefit, states must maneuver real-time challenges in managing their beneficiaries' health, while adjusting to the benefit's new financial requirements for states. These changes affect all health care stakeholders who must develop new policy and commercial strategies in response to the new evolution in Medicaid.

Join national thought leaders for an engaging three-day session that will address critical questions about emerging Medicaid reform models, the expanded role of Medicaid managed care, new federal and state strategies to manage costs, the impact of the Medicare prescription drug benefit, and the future of Medicaid long-term care.

  • Medicaid Prescription Drug Primer: How does Medicaid reimburse for prescription drugs work? Learn the basics of the Medicaid rebate program, 340b, federal upper payment limits, treatment of drugs by MCOs, and policy issues and implications.
  • Medicaid Reform Primer: How do the federal government and states modify state Medicaid programs? What is the role of Congress, CMS, state legislatures and state Medicaid agencies? What changes require a state plan amendment, a federal waiver, or a change in federal law? The session will use as examples previous Medicaid reform initiatives, such as Tennessee, Oregon, and Arizona's 1115 waivers.

  • New Directions in Medicaid and State Health Reform
  • Medicaid Cost Containment Strategies
  • Implementation of the Medicare Prescription Drug Benefit and the impact on states and dual eligible beneficiaries
  • Medicaid and Long-Term Care
  • New approaches to Medicaid managed care: The Florida and South Carolina Models
  • New approaches to pharmacy management and cost containment
  • Dual eligible and low-income beneficiaries experiences in the Medicare new prescription drug benefit to date
  • Effects of Medicare Part D on Dual Eligibles in Community and Facility LTC Settings
  • New Approaches to Medicaid: The Utah and Idaho Models
  • Evidence-based practices and new definitions of medical necessity
  • State Pharmaceutical Assistance Programs and other state strategies to supplement the new benefit
  • Innovations in Medicaid-Medicare Integration: Breakthroughs At Last?
  • New Approaches to Medicaid: Medicare and Medicaid Integration Models
  • New opportunities for disease management and care coordination programs in Medicare
  • Special Needs Plans and new innovations in designing prescription drug benefits for dual eligible beneficiaries
  • State Leadership in LTC Reform - A Case Study of Vermont's Medicaid Waiver Program
  • New Approaches to State Health Reform: Extending Coverage to the Uninsured and Reducing state health care costs
  • Medicaid Managed Care - opportunities and implications of state expansions
  • Future directions for the Part D benefit
  • LTC Industry Perspectives on Medicaid LTC Issues (including dual eligibles in LTC)
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from the Medicaid Congress.

Medicaid Congress content available either on CD-ROM or conference podcast via Video iPOD. Both offer plenary session video with synchronized PowerPoint slides and concurrent sessions audio. Purchase both for deep discount.

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Debbie Chang
Senior Vice President
and Executive Director
Nemours Division of Health and Prevention Services
Newark, DE
John Iglehart
Founding Editor, Health Affairs
National Correspondent, New England Journal of Medicine
Washington, DC
Dan Mendelson
President and Founder, Avalere Health
Former Associate Director for Health, Office of Management and Budget
Washington, DC
Thomas Scully
Senior Counsel, Alston & Bird
Senior Adviser, Welsh, Carson, Anderson and Stowe
Former Administrator, Centers for Medicare and Medicaid Services
Department of Health & Human Services
Washington, DC


Thomas C. Alexander
Member, Labor, Commerce and Industry Committee, South Carolina Senate, Columbia, SC

Scott J. Allocco
Vice President, Business Development, First Health Services Corporation, Glen Allen, VA

Stephanie Anthony
Deputy Medicaid Director, Office of Medicaid, EOHHS, Boston, MA

Gale Arden
Director, Disabled and Elderly Health Programs Group, Center for Medicaid and State Operations, Centers for Medicare and Medicaid Services, Baltimore, MD

Thomas W. Arnold
Deputy Secretary for Medicaid, Agency for Health Care Administration, Tallahassee, FL

Lauren Barnes
Senior Manager, Avalere Health, LLC, Washington, DC

Melanie Bella
Vice President for Policy, Center for Health Care Strategies, Princeton, NJ

John Bentivoglio
Partner, King and Spalding, Former Special Counsel for Healthcare Fraud, Chief Privacy Officer, United States Department of Justice, Washington, DC

Linda Berglin
Chair, Health and Human Services Budget Division, Minnesota Senate, St. Paul, MN

Mark D. Birdwhistell
Secretary, Kentucky Cabinet for Health and Family Services, Frankfort, KY

Jon Blum
Vice President, Avalere Health, LLC, Washington, DC

Tanisha V. Carino, PhD
Director, Avalere Health, LLC, Washington, DC

Mike Cheek
Manager, Avalere Health, LLC, Washington, DC

Carolyn Clancy
Director, Agency for Healthcare Research and Quality, Rockville, MD

Chuck Clapton, Esq.
Chief Counsel for Health, Committee on Energy and Commerce, Majority Staff, United States House of Representatives, Washington, DC

Tom Clark
Director of Policy and Advocacy, American Society of Consultant Pharmacists, Alexandria, VA

Andrea Cohen
Counsel, Manatt, Phelps & Phillips, LLP, New York, NY

Kevin Concannon
Director, Iowa Department of Human Services, Des Moines, IA

Brian Coyne
Vice President, Federal Government Relations Amerigroup, Washington, DC

Gene Davis
Minority Whip, Utah Senate, Salt Lake City, UT

Bob Donnelly
Former Director, Medicare Drug Benefit Group, Center for Beneficiary Choices, Centers for Medicare and Medicaid Services, Member Health, Washington, DC

Suzanne Duda
Senior Manager, Avalere Health, LLC, Washington, DC

Julie M. Eckstein
Director, Missouri Department of Health and Senior Services, Jefferson City, MO

Barbara Edwards
Principal, Health Management Associates, Columbus, OH

Barbara Eyman
Partner, Powell Goldstein, LLP, Washington, DC

Michael Fiore
Division of Plan Policy, Medicare Advantage Group, Center for Beneficiary Choices, Centers for Medicare and Medicaid Services, Baltimore, MD

Donna Folkemer
Group Director, National Conference on State Legislatures, Washington, DC

Richard Friedman
Director, Division of State Systems, Center for Medicaid and State Operations, Centers for Medicare and Medicaid Services, Washington, DC

Mark Frisse
Director, Regional Health Initiatives, Vanderbilt Center for Better Health, Nashville, TN

Jim Frogue
Chief Liaison to State Policy Projects, Center for Health Transformation, Washington, DC

Suellen Galbraith
Director of Governmental Relations, American Network of Community Options and Resources, Alexandria, VA

Mark Gibson
Deputy Director, Center for Evidence Based Policy, Program Officer, Milbank Memorial Fund, Portland, OR

Governor Tim Kaine (D-VA)
Richmond, VA

Mary Kennedy
Vice President, State Public Affairs, Ovations/Evercare, Minnetonka, MN

Larry Kocot
Senior Policy Advisor, Centers for Medicare and Medicaid Services, Washington, DC

Shannah Koss
Vice President, Avalere Health, LLC, Washington, DC

Karissa Laur
Director, Patient Assistance Programs, AstraZeneca, Wilmington, DE

Michael O. Leavitt (Invited)
Secretary of Health and Human Services, Department of Health and Human Services, Washington, DC

Senator Jim Leddy (D)
Chair, Health and Welfare Committee, Vermont Senate, South Burlington, VT

Steve Lund
Senior Director, State Relations and Administrative Services, National Association for Home Care and Hospice, Washington, DC

Tony McCann
Secretary, Maryland Department of Health and Mental Hygiene, Baltimore, MD

Mark McClellan, MD, PhD (Invited)
Administrator, Centers for Medicare and Medicaid Services, Former Commissioner, Food and Drug Administration, Washington, DC

Hunter McKay
Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Washington, DC

Teresa Ann Miller, PharmD
California Department of Health Services, Medi-Cal, Policy Division, Sacramento, CA

Hazel Moran
Senior Director, Healthcare Reform, National Mental Health Association, Alexandria, VA

Meg Murray
Executive Director, Association for Community Affiliated Health Plans, Washington, DC

Len Nichols
Director, Health Policy Programs, New America Foundation, Washington, DC

Elizabeth Priaulx
Senior Disability Legal Specialist, National Disability Rights Network, Washington, DC

Mark Reynolds
Chief Executive Officer, Neighborhood Health Plan of Rhode Island, Providence, RI

David Rogers
Administrator, Medicaid Division, Idaho, Health and Welfare Department, Boise, ID

John Richardson
Vice President, Avalere Health, LLC, Washington, DC

Alan Rosenbloom
President, Alliance for Quality Nursing Home Care, Washington, DC

David Rosenfeld
United States House of Representatives, Committee on Energy and Commerce, Washington, DC

Diane Rowland
Executive Vice-President of the Henry J. Kaiser Family Foundation, Executive Director of the Kaiser Commission on Medicaid and the Uninsured, Washington, DC

Matt Salo
Director, Health and Human Services Committee, National Governors Association, Washington, DC

Marc Samuels
Partner, Hillco Partners, LLC, Washington, DC

Andy Schneider
Principal, Medicaid Policy, LLP, Washington, DC

Dexter W. Shurney, MD, MBA, MPH
Vice President, National Business Medical Director, American Healthways, Nashville, TN

Bridget Taylor
Committee on Energy and Commerce, Minority Staff, United States Senate, Washington, DC

Jane Tilly, Dr. P.H.
Director, Quality Care Advocacy, The Alzheimer's Association, Washington, DC

Michael Tutty, MHA
Senior Project Director for the Center for Health Policy and Research, Instructor for the Department of Family Medicine and Community Health, University of Massachusetts Medical School, Shrewsbury, MA

Leticia Van de Putte
Chair, Veteran Affairs and Military Installations Committee, Texas Senate, President-elect, the National Conference of State Legislatures, Chair, RSG Steering Committee, San Antonio, TX

William Vaughan
Senior Policy Analyst, Consumers Union, Washington, DC

Linda Velgouse
Aging Services Program Specialist, Administration on Aging, Department of Health and Human Services, Washington, DC

Jim Verdier
Director of State Health Policy, Mathematica Policy Research, Washington, DC

Sandeep Wadhwa, MD
Vice President, Care Management, McKesson Health Solutions, Broomfield, CO

Lorraine Wargo
Vermont Department of Aging, Disability and Independent Living, Waterbury, VT

Brian Wheelan
Deputy Director of Medicaid, Massachusetts Department of Health and Human Services, Boston, MA

Chiquita White
Senior Manager, Avalere Health, LLC, Washington, DC

Jean Moody Williams, RN, MPP
Director Division of Quality, Evaluation, and Health Outcomes, Center for Medicaid and State Operations, Centers for Medicare and Medicaid Services, Washington, DC

Susan Winckler
Vice President, Policy and Communications Staff Council, American Pharmacists Association, Washington, DC

Ken Yale, DDS, JD
Vice President of Government Programs, Matria Healthcare, Washington, DC

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