HMA Weekly Roundup

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  • This week, our In Focus section examines how the federal government implemented changes to the Medicare program in response to COVID-19. As the COVID-19 pandemic began in the United States, Congress and the Administration responded with a series of legislative, Read More

    California Medi-Cal to Amend Certain Contracts to Address Racial Disparities

    Maine Budget Committee Projects Fiscal 2021 Shortfall

    Missouri Voters Approve Medicaid Expansion Ballot Measure

    Washington Announces IMC Expanded Access Awards

    Trump Administration Moves to Make Certain Medicare Telehealth and Scope of Practice Flexibilities Permanent

  • This week, our In Focus section reviews the Hawaii request for information (RFI) regarding reprocurement of the state’s QUEST Integration (QI) Medicaid managed care program, released on July 21, 2020. QI covers approximately 360, 000 individuals, including pregnant women, children, Read More

    California Seeks Section 1115 Medicaid Waiver Extension

    Florida Expects ‘Significant’ Fiscal 2020 Medicaid Budget Gap

    Georgia Lacks Proper Oversight of Medicaid Plans, Audit Says

    Iowa Medicaid Director to Step Down

    Medicaid Housing Support: Minnesota, Virginia

    New York to Leverage Exchange to Connect Individuals with Home Care Agencies

    Ohio Releases Single Pharmacy Benefit Manager RFP

    Texas Taps Cecile Young as Executive Commissioner of HHSC

    Senate COVID-19 Relief Bill Excludes More Medicaid Funding

  • This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state’s Read More

    District of Columbia Announces Medicaid Managed Care Awards

    Florida Medicaid Expansion Could Cover Nearly 700,000

    Kentucky Medicaid Plans Point to Flaw in Bidding, Awards Process

    Montana Announces Behavioral Provider Relief Grants

    Nevada Legislature Approves Cuts to Medicaid

    Oklahoma Seeks Input for Medicaid Managed Care RFP

    South Dakota Medicaid Expansion Advocates Prepare for 2022 Ballot Measures

    CMS Issues Medicare Advantage MLR Requirement Guidance

  • This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “March 2020 Medicaid and CHIP Applications, Eligibility Determination, Read More

    Georgia Delays Transition Away from Federal Exchange

    Kansas Appoints Sarah Fertig as Medicaid Director

    Michigan Plans to Cut Medicaid Rates by 3.3 Percent

    Medicaid Expansion News: Missouri, Nebraska, Oklahoma

    Nevada Considers Medicaid Reimbursement, Program Cuts

    New Jersey Extends Duration of Telehealth Access

    North Carolina Governor Signs Medicaid Managed Care Bill

    Pennsylvania Announces HealthChoices Awards

    Walmart to Sell Medicare Health Insurance in Texas

    Number of Uninsured Adults Rises by 5.4 Million, Study Shows

  • This week our In Focus section summarizes the United States Government Accountability Office (GAO) Medicaid report, State Views on Program Administration Challenges, released earlier this year. GAO conducted interviews with Medicaid officials from 50 states and the District of Columbia Read More

    Florida Governor Vetoes Disability Provider Rate Increase for Providers Serving Individuals with Disabilities

    Illinois Unit of Centene to Acquire NextLevel Members

    Kentucky Health Plans Formally Protest Medicaid Awards

    New York Medicaid Plan Sells Certain Assets to Molina

    North Carolina Medicaid Bill Awaits Governor’s Signature

    Oklahoma Voters Approve Medicaid Expansion Measure

    Virginia Governor Redirects $30 Million From Medicaid Plans

    House Votes to Increase Exchange Subsidies

  • This week, our In Focus section examines new guidance issued by the Centers for Medicare & Medicaid Services (CMS) regarding Medicare Advantage (MA) plan network adequacy requirements. On June 17, 2020, CMS released updated Medicare Advantage and 1876 Cost Plan Read More

    California Budget Adopts Cuts to Medicaid Managed Care

    Delaware to Tap Magarik to Head Health and Social Services

    Kentucky Seeks to Bring Back State-Based Health Exchange

    North Carolina House Committee Advances Medicaid Managed Care Bill

    North Dakota Seeks Input on Re-Procurement of Medicaid Expansion Managed Care Plan

    Oklahoma to Release Medicaid Managed Care RFP This Fall

    Texas Names McCreary COO of Health and Human Services

    CMS Can Force Hospitals to Reveal Prices Negotiated with Insurers, Federal Judge Rules

  • This week, our In Focus section examines the operational impacts of federal Medicare Advantage policy changes in response to the COVID-19 pandemic. On January 31, 2020, the Secretary of Health and Human Services declared a public health emergency. This was Read More

    California Names Lightbourne Health Care Services Director

    Kansas Names Christiane Swartz Interim Medicaid Director

    Missouri Chamber of Commerce Supports Medicaid Expansion

    North Carolina Senate Committee Clears Bill Delaying Transition to Medicaid Managed Care Until July 2021

    West Virginia Awards Medicaid Managed Care Contracts

    Medicare Would Permanently Cover Telemedicine at FQHCs, Rural Clinics Under House Bill

    MedPAC Calls for Accelerated Transition to Medicare Value-based Payments

  • This week, our In Focus section discusses an issue brief prepared by Health Management Associates (HMA), Optimizing Capacity for Prescribing Buprenorphine in Jails and Prisons, authored by HMA Principals Shannon Robinson, MD and Donna Strugar-Fritsch, BSN, MPA, CCHP. Read More

    California Provides Updated Timeline for Medicaid Managed Care Procurement RFP

    District of Columbia Medicaid May Integrate Behavioral

    Florida Medicaid to Update Inpatient Payment Methodology

    Illinois Medicaid Plan NextLevel Health to Close Down

    Illinois Health System to Accept Molina Medicaid Members

    Kentucky Plan to Protest Medicaid Managed Care Awards

    Missouri Medicaid Expansion Ballot Measure Can Proceed

    New Jersey Falls Short in Medicaid LTSS Payment Audit

    New York Primary Care Practices Are Hard Hit By COVID-19

    CMS to Use ‘Glide Path’ to Phase Out Medicaid 1135 Waivers

    CMS Releases Medicaid, CHIP Plan MLR Guidance

  • This week, our In Focus section provides a model framework examining an option for care for individuals with behavioral health needs who often find themselves involved with law enforcement or in hospital emergency rooms during times of crisis. The framework Read More

    California DHCS Director Bradley Gilbert Resigns

    California Governor Proposes Fiscal 2021 Medicaid Cuts

    Florida AHCA Secretary Mayhew Eyes Medicaid Changes

    Hawaii to Rescind Medicaid Managed Care Contracts Scheduled to Take Effect in July

    Illinois to Extend Medicaid to Undocumented Seniors

    Kentucky Awards Medicaid Managed Care Contracts

    Louisiana to Form Joint Medicaid Oversight Committee

    New Jersey Proposes Revisions to Telehealth Requirements

    New York Governor Holds Back On Budget Cuts

    Puerto Rico Medicaid Plan Is For Sale, Molina Says

  • Pre-Conference Workshop: October 25 Conference: October 26-27 Location: Fairmont Chicago, Millennium Park Dear Friends, The fifth annual HMA conference on trends in publicly sponsored health care is schedule for October 25-27 at the Fairmont Chicago, Millennium Park. It was well Read More

    Illinois Lawmakers Pass Hospital Bill Without Funds to Support Merger of Troubled Safety-Net Hospitals

    Indiana Awards Medicaid Managed Care ABD Contracts

    Medicaid Expansion News: Kansas, Missouri, Oklahoma

    Kentucky Medicaid Managed Care Awards Expected In May

    CMS Releases Final Rule on Medicare Advantage Use of Telehealth, Coverage of ESRD Patients