HMA Weekly Roundup

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  • Health Management Associates (HMA) announced on January 14, 2021, the creation of the HMA Institute on Addiction (IOA), a division dedicated to supporting the national effort to build an evidence-based, patient-centered, and sustainable addiction treatment ecosystem. HMA is home to Read More
    Roundup:

    Kentucky Medicaid Directed Payments Initiative Is Approved

    North Carolina Readies for Medicaid Managed Care Launch

    Ohio Delays Implementation of Medicaid Work Requirements

    Pennsylvania Receives Health Care Reform Recommendations

    Texas Uncompensated Care Waiver Extension Is Approved

    CMS Reports 4.6 Million Medicaid Beneficiaries Were Treated for Substance Use Disorder in 2018

    CMS Releases Preliminary State Medicaid Expenditure Data

    CMS Rule Change Lets Physicians Prescribe Buprenorphine for Opioid Use Disorder Without Waiver

    CMS Announces 2022 Medicare Advantage, Part D Rates

  • This week’s In Focus highlights a recent HMA publication examining the drivers and barriers to Medicare Advantage plan adoption of newly available supplemental benefits intended to address unmet health and social needs. Unlike Traditional Medicare, Medicare Advantage plans, which provide Read More
    Roundup:

    Arizona Approves UnitedHealth Group Acquisition of Certain Solstice Health Plans Operations

    Colorado Releases Report on Medicaid Prescription Drugs

    Medicaid Expansion News: Georgia, Oklahoma, Texas, Virginia

    Minnesota Releases Medicaid Plan Procurement Timeline

    Oklahoma Medicaid RFP Bidders to Include CareSource

    South Carolina Governor Taps Thomas Clark Phillip Jr. as Acting Medicaid Director

    Tennessee Medicaid Block Grant Receives CMS Approval

    CMS Withdraws Medicaid Fiscal Accountability Rule

  • This week, our In Focus section reviews the Hawaii Quest Integration (QI) Medicaid managed care request for proposals (RFP) released on December 8, 2020, and the Minnesota Families and Children Medical Assistance (MA) and MinnesotaCare programs RFP released on January Read More
    Roundup:

    Hawaii Releases Medicaid Dental TPA RFI

    Indiana Governor To Make Long-Term Care Reform a Priority

    Kentucky Awards Medicaid Managed Care PBM Contract

    Kentucky Awards Aetna Foster Care Contract

    Minnesota Releases Medicaid Managed Care RFP

    Nevada to Implement D-SNP Program in 2021

    New Jersey DHS Commissioner to Join Biden COVID-19 Team

    South Carolina Bills Propose Medicaid Expansion Referendum

    Texas Releases Medicaid Plan Procurement Timelines

    Congress Gives Medicare Physicians 2021 Pay Boost

  • This week, our In Focus section focuses on five critical policy and program trends to provide integrated care to dual-eligible individuals for Medicare and Medicaid. Both federal and state governments continue to look for ways to improve coordination and integration Read More
    Roundup:

    District of Columbia Judge Rules Medicaid Managed Care Procurement Violated Law

    Florida Medicaid Finds $89.6 Million Differential Between Prices Paid to PBMs, Prices Paid to Pharmacies

    Hawaii Medicaid Plans Sought to Limit Number of Award Winners in Current Procurement

    Louisiana to Release Medicaid Managed Care RFP in Spring

    South Carolina Medicaid Director to Step Down

    Texas Sees High Early Turn Out for Exchange Plans

    MACPAC Releases 2020 MACStats Medicaid, CHIP Data Book

  • This week, our In Focus section reviews the finalized coverage expansions for Medicare telehealth services in the Centers for Medicare & Medicaid Services (CMS) Calendar Year (CY) 2021 Physician Fee Schedule (PFS) Final Rule. Telehealth advocates will be pleased to Read More
    Roundup:

    Hawaii Releases RFP For QUEST Integration Medicaid Plans

    Missouri RFP to Carve-in Behavioral Health for Foster Kids

    Montana Receives One-Year Extension of Medicaid Expansion

    New York to Seek Medicaid Redesign Team Waiver Extension

    Ohio Taps Gainwell As Medicaid Fiscal Intermediary

    Oklahoma Medicaid Waiver Providers to Receive 20 Percent Retroactive Rate Adjustment

    Biden’s Potential Administrative Actions Could Impact Six Key Medicaid Regulations, Policies, Kaiser Reports

  • This week, our In Focus section reviews the statewide North Carolina request for applications (RFA) for Behavioral Health and Intellectual/Developmental Disability (BH IDD) Tailored Plans released by the North Carolina Department of Health and Human Services (DHHS) on November 13, Read More
    Roundup:

    Arizona to Release Procurement in August 2021 for Expanded Integrated SMI, Medicaid Managed Care Program

    Delaware Care Collaborative to Serve as Medicaid, CHIP ACO

    New Jersey Medicaid Plan to Terminate Contract with Children’s Hospital of Philadelphia

    Oregon Governor Proposes Medicaid Cuts

    Oregon CCOs Post 0.6 Percent Operating Margin

    Pennsylvania Enacts Medicaid PBM Price Transparency Law

    Texas to Drop Planned Parenthood From Medicaid Network

    CMS Releases 2021 Physician Fee Schedule

  • This week, our In Focus section looks at a new Medicare model, Direct Contracting, introduced by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. The new model will build on and continue testing potential reforms to the Medicare Read More
    Roundup:

    California Legislative Analyst Projects 14.2 Percent Increase in Fiscal 2022 Medicaid Spending

    California Delays Implementation of Medi-Cal Rx

    Illinois Unveils Medicaid Transformation Proposal

    Kentucky Submits Waiver to Treat SUD in Prisons

    Kentucky Judge Orders Mediation of Medicaid Managed Care Procurement Dispute

    Missouri to Release Medicaid Managed Care RFP By July 2021

    North Carolina Releases RFA for Behavioral, IDD Plans

    CMS Releases Final Rule Revising Several Provisions of Medicaid and CHIP Managed Care Regulations

    State Tax Revenues Fall $28 Billion, Report Finds

  • In this week’s In Focus section, Health Management Associates (HMA) Managing Director MMS Matt Powers, Senior Consultant Kaitlyn Feiock, and Regional Vice President Kathleen Nolan look at the future of the Patient Protection and Affordable Care Act (ACA). Read More
    Roundup:

    Hawaii Releases Community Care Services Program RFP

    New Jersey to Submit Section 1115 Waiver Renewal

    New York Lawmakers Seek To Delay Medicaid Drug Carve-out

    North Carolina Launches Medicaid Managed Care Enrollment Website

    Neighborhood Health Plan of Rhode Island Signs Three-Year Duals Demo Contract Extension

    Tennessee Receives Federal Waiver Approval for Katie Beckett Program for Children with Disabilities

    CMS Issues Final Rule on Medicaid Managed Care Changes

  • This week our In Focus section highlights a paper by Health Management Associates (HMA) Principal Sarah Barth, JD and Research Assistant Sarina Coates-Golden entitled, Reimbursement for Evidence-Based Health Promotion Programs in the Community – Strategies and Approaches to Medicaid and Read More
    Roundup:

    Arizona Is Approved to Increase Hospital Reimbursements

    Georgia Receives Federal Approval to Exit ACA Exchanges

    Kentucky to Comply With Court Order to Grant Medicaid Managed Care Contract to Anthem

    Nebraska Names Kevin Bagley as Medicaid Director

    Ohio Releases OhioRISE Managed Behavioral Plan RFA

    Texas Republican Lawmakers Consider Medicaid Expansion

    CMS Issues Final Rule on Health Plan Price Transparency

    Telehealth Flexibilities to Be Permanent for Medicare Home Health Providers

  • This week, our In Focus section reviews the statewide Oklahoma Medicaid managed care request for proposals (RFP) released by the Oklahoma Health Care Authority on October 15, 2020, and the North Dakota Medicaid expansion managed care RFP released by the Read More
    Roundup:

    California Releases RFI for Dental ASO

    Florida Procurement for Canada Drug Importation Program Fails to Attract Any Bidders

    Georgia Eyes Privatization of Prison Healthcare Services

    Hawaii Tentatively Schedules QUEST Integration RFP Release for December 2020, Community Care Services RFP for November

    Indiana Receives 10-Year Extension for HIP Alternative Medicaid Expansion Program

    Kentucky Health Plan Appeals Order to Grant Medicaid Managed Care Contract to Anthem

    Verma Says CMMI Record on Value-Based Payments ‘Is Deeply Concerning,’ Calls for Change