Author Archives: Elyse VanderWoude
CO RAE Enrollment is Down 7.8%, Feb-24 Data
Enrollment in Colorado’s six Regional Accountable Entities was down 7.8% to 1.2 million in February 2024, compared to year-end 2023, after decreasing 19.7% in 2023, and increasing 7.8% in 2022 and 10.4% in 2021.
WA Medicaid Managed Care Enrollment is Down 2.7%, Mar-24 Data
Medicaid managed care enrollment in Washington is down 2.7% to 1.7 million in March 2024, compared to year-end 2023, after decreasing 11.3% in 2023 and rising 7.2% in 2022, 7.4% in 2021, 11.8% in 2020, and 1.9% in 2019. Enrollment totals were adjusted to no longer include various tribal and county organizations with Primary Care Case Management (PCCM) lives. Enrollment data can be found here.
NY Senator Introduces Bill to Increase Transparency in Medicaid Managed Long Term Care Plans
Spectrum Local News reported on May 16, 2024, that New York State Senator Rachel May (D-Syracuse) introduced a bill that would require the state to make Medicaid Managed Long Term Care (MLTC) data public, including the number of enrollees, types of services received, and amount of home care hours provided. The bill is intended to enhance accountability of MLTC plans and ensure allocated funding goes to home care services. The bill is currently being reviewed by the Senate Health Committee. Lawmakers previously proposed legislation to eliminate MLTC plans and revert to a fee-for-service model; however, it is unlikely to pass during the current legislative sessions. Read More
TN Receives CMS Approval for Section 1115 TennCare III Waiver Amendment
The Centers for Medicare & Medicaid Services (CMS) approved on May 17, 2024, Tennessee’s request to amend its Medicaid section 1115 demonstration entitled, “TennCare III,” effective through December 30, 2030. The amendment allows for modifications including the expansion of eligibility for parents and caretaker relatives of dependent children, a new benefit to cover a supply of diapers for infants and young children, and enhanced home and community-based services for beneficiaries with disabilities. Read More
FL Lawsuit Over CHIP Guidelines Challenged by Biden Administration
Health News Florida reported on May 16, 2024, that the Biden administration filed a motion to dismiss Florida’s lawsuit challenging guidelines from the Centers for Medicare & Medicaid Services prohibiting the state from removing children from the Children’s Health Insurance Program (CHIP), KidCare, if parents stopped paying required premiums. The Biden administration contends that the guidelines adhere to the Consolidated Appropriations Act of 2023 while Florida has argued that the guidelines violate the Administrative Procedure Act. Florida initially filed the lawsuit in February and additionally requested a preliminary injunction, which has not yet been ruled upon. Read More
NV Solicits Public Input for Upcoming Coordination-only D-SNP RFP
The Nevada Division of Health Care Financing and Policy released on May 17, 2024, a solicitation of public input regarding an upcoming request for proposals (RFP) for the Coordination-Only Dual Special Needs Plan (CO D-SNP) Program. CO D-SNP State Medicaid Agency Contracts will be effective from January 1, 2026, through December 31, 2029, with awards to be announced in early January 2025. The solicitation will accept input from plans and stakeholders on items such as inclusion of health risk assessments, covered populations, expansion of service area, supplemental benefits, and quality measures through June 17. Read More
NV CO D-SNP Solicitation of Public Input, May-24
Nevada Solicitation of Public Input for Coordination Only Dual Special Needs Plan (CO D-SNP) Program Request for Proposals (RFP), Issued May 17, 2024
Jefferson Health, Lehigh Valley Health Network Health Systems to Merge
Modern Healthcare reported on May 15, 2024, that health systems Jefferson Health and Lehigh Valley Health Network have signed a definitive agreement to merge. The merger will establish a $15 billion regional nonprofit system operating 30 hospitals and more than 700 care facilities in Pennsylvania and New Jersey. The deal is expected to close this summer. Financial details have not been disclosed. Read More
Senators Introduce Bill to Improve Pay for PCPs, Reduce Cost-Sharing For Medicare Beneficiaries
Fierce Healthcare reported on May 15, 2024, that United States Senators Sheldon Whitehouse (D-Rhode Island) and Bill Cassidy (R-Louisiana) introduced a bill, titled the Pay Primary Care Providers (PCPs) Act aimed at supporting and improving pay for PCPs. The bill would reward PCPs providing high-quality care and provide Medicare beneficiaries with reduced cost-sharing for some primary care services. The senators released a request for information for feedback on policy questions. The deadline to respond is July 15. Read More
Senators to Introduce Bill that Would Extend Acute Hospital Care at Home Bill for Five Years
The Hill reported on May 15, 2024, that U.S. Senators Tom Carper (D-Delaware) and Tim Scott (R-South Carolina) plan to introduce a bill that would extend the expiration date of the Acute Hospital Care at Home (AHCAH) waiver program for another five years. The program, currently set to expire December 31, 2024, permits inpatient-level hospital services to be conducted in patients’ homes. Read More
