Author Archives: Alona Nenko

HMA Federal Health Policy Snapshot, Apr-25

1. HMA Federal Health Policy Snapshot, April 21, 2025. This week, the federal health policy Quick Takes covers developments for the week ending April 18 and other late breaking developments from April 11. This includes the prescription drug executive order, FY2026 proposed payment rules including for inpatient hospitals and SNFs, HRSA’s letter regarding Ryan White grant funding, CMS letter about Medicaid coverage of gender affirming care, HHS Secretary’s public events focused on his health initiatives, and new regulations being reviewed by OMB.
2. HMA Federal Health Policy Snapshot, April 11, 2025. This week, the federal health policy Quick Takes reflects the uptick in federal policy developments. Topics we cover this week include Congress’ transition to the budget reconciliation process, deregulation RFI opportunities, HHS MAHA tour priorities, CMS Administrator vision, change in CMS Medicaid demonstration financing options, MA and Part D final policies, and regulations tracker.
3. HMA Federal Health Policy Snapshot, April 4, 2025. This week, the federal health policy Quick Takes covers the revised Senate Budget Resolution, confirmations and nominations, tariffs, HHS reorganization, Title X grant funding developments, and the litigation seeking to overturn recission of COVID-19 funding to states. Consultants can use this as a resource and opportunity to reach out to clients and contacts.
4. HMA Federal Health Policy Snapshot, March 28, 2025. This week, the federal health policy Quick Takes covers Senate actions on President Trump’s nominees and new nominations, HHS’ reorganization plans, HHS statement regarding public health grant funding recovery, and the regulations tracker.
5. HMA Federal Health Policy Snapshot, March 24, 2025. This week, the federal health policy Quick Takes covers new Executive Orders, new postponement of telehealth rules effective dates, extension of the opioid PHE declaration, and the regulations tracker.
6. HMA Federal Health Policy Snapshot, March 14, 2025. This week, the federal health policy Quick Takes covers the federal spending deal, the ACA Marketplace proposed rule, an update from CMS’ Innovation Center, extension of Medicaid planning grants related to supporting reentry for incarcerated people, ACF’s letter to state and local officials, MedPAC and MACPAC reports, updates to our regulatory tracker, and other issues.
7. HMA Federal Health Policy Snapshot, March 7, 2025. This week, the federal health policy Quick Takes covers the expiration of the temporary funding measure for fiscal year 2025, CMS safety alert to hospitals and other entities, Medicaid guidance on health-related social needs, HHS OCR HIPAA penalties, OIG fraud recommendations, and one addition to the regulations tracker.
8. HMA Federal Health Policy Snapshot, March 3, 2025. This week, the federal health policy Quick Takes covers developments with Congress’ budget resolution and reconciliation policies, executive orders on price transparency, CDC data on drug overdose deaths, HHS and agency leadership updates, and updates to our regulations tracker.
9. HMA Federal Health Policy Snapshot, February 17, 2025. This week, the federal health policy Quick Takes includes an update on Congress’ budget reconciliation work and confirmation of the HHS Secretary, the Make America Healthy Again E.O, DEA’s delay of telemedicine rules, the RFI for a new AI Action Plan, announced changes to CMS policies, and the regulations tracker.
10. HMA Federal Health Policy Snapshot, February 10, 2025. This week, the federal health policy Quick Takes includes a brief update on federal budget reconciliation developments, CMS’ announcement about collaboration with DOGE, the NIH policy change affecting indirect rates to grantees, and Trump Administration leadership updates.
11. HMA Federal Health Policy Snapshot, February 3, 2025. This week, the federal health policy Quick Takes reviews CBO’s revised congressional budget baseline projections, OMB memos, HHS OCR’s plans to review women’s health policies, and other topics.
12. HMA Federal Health Policy Snapshot, January 20, 2025. This week, the federal health policy Quick Takes covers President Trump’s executive actions, including new Executive Orders and those he revoked in his first week.
13. HMA Federal Health Policy Snapshot, January 20, 2025. This week, the federal health policy Quick Takes reviews several of the final health and health adjacent administrative actions under former President Biden, including DEA’s telemedicine rules, an AI strategic plan for health, grants to states related to justice-involved populations, and SAMHSA’s crisis guidelines among others. The deck also outlines President Trump’s nominees and policy officials and provides a brief update on Congress’ budget reconciliation plans.
14. HMA Federal Health Policy Snapshot, January 13, 2025. This week, the federal health policy Quick Takes covers the Advance Notice for Medicare Advantage rates and Part D payment policies, the MA SNP Model of Care update, CMS’ Maternal Health Model awardees, SAMHSA’s CCBHC planning grant awards, HUD’s final rule revising HOME program regulations, and updates to the regulations tracker, among other developments.
15. HMA Federal Health Policy Snapshot, January 6, 2025. The federal health policy Quick Takes covers a few developments from the last week of December and into January 2025. Topics include Dept. of Veterans Affairs grant programs to address homelessness, a proposal to update the HIPAA Security Rule to address cybersecurity, CMS coverage program enrollment updates, SAMHSA’s maternal BH grant recipients, and the Surgeon General’s advisory on the link between alcohol and cancer risk. In addition, we include a congressional update and the updated regulations tracker.

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NM To Create Medicaid FFS Preferred Drug List

The New Mexico Health Care Authority issued on April 16, 2025, a request for proposals to develop and maintain a preferred drug list (PDL) and supplemental rebate program for the Medicaid fee-for-service program. While Medicaid managed care has a PDL, FFS Medicaid, which serves approximately 167,000 members, does not. The state is seeking to award one vendor a single contract. Proposals are due May 5, 2025, and awards are expected June 9, 2025. The contract will run for one year with three one-year renewals.

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NM Medicaid FFS Preferred Drug List (PDL) and Supplemental Rebate Program Creation RFP, Apr-25

New Mexico Creation and Maintenance of Medicaid Fee-for-Service Preferred Drug List (PDL) and Supplemental Rebate Program request for proposals (RFP), Issued April 16, 2025

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PA MLTSS Subcommittee Meeting Materials, Apr-25

Pennsylvania Managed Long Term Services and Supports (MLTSS) Subcommittee Meeting Materials, 2021-25

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PA Medical Assistance Advisory Committee (MAAC) Meeting Materials, Mar-25

PA Medical Assistance Advisory Committee Meeting Materials, January 2021 – March 2025

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Special Needs Plans (SNP) Enrollment by State and Plan, Mar-25 Data

Special Needs Plans (SNP) Enrollment by State and Plan, March 2025

This table provides Medicare Advantage Special Needs Plans (SNP) enrollment by state and plan as of November 2024. The file includes enrollment in Dual Eligible SNPs, Chronic Care SNPs, and Institutional SNPs.

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Medicaid Fee-for-Service Pharmacy Benefit Management RFP Calendar

Presented in the data package below are current contract holders, contract terms, anticipated RFP timing in states with pharmacy benefit management (PBM) services for the fee-for-service population.

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IN Pharmacy Benefit Management Services Proposals, Contract, and Amendments, 2011-25

1. Indiana Pharmacy Benefit Management Services Proposals, 2011
2. Award Documents, Issued March 8, 2012
3. Contract with OptumRx, Signed July 20, 2017
4. Amendment 1, Approved August 17, 2017
5. Original PBM Contract Documents with OptumRx, 2012-15
6. Contract with OptumRx, January 1, 2022. through December 31, 2025

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ID Pharmacy Benefits Management System (PBM) Contracts, 2018-24

1. Idaho Pharmacy Benefits Management System (PBM) Contract with Magellan, Amendment 6, February 1, 2023 – January 31, 2024
2. Idaho Pharmacy Benefits Management System (PBM) Contract with Magellan, Amendment 5, February 1, 2022 – January 31, 2023
3. Idaho Pharmacy Benefits Management System (PBM) Contract with Magellan, February 1, 2018 – January 31, 2021

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NV Medicaid Biennium Budget Priorities Fact Sheet, SFY 2026-27

Nevada 2026-2027 Medicaid Budget Priorities Fact Sheet, Published February 2025

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