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- This week, our In Focus section reviews the New Hampshire Medicaid Care Management (MCM) request for proposals (RFP), which the state’s Department of Health and Human Services released on September 8, 2023. Read MoreRoundup:
California Medicaid Director Jacey Cooper Is Leaving to Join CMS
District of Columbia Receives Approval for Community-Based Mobile Crisis Services SPA
Florida Renews Medicaid Utilization Management Contract with Acentra Health
Hawaii Receives $4 Million Project LAUNCH Federal Grant to Improve Children’s Behavioral Health
Michigan Expects Medicaid Community Health Worker Benefit to Impact 50,000 Residents If Approved
BCBS-NC Names Angela Boykin CEO of Medicaid Plan
Oregon to Seek Federal Approval for Basic Health Plan
Pennsylvania to Review Rates for Providers Serving Individuals with Intellectual Disabilities, Autism
CMS to Lower Cost of 34 Prescription Drugs Beginning October 1
Walmart May Buy Majority Stake in ChenMed
- This week, our In Focus section reviews the request for proposals (RFP) for the Virginia Cardinal Care Medicaid managed care program, released by the Department of Medical Assistance Services (DMAS) on August 31, 2023. Read MoreRoundup:
California Medi-Cal Contracts Are Scheduled to Begin January 1
PBMs Face Lawsuit from Los Angeles County Over Opioid Crisis
Georgia Receives Approval of Waivers to Streamline Medicaid Unwinding Process
Montana Medicaid Providers Face Further Delay in Receiving Increased Rates
New York Managed Long-term Care Plan Is Closing Down
Oregon to Step Up PBM Regulation After Audit Finds Lax Oversight
Pennsylvania Senate Passes Bill to Raise Reimbursement Rate for Ambulance Services
Tennessee Awards Findhelp Contract to Connect Medicaid Beneficiaries with Social Services
West Virginia Receives CMS Approval for Medicaid Mobile Crisis State Plan Amendment
CMS to Provide Funding to Help States Implement AHEAD Total Cost of Care Delivery System Model
Molina Acquires My Choice Wisconsin
- This week’s In Focus centers on the U.S. Department of Health and Human Services (HHS) August 29, 2023, announcement of the first 10 prescription medications that will be subject to price negotiation for Medicare coverage. Read MoreRoundup:
Medicaid Eligibility Redeterminations News: Alaska, Illinois, Maine, Massachusetts
Georgia Looks to Increase Oversight of Medicaid Plans
Idaho Gears Up for Transition to Single Behavioral Health Plan Covering Inpatient, Outpatient Services
Indiana Medicaid Beneficiaries Struggle to Access Dental Care
Iowa Increases Medicaid Reimbursements for Substance Abuse, Mental Health Counseling
Michigan Governor to Call for Legislation Locking in ACA Protections
Nevada Awards Magellan Contract for Complex Behavioral Care Management for Youths
North Carolina Medicaid Expansion Will No Longer Launch on October 1
Oklahoma Proposes 12 Months of Continuous Eligibility for Children on Medicaid, CHIP
CMS Takes Additional Action to Halt Wrongful Medicaid Disenrollments
Centene to Sell Circle Health Group to PureHealth
- In this week’s In Focus, we continue our review of Medicare developments from this summer and look ahead at Centers for Medicare & Medicaid Services (CMS) activities to watch for this fall. Read MoreRoundup:
Florida Residents File Federal Lawsuit Challenging Their Disenrollment from Medicaid
Georgia Medicaid Expansion Program Sees Slow Enrollment
Hawaii Halts Medicaid Eligibility Redeterminations on Maui For Remainder of 2023
Amerigroup Iowa Names Teresa Hursey President
Louisiana Lawmakers Push to Delay Sale of BCBS Louisiana to Elevance Health
Michigan New Medicaid Managed Care Contracts Will Take Effect October 2024
CareSource, HAP Receive Approval to Form Medicaid Joint Venture
New Mexico Releases $80 Million Rural Health Care Delivery Fund RFA
Ohio Renews Contract with Medicaid EVV Company
Oregon to Implement Mandatory Annual Audits of Medicaid PBMs
Texas to Restore Medicaid Coverage of 90,000 Disenrolled Individuals
Virginia Delays Release of Medicaid Managed Care RFP to September 1
Washington Allocates Over $100 Million to Apple Health, Homes Program
CMS Warns States That Call Center Wait Times, Dropped Calls Are Impeding Medicaid Coverage Renewals
Centene to Challenge Tricare Contract Loss in Federal Claims Court
- This week, our In Focus section reviews the Arizona Long Term Care System (ALTCS) Elderly and Physically Disabled (EPD) Program request for proposals (RFP), which the Arizona Health Care Cost Containment System (AHCCCS) released on August 1, 2023. Read MoreRoundup:
Colorado Hospitals Continue to Post Operating Losses
Florida Projects $600 Million Medicaid Budget Deficit for Fiscal 2024
Medicaid Eligibility Redeterminations News: Florida, Illinois, Massachusetts, Michigan, Nevada, Rhode Island, Wyoming
Idaho Medicaid Managed Care Task Force Holds Second Hearing
Illinois Governor Signs Law Increasing Oversight of Healthcare Mergers
Indiana Parents, Advocates Call on Governor to Reconsider Funding Cut for Autism Therapy
Massachusetts to Raise Income Eligibility Limits for ConnectorCare
Nebraska to Lift $750 Cap on Medicaid Dental Benefits
New Mexico to Award Previously Announced Medicaid Plan Contracts in Defeat for Governor
New York City Cannot Switch Retirees to Aetna Medicare Advantage Plan, Judge Rules
North Carolina Medicaid Behavioral Health Plans Sandhills Center, Eastpointe to Merge
Vermont All-Payer ACO Model Lowers Medicare Spending, Hospitalizations, Analysis Finds
CMS Launches Changes to Encourage Participation in Medicare ACO REACH
4.8 Million Medicaid Beneficiaries Are Disenrolled from Medicaid Following Redeterminations, Analysis Finds
5.6 Million Medicaid Enrollees Utilize Long-term Services, Supports in 2020, KFF Finds
U.S. Appeals Panel Rules False Claims Lawsuit Against Walgreens Can Proceed
- This week, our In Focus section continues analysis and insights from Health Management Associates (HMA) and its affiliate The Moran Company on recent Medicare payment and policy developments. Read MoreIn Focus:Roundup:
Arizona Releases Long Term Care System RFP
Arkansas Releases Medicaid Enterprise Pharmacy System and Services RFP
Medicaid Eligibility Redeterminations News: Arkansas, California, Idaho, Illinois, Kansas, Louisiana, Maine, Minnesota, Pennsylvania, West Virginia
California Releases Medi-Cal Dental Managed Care RFP for Los Angeles, Sacramento Counties
Massachusetts Releases Section 1115 Waiver Amendment for Public Comment
New York To Continue Coverage of Extended Medicaid Telehealth Services Through 2024
North Carolina State Budget May Stall Until September, Delay Medicaid Expansion Until At Least December
Utah Requests Three 1115 Demonstration Amendments for Chronic Conditions, Dental Services, Family Planning
Virginia to Release NEMT RFP September 1
Washington Requests Section 1115 Medicaid Waiver Amendment To Cover Former Foster Care Youth, CHIP Children
Wyoming Releases Draft Section 1115 Medicaid Waiver to Expand Income, Asset, Need Eligibility for Existing HCBS Waiver Services
CMS Extends HCBS Flexibilities Granted During COVID-19 Until November 11
OIG Finds High Rates of Prior Authorization Denials Among Medicaid MCOs
Health Connect America Acquires Specialized Youth Services of Virginia
- This week, our In Focus section reviews the new Guiding an Improved Dementia Experience (GUIDE) Model, announced by the Centers for Medicare & Medicaid Services (CMS) Center for Medicaid and Medicare Innovation (the Innovation Center) on July 31, 2023. Read MoreRoundup:
Alabama Seeks Medicaid Waiver to Cover Opioid, SUD Services for Individuals in IMDs
Alaska Medicaid to Cover Assisted Living Services in At-home Settings
California Receives Approval to Lift the Medicaid Asset Test in 2024
Florida Seeks Waiver to Pilot Managed Care Program for Individuals with IDD
Medicaid Eligibility Redeterminations News: Louisiana, Michigan, Minnesota, Missouri, New Hampshire
North Carolina Reaches Agreement with CMS in Hopes of Launching Medicaid Expansion by October
Virginia Medicaid Managed Care RFP Release Delayed to Mid to Late August
CMS Releases Final Medicare Inpatient, Long Term Care Prospective Payment System Rule
CMS Increases Medicare Reimbursement Rates for Skilled Nursing Facilities by 4 Percent in Fiscal 2024
CMS Projects 1.8 Percent Decrease in Medicare Part D Premiums in 2024
CMS Increases Medicare Hospice Rates by 3.1 Percent in Fiscal 2024
Medicaid, CHIP Enrollment Is Nearly 94.2 Million in April 2023
Medicaid Disenrollments Near 4 Million Following Redeterminations
The Ensign Group Acquires Skilled Nursing Facilities in Colorado, Washington
Help at Home Acquires IN-based My Care at Home, OH-based Berkshire Homecare
- This week’s In Focus section is the second in a summer series of analysis and insights from Health Management Associates (HMA) on recent Medicare payment and policy developments. Read MoreRoundup:
California Exchange Plan Premium Hikes Softened by State Financial Support
Medicaid Eligibility Redeterminations News: Indiana, Massachusetts, Minnesota, Montana, Washington, West Virginia, Wisconsin
Molina Healthcare Names Aaron Dunkel as President of Kansas Operations
Michigan Ends Cost Sharing in Medicaid Expansion Program
Nevada Releases Medicaid Managed Care RFI
Oklahoma Health Care Authority CEO Kevin Corbett to Resign
Medicaid Disenrollment Rates Vary Widely Among States, Report Finds
Community Health Systems to Sell Three Hospitals to Tampa General Hospital in $290 Million Deal
United’s Optum Health Names Amar Desai as CEO
- This week, our In Focus section is the first in a summer series of analysis and insights from Health Management Associates (HMA) on recent Medicare payment and policy developments. Read MoreRoundup:
Redeterminations News: Arkansas, Connecticut, Georgia, Iowa, Kentucky, North Carolina, North Dakota, Texas, Wyoming
California Health Plan to Provide $46 Million in Grants for Housing, Other Services
Colorado Medicaid, CHIP Are Among Payers Most Likely to Reimburse for Unnecessary Health Services, Study Finds
Florida Is Ordered to Amend Medicaid Program to Prevent Institutionalization of Children with Complex Needs
Hawaii to Seek Medicaid Services for Justice-involved Populations Prior to Release
Illinois Provides $75 Million in Funding to Address Health Disparities, Housing
Medicaid Disenrollments Top 3 Million Following Redeterminations
MTM Acquires Medical Transportation Brokerage of Arizona
- This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS) report to Congress on Non-emergency Medical Transportation (NEMT) in Medicaid, released June 20, 2023. Read MoreRoundup:
Medicaid Eligibility Redeterminations News: Arizona, District of Columbia, Florida, Idaho, Maryland, Michigan, Mississippi, New Jersey, Tennessee, Wyoming
Florida Extends Deadline for Medicaid Managed Care ITN Responses
Georgia Launches Partial Medicaid Expansion Program With Work Requirements
Idaho Medicaid Managed Care Task Force Holds Hearing on Structure of Program Funding
New Jersey Will Allocate $5 Million to Improve Housing for Individuals with Disabilities, Acute Medical Needs
New York Releases Third-Party Liability Match, Recovery Services RFP
North Carolina Further Delays Implementation of Behavioral Health IDD Tailored Plans
Ohio Releases RFP for Medicaid Enterprise System Alternate Payment Model Logic, Reporting Tool
Pennsylvania Medicaid to Cover Care Delivered on Streets to Homeless
ACA Risk Adjustment Pool to Redistribute $15.2 Billion to Individual Plans
AmeriHealth Caritas CEO Paul Tufano to Step Down
