HMA Weekly Roundup

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  • This week, our In Focus section highlights the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) and Part D programs for contract year 2023 and how these changes may impact plan applications, bid submissions, Read More
    Roundup:

    Florida Governor Snubs Federal COVID-19 Vaccine Mandate

    Georgia Budget Proposal to Fund New Insurance Exchange

    Louisiana Releases Medicaid PBM Services RFP

    Minnesota Releases Medicaid Managed Care, MinnesotaCare RFP Covering 80 Counties

    Missouri Receives 3 Bids for Medicaid Managed Care Program

    New Mexico to Extend Medicaid Postpartum Coverage

    New York Eyes Competitive Bidding for Medicaid Plans

    New York Governor Proposes Medicaid Rate Increases

    Wisconsin Releases HCBS Care Management System RFP

    Behavioral Health Group Buys Center for Behavioral Health

  • This week, our In Focus section highlights a Wakely white paper titled, CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings. Read More
    Roundup:

    Arkansas Reaches Settlement with Empower Healthcare

    California FQHCs to Receive Less 340B Funding

    Florida Bill Would Reshape Medicaid Managed Care Regions

    Indiana Awards Medicaid Managed Care Contracts

    Expansion News: Kansas, Missouri, South Dakota, Wyoming

    Minnesota Seeks Models that Increase HCBS Provider Wages

    New York Looks to Rebuild State Healthcare Economy

    Oregon Clears Centene/Trillium to Enroll New Members

    CMS Looks to Partnerships to Address Costs, Disparities

  • This week, our In Focus highlights a new report prepared by Health Management Associates (HMA) on the potential for Medicaid Managed Care to enable states to address social determinants of health (SDOH) and health equity above and beyond what’s possible Read More
    Roundup:

    California Receives Approval for CalAIM Demonstration

    Georgia Must Remove Medicaid Expansion Work Requirements

    Idaho Seeks Offers to Administer Behavioral Health Plan

    Iowa Delays Release of Medicaid Managed Care RFP

    Montana Must Wind Down Medicaid Expansion Premiums Above 2 Percent of Income, CMS Says

    Anthem Acquires Ohio Medicaid Contract from Paramount

    South Dakota Voters to Decide on Medicaid Expansion

    CMS Proposes Rule to Standardize Exchange Plans

  • This week, our In Focus reviews the Mississippi request for qualifications (RFQ) for the state’s traditional Mississippi Coordinated Access Network (MississippiCAN) Medicaid program and the state Children’s Health Insurance Program (CHIP). Read More
    Roundup:

    Arkansas Is Cleared to Continue Covering Medicaid Expansion Eligibles Through Exchange Plans

    California to Tighten Medicaid Plan Subcontracting Rules

    District of Columbia Delays Carve-In of Medicaid Behavioral

    Louisiana Is Cleared to Launch Medicaid Coverage for Children with Disabilities

    Montana to Increase Income Eligibility Limit for Medically Needy Program

    Utah Appoints Jack Szczepanowski as Medicaid Director

    Individual Health Plans Pay $1.3 Billion in MLR Rebates

    CMS to Investigate PBM Fees Charged to Pharmacies

    CMMI to Launch New Payment Models in 2023 at the Earliest

  • This week, our In Focus section reviews the District of Columbia (DC) Medicaid managed care request for proposals (RFP), released on November 19, 2021, by the District of Columbia Department of Health Care Finance. Read More
    Roundup:

    California OKs Single Medicaid Plan Model in 3 Counties

    Delaware Releases Medicaid Managed Care RFP

    HCBS News: Arkansas, New Hampshire, Wisconsin

    Mississippi Releases RFQ for MississippiCAN, CHIP

    Missouri ACOs Produce $58 Million in Medicare Savings

    Nebraska Seeks Input Ahead of Medicaid Plan Procurement

    Virginia Releases Medicaid Dental Benefits Administrator RFP

    Medicaid, CHIP Enrollment Rises 8.9 Percent, MACStats Says

    States Turn to Medicaid Plans to Address SDOH

  • This week, our In Focus section highlights a recent HMA analysis of the impact of Medicaid managed care on key quality indicators. Read More
    Roundup:

    Arkansas Investigates Medicaid PASSE for Fraud

    Colorado RAE Won’t Recoup Behavioral Provider Claims

    Louisiana Expects to Make Medicaid Managed Care Contract Award Recommendations This Week

    CareSource, TrueCare Eye Mississippi Medicaid Plan Contract

    North Dakota Contracts with Conduent to Upgrade MMIS

    Ohio Issues Dental OPTIONS Program RFI

    Oregon Releases Medicaid 1115 Waiver Renewal Draft

    Wisconsin Medicaid Director to Step Down

    CMS Says State Medicaid Can Cover Audio-Only Telehealth

  • This week our In Focus reviews the Missouri MO HealthNet (MHD) Medicaid Managed Care Program request for proposals (RFP), released on November 19, 2021, by the Department of Social Services (DSS). Read More
    Roundup:

    Arkansas Suspends New Enrollment in Empower Healthcare

    District of Columbia Releases Medicaid Managed Care RFP

    Maryland Expects Medicaid Enrollment to Fall in Fiscal 2023

    Nevada Seeks Equal Distribution of Medicaid Plan Membership

    North Carolina to Appoint Kody Kinsley Secretary of Health

    Pharmacy Chains Helped Fuel Opioid Crisis, Jury Finds

    Texas to Pilot LTSS Managed Care Carve-in

    Vermont Will Not Be Penalized for Failing to Meet All-Payer ACO Enrollment Target, CMS Says

  • This week our In Focus reviews the Rhode Island Medicaid managed care request for qualifications (RFQ), released on November 12, 2021, by the Executive Office of Health and Human Services (EOHHS). Contracts are worth approximately $1.4 billion annually and cover Read More
    Roundup:

    Florida Releases Invitations to Negotiate for MMIS Upgrades

    Louisiana Releases Medicaid NEMT RFP

    North Carolina Delays Launch of Behavioral Health IDD Tailored Plans to December 2022

    Oregon Seeks Waiver for In-Home Personal Care, Family Caregiver Assistance Program

    Michigan Issues RFP for Senior Center Wellness Program

    Medicaid Expansion News: Missouri, North Carolina

    Pennsylvania Court Rules in Favor of State in Two Separate Protests of Medicaid Managed Care Awards

    Virginia Reports $654 Million Medicaid Surplus

    CMS Announces Increased Medicare Part B Premiums for 2022

  • This week our In Focus reviews Minnesota Department of Human Services (DHS) requests for proposals (RFPs) for two of the state’s Medicaid managed care programs: Minnesota Senior Health Options/Minnesota Senior Care Plus and Special Needs BasicCare/Integrated Special Needs BasicCare. Both Read More
    Roundup:

    Arkansas Governor Expects Approval of Expansion Waiver

    alifornia Medicare Plan Faces Whistleblower Lawsuits

    District of Columbia to Increase Procurement Oversight

    Maryland Announces Medicaid Rate Increases for HCBS

    Minnesota Names Medicaid Managed Care Award Winners

    New Hampshire Releases MMIS RFI

    Ohio Official Says PBMs are Improperly Collecting Clawbacks

    Oregon Publishes Concept Papers for 1115 Waiver Renewal

    Jefferson Health Buys Stake in Health Partners Plans

    Wisconsin Transitions Medicaid NEMT Business to Veyo

    Democrats Agree to Let Medicare Negotiate Some Drug Prices

    Centene Sells Majority Stake in U.S. Medical Management

    Centene to Put PBM Business Out to Bid

  • This week, our In Focus section shares HMA’s takeaways from the Centers for Medicare & Medicaid Services (CMS) white paper on the CMS Innovation Center Strategy Refresh: Driving Health System Transformation – A Strategy for the CMS Innovation Center’s Second Read More
    Roundup:

    Arkansas Governor Expects Approval of Expansion Waiver

    alifornia Medicare Plan Faces Whistleblower Lawsuits

    District of Columbia to Increase Procurement Oversight

    Maryland Announces Medicaid Rate Increases for HCBS

    Minnesota Names Medicaid Managed Care Award Winners

    New Hampshire Releases MMIS RFI

    Ohio Official Says PBMs are Improperly Collecting Clawbacks

    Oregon Publishes Concept Papers for 1115 Waiver Renewal

    Jefferson Health Buys Stake in Health Partners Plans

    Wisconsin Transitions Medicaid NEMT Business to Veyo

    Democrats Agree to Let Medicare Negotiate Some Drug Prices

    Centene Sells Majority Stake in U.S. Medical Management

    Centene to Put PBM Business Out to Bid