HMA Weekly Roundup

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  • This week, our In Focus section reviews recent announcements and actions by Congress and the Centers for Medicare & Medicaid Services (CMS) that have significant financial and operational implications for the hospital industry. This brief begins with the most recent Read More
    Roundup:

    State Budget News: California, Michigan

    Hawaii Medicaid Enrollment Hits 348,000 as Applications Spike

    Kansas Medicaid Director Adam Proffitt Resigns

    Nebraska Is on Track to Implement Medicaid Expansion

    Oklahoma Senate Confirms Kevin Corbett to Head OHCA

    1199SEIU, Home Care Providers Call On Congress for Support

    CMS Gives States Medicaid Managed Care Rate Flexibility

    States Expect Medicaid Spending Growth to Accelerate

    Medicaid Plan Profit Margin Dips to 0.1% In 2019

  • This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a Freedom of Information Act request to the Centers for Medicare & Medicaid Services (CMS), we have received a draft Read More
    Roundup:

    California Faces $54 Billion Budget Deficit

    Colorado Eyes 25 Percent Cut to IDD Services

    Florida Projects $1 Billion in Additional State Medicaid Costs

    Illinois SEIU, Nursing Homes Continue to Negotiate

    New Mexico Medicaid Serves 40 Percent of State Population

    New York Requests Emergency Medicaid Waiver Extension

    Ohio to Cut Rates to Medicaid Managed Care Plans

    Pennsylvania Projects Financial Hit to CHIP

    Texas Awards STAR Kids Medicaid Contract to Aetna

    CMS Issues Final Rule, Backs Off Plan to Alter Auto Re-enrollment Process on Exchanges

  • This week, our In Focus section reviews key takeaways from the report, How State Medicaid Programs are Managing Prescription Drug Costs: Results from a State Medicaid Pharmacy Survey for State Fiscal Years 2019 and 2020, prepared by Kaiser Family Foundation Read More
    Roundup:

    Colorado Public Option Bill Is Tabled Until 2021

    Illinois Hospital Files Federal Lawsuit Claiming Inadequate State Oversight of Medicaid Plans

    Maine Experiences Surge in Medicaid Enrollment

    Missouri Advocates Gather Enough Signatures to Put Medicaid Expansion on November Ballot

    North Carolina Gets COVID-19 Relief Package, But Not Medicaid Expansion

    Texas Taps Stephanie Stephens as Medicaid Director

    Virginia Order to Make Medicaid Services More Accessible

    HHS Signals Approach to Distributing CARES Act Funds to Medicaid Providers

    Molina Healthcare to Acquire Magellan Complete Care

  • This week, our In Focus section reviews an issue brief written by HMA consultants examining Medicare-Medicaid integration. In 2019, 7.7 million people in the United States were eligible to receive access to full benefits under Medicare and individual state Medicaid Read More
    Roundup:

    Medicaid Expansion News: Florida, North Carolina

    New Jersey to Temporarily Increase Wages for Professionals Caring for Adults with IDD

    New Jersey Issues Behavioral Telehealth Guidelines

    New York Signals Additional Cuts to Health Care

    Rhode Island Names Benjamin Shaffer as Medicaid Director

    Tennessee Plan to Use Medicaid Funds to Care for Uninsured COVID-19 Patients Is In Doubt

    Washington Receives Federal Approval for Section 1115 Emergency Medicaid Waiver

    Exchange Plans Win $12 Billion Supreme Court Ruling

  • This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for beneficiaries dually eligible for Medicare and Medicaid (duals) in nine states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Read More
    Roundup:

    Medicaid Expansion News: Arkansas, North Carolina, Oklahoma

    California Delays CalAIM Implementation

    Illinois Foster Families Worry Transition to Managed Care Will Disrupt Care

    Oklahoma Submits HAO Waiver for Federal Approval

    Washington Releases Medicaid Integrated Managed Care RFP for Additional Service Areas

    Trump Administration Lacks Details on Plan to Cover Treatment of Uninsured COVID-19 Patients

  • This week, our In Focus section examines the extensive scope of flexibilities Federal and State governments have made to Medicare and Medicaid telehealth coverage in response to the COVID-19 national emergency. In March and April 2020, federal and state policymakers Read More
    Roundup:

    Medicaid Expansion News: Florida, Nebraska

    Oregon Could See Medicaid Enrollment Increase by 320,000

    Health Systems Criticize HHS for Tying Emergency COVID-19 Funding to Medicare Billings

    Many ACOs May Leave Medicare Shared Savings Program

    Molina, NextLevel Health Break Off Merger Talks

    Blue Shield of California Affiliate to Buy Brown & Toland

  • A model developed by Health Management Associates (HMA) assesses COVID-19’s potential impact on health insurance coverage for each state and forecasts Medicaid enrollment could increase by 11 to 23 million across all states over the next several months. Read More
    Roundup:

    Medicaid Expansion News: Alabama, Tennessee, Texas

    Louisiana Medicaid Director Ruth Johnson Takes Office

    Missouri FQHCs Face Financial Hardship as COVID-19 Keeps Patients Home

    New York Reaches Final Budget for Fiscal 2021

    CMS to Raise Medicare Advantage Plan Payment Rates by 1.66 Percent in 2021

    CMS Delivers $34 Billion to Medicare Providers, Suppliers Through Accelerated and Advance Payment Program

  • This week, our In Focus section comes from HMA Principals Ellen Breslin (MA) and Sharon Lewis (OR). In direct response to COVID-19, the Centers for Medicare & Medicaid Services (CMS) has encouraged states to maximize Medicaid flexibilities to protect people Read More
    Roundup:

    Medicaid Dental Managed Care News: Florida, Louisiana

    Hawaii Postpones Implementation of New Medicaid Managed Care Contracts Amid COVID-19 Outbreak

    Navajo Nation President Vetoes New Mexico Medicaid Managed Care Initiative

    New York Governor to Refuse Federal Medicaid Aid

    South Carolina Puts Limit on Medicaid Mental Telehealth

    Texas Cancels STAR, CHIP Procurement, Scraps STAR+PLUS Awards

    Wisconsin Expects Medicaid Expenditures to Surge

    Healthcare.gov Will Not Have Special Enrollment Period

  • This week, our In Focus section provides an overview of new requirements and opportunities for states and Medicare Advantage (MA) Dual Eligible Special Needs Plans (D-SNPs) to increase Medicare and Medicaid coordination in plan year 2021. Specifically, states and health Read More
    Roundup:

    1135 Waiver News: Arizona, California, Illinois, Iowa, Massachusetts, Minnesota, New York, North Carolina, Oklahoma, Washington

    Alaska to Ration Medicaid Payments

    Arizona Legislature Passes Hospital Fee

    Missouri Medicaid Expansion Initiative Has Enough Signatures for November Ballot, Backers Say

    Oklahoma Health Care Authority Releases HAO Waiver for Public Comment

    CMS Issues Guidance on 6.2 Percent Medicaid FMAP Increase

  • This week, our In Focus comes from HMA Vice President Kathleen Nolan and Managing Principal Jon Blum. On March 13, 2020, President Trump declared a national emergency due to the rapid spread of COVID-19 virus. This declaration provides Health and Read More
    Roundup:

    Florida Receives Federal Approval for 1135 Medicaid Waiver to Help Address COVID-19

    Florida Lawmakers Agree on Budget Without Cuts To Medicaid Supplemental Payments

    Illinois Bill Would Further Delay Transition to Managed Care for Foster Children

    New Jersey Seeks to Re-open ACA Enrollment

    New York Medicaid Redesign Team to Recommend Cuts

    House Passes FMAP Increase as Part of COVID-19 Relief Bill

    Medicare to Cover In-Home Telehealth Visits Nationwide in Response to COVID-19