HMA Weekly Roundup

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  • This week’s second In Focus section delves into the Ensuring Access to Medicaid Services final rule. The Centers for Medicare & Medicaid Services (CMS) published the access rule May 10, 2024, alongside the similarly significant Medicaid managed care final rule. Read More
    Roundup:

    California Governor Retracts on Budget Deal to Use MCO Tax Revenue for Medicaid, Hospital Investments

    Colorado Releases Accountable Care Collaborative Phase III RFP

    Colorado Releases Behavioral Health ASO RFP

    Florida Governor Signs Bill Allowing Medicaid Home Health Services Ordered by Nurses, Physician Assistants

    Kansas Announces Intent to Award KanCare, CHIP Medicaid Managed Care Contracts

    Michigan Invests $1.3 Million to Expand Hospital Rooming-in for Substance-exposed Babies

    Missouri House Committee Advances Medicaid Hospital Tax Renewal

    New York Releases RFA for Medicaid Housing Subsidies, Services through $87 Million Grant Funding

    Oklahoma Hospitals See Higher Payments Under Managed Care

    Texas Releases STAR Kids RFP

    CMS Extends Medicaid Unwinding-related Waiver Demonstrations to June 2025

    DOJ Creates Antitrust Task Force to Combat Healthcare Consolidations, Acquisitions Violating Laws

    Eventus WholeHealth Acquires Premier Geriatric Solutions

  • This week, our In Focus section highlights a new Health Management Associates, Inc. (HMA), report released on May 7, 2024, titled Medicare Physician Fee Schedule Reform: Structural Topics and Recommendations to Strengthen the System for the Future. Read More
    Roundup:

    Arizona Restructures Medicaid Agency, Expands Leadership Roles

    Arkansas Launches Four Preventative Pilot Programs for Children with Behavioral Health Conditions

    Massachusetts Submits Amendment Request for MassHealth Section 1115 Demonstration

    Michigan Requests Section 1115 Demonstration Extension Including SUD Pilot Program

    Montana Medicaid Expansion Helps Decrease Inpatient, Emergency Service Costs

    Nebraska Seeks Input on Medicaid Enterprise System Modernization Jump to section

    Joint Commission to Launch Rural Health Clinic Accreditation Program

    Senate Finance Committee Introduces Legislation to Create Medicare Drug Shortage Prevention, Mitigation Program

    Justice Department Advances Cigna’s Medicare Advantage Sale

  • In this week’s In Focus section, Health Management Associates (HMA) Managing Director Matt Powers and Associate Principal Lora Saunders discuss observations and perspectives as we approach completion of the Medicaid unwinding. Read More
    Roundup:

    Alabama Legislators Hear from Arkansas, North Carolina Officials on Medicaid Expansion Jump to section

    Arkansas Cancels Medicaid Dental Services Procurement; Fails to Reach Agreement with Bidders Jump to section

    California to Adopt Health Care Spending Limit Beginning 2025 Jump to section

    Colorado Extends Medicaid Eligibility for Beneficiaries Living with Disabilities Jump to section

    Connecticut House Passes Bill Aimed at Improving Elder Health Care System Jump to section

    Illinois CBOs to Receive More than $5 Million in Funding for Maternal, Infant Healthcare Jump to section

    Kansas to Implement Supplemental Waiver to Shorten IDD, Physical Disability Waiver Waitlists Jump to section

    Mississippi Medicaid Expansion Bill Heads to House, Senate for Vote Jump to section

    Oregon Medicaid Program Offers Equipment to Protect Beneficiaries Against Climate Change Jump to section

    CMS, NCQA Grant Two Week Extension for Insurers to Submit Star Quality Data Jump to section

    FTC Finalizes Rule to Prevent Digital Health Apps from Releasing Sensitive Medical Data Jump to section

    CVS to Acquire Medicare Advantage Broker Hella Health Jump to section

  • This week, our In Focus section reviews significant Medicaid policy announcements from the Centers for Medicare & Medicaid Services (CMS). Read More
    Roundup:

    Connecticut Lawmakers Plan to Revisit Medicaid Managed Care for Enrollees Jump to section

    Florida Receives Eight Intents to Protest Against SMMC Awards Jump to section

    Georgia Governor Signs Bill to Relax Certificate-of-need Regulations, Form Health Commission Jump to section

    Maryland Total Cost of Care Model Improved Medicare Spending, Decreased Health Disparities in First Four Years Jump to section

    Massachusetts Receives Federal Approval to Provide Medicaid-funded Temporary Housing for Emergency Shelter Program Jump to section

    Michigan Medicaid to Offer Maternal Health Quality Payments Jump to section

    New York Enacted Fiscal 2025 Budget Invests in Health Equity, New Policies Promoting Access to Care Jump to section

    New Mexico Extends Medicaid Coverage for Seniors Receiving Long-term Care, Individuals with Disabilities Jump to section

    Texas Lawmakers Urge Governor to Cancel, Delay STAR, CHIP Awards Jump to section

    HHS Launches Investigation Examining PBMs Jump to section

    Change Healthcare’s Patient Personal Data Still in Jeopardy Jump to section

  • This week, our In Focus section reviews a wide-ranging and comprehensive final rule released April 4, 2024, by the Centers for Medicare & Medicaid Services (CMS). Read More
    Roundup:

    California Medicaid FFS Contracts with Heali’s Food as Medicine Platform Jump to section

    Colorado Settles Lawsuit Regarding Mental Health Care for Children, Agrees to Outside Examination of Program Jump to section

    Avesis, Elevance Health Partner with Uber to Improve Maternal Health in Georgia Jump to section

    Michigan Announces Medicaid Managed Care Awards Jump to section

    New York Governor Invests $359 Million to Expand Supportive Housing Options Jump to section

    North Dakota Approves Pilot Program for Paid Family Caregivers Jump to section

    Vermont Receives Approval for Medicaid Mobile Crisis State Plan Amendment Jump to section

    Virginia Governor Vetoes Prescription Drug Affordability Board Legislation Jump to section

    CMS Announces Final Rule to Promote Competition, Access to Care in Medicare Advantage, Part D Plans Jump to section

    Medicaid Supplemental, Base Payments Vary Among States, MACPAC Finds Jump to section

    Lawmakers Call on FTC, DOJ to Block Optum-Steward Acquisition Jump to section

  • This week, our In Focus section looks at the voluntary Accountable Care Organization Primary Care Flex (ACO PC Flex) Model, which the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced on March 19, 2024. Read More
    Roundup:

    Introducing HMA's New Podcast: Vital Viewpoints on Healthcare Jump to section

    Alaska Receives Extension for Behavioral Health Reform 1115 Demonstration Jump to section

    California Approves Proposition 1 to Provide Funding Addressing Homelessness Crisis, Substance Misuse Jump to section

    Florida Governor Signs Legislative Package Aimed at Boosting Healthcare Workforce, Access Jump to section

    Georgia Submits Section 1115 Waiver Amendment for Personal Care Services Jump to section

    Maryland Submits Section 1115 Waiver Amendment for Pre-release Services Jump to section

    Maryland Submits AHEAD Model Application to CMS Jump to section

    Nebraska Legislature Passes Provider Tax Bill to Increase Medicaid Hospital Payment Rates Jump to section

    New York Announces RFP For Development of 13 Certified Community Behavioral Health Clinics Jump to section

    New York Governor Allocates $102 Million to Fund New Mental Health Care Programs Jump to section

    Rhode Island Senate Considers Bill to Establish a Prescription Drug Affordability Board Jump to section

    Rhode Island Receives CMS Approval for 1115 Waiver Amendment Permitting HCBS in Acute Hospital Settings Jump to section

    Vermont Submits AHEAD Model Application to CMS Jump to section

    Virginia Rescinds Notice of Intent to Award for Statewide Medicaid Managed Care Procurement Jump to section

    Biden Administration Issues Final Rule to Streamline Medicaid, CHIP Enrollment Jump to section

    HHS Announces Lower Coinsurance Rate for 41 Medicare Part B Drugs Jump to section

    CMS Signals New Guidance on Medicare Part D Coverage of Obesity Drugs Jump to section

    Kaiser, Town Hall Ventures Launch PACE Joint Venture Jump to section

    United/Optum to Acquire Steward Health Care’s Physician Network Jump to section

  • This week, our In Focus section highlights the Children’s Behavioral Health (CBH) State Policy Lab, held February 7−9, in Baltimore, MD. Read More
    Roundup:

    HMA Offers a New Way to Approach Grant Funding for Behavioral Health Providers

    California Names Tyler Sadwith Medicaid Director

    Colorado Plans to Submit 1115 Waiver Expanding SMI Inpatient Mental Health Services

    Georgia Senate Advances Bill to Relax Certificate-of-need Regulations, Form Health Commission

    Georgia Medicaid Work Requirements Program Faces Low Enrollment, Higher than Projected Admin Costs

    Kansas House, Senate Committees to Hold Hearings on Medicaid Expansion

    Kentucky Supreme Court Rules Medicaid Managed Care Contracts to Remain in Place

    Mississippi Senate Medicaid Expansion Bill Dies; Focus Shifts to House Bill

    New York Releases Self-directed Care Initiative RFI

    Ohio to Release RFA for FIDE SNPs in Coming Months

    HHS Announces New Model to Improve Primary Care Access for Medicare Beneficiaries

    U.S. Senators Introduce Bill to Streamline Care Coordination for Dual Eligibles

    CMS to Hasten Medicaid Reimbursements for Providers Affected by Cyberattack

    States Consider Medicaid Rate Hikes in Fiscal 2025

    MedPAC and MACPAC Release Respective March 2024 Reports to Congress

    Medicare Billed $101.4 Million for Remote Monitoring Services in 2021, KFF Finds

    Elevance to Acquire Kroger’s Specialty Pharmacy Business

    UnitedHealth Group Pays $2 Billion to Providers Affected by Cyberattack

  • This week, our In Focus section covers Congress’s and the Administration’s parallel efforts to finalize fiscal year (FY) 2024 spending bills and begin the budget process for FY 2025. Read More
    Roundup:

    Arizona Medicaid to Reimburse for Community Health Worker Organizations

    Arkansas Governor Approves Committee, Strategic Plan to Support Maternal Health

    Florida House Passes Bill to Establish Rural Emergency Hospitals

    Georgia Senate Committee Advances Bill to Relax Certificate-of-need Regulations

    Minnesota House Committee Holds Hearing on Bills to Support HRSNs Through Section 1115 Waiver

    Nevada Receives Federal Approval Allowing Medicaid Funds to Cover Housing, Supportive Services

    Oregon Awards $17 Million to CBOs Supporting Health Equity

    Texas Announces Awards for STAR, CHIP RFP

    Texas FQHCs Receive $19.3 Million to Expand Services to Underserved, Uninsured Populations in 2023

    Virginia Postpones Several Caregiver Policies

    Redetermination Updates: Montana, Texas

    States Pause Nursing Home Staffing Penalties Amid Review of CMS Rule

    CMS Permits States to Expand Medicaid Behavioral Health Professionals, Claim Federal Match Funding for Nurse Advice Lines

    HHS to Investigate Cyberattack at UnitedHealth Group’s Change Healthcare

    White House Pressures UnitedHealth Group to Increase Funding for Providers Affected by Cyberattack

  • This week, our In Focus section analyzes preliminary 2023 Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. Read More
    Roundup:

    Colorado Receives Feedback on Behavioral Health Administrative Service Organizations; RFP Expected Spring 2024 Jump to section

    Idaho House Committee Advances Bill to Expand Postpartum Medicaid Coverage to 12 Months Jump to section

    Iowa Releases Health Link Medicaid Managed Care RFP to Reprocure One Contract Jump to section

    Maryland Faces $236 Million Medicaid Budget Shortfall Jump to section

    Minnesota Requests Additional Five-year Extension of Substance Use Disorder Reform Demonstration Jump to section

    Mississippi Legislature Passes Bill that Would Grant Early Medicaid Coverage for Pregnant Women Jump to section

    Nebraska Waiver Expands HCBS to 850 Children on Developmental Disabilities Registry Jump to section

    Nevada Holds Workshop on Medicaid Managed Care Procurement Jump to section

    New York Receives Federal Approval for Section 1332 State Innovation Waiver to Expand Essential Plan Eligibility Jump to section

    Oregon CCOs to Offer Grant Funding to Support Community Organizations in HRSN Delivery Jump to section

    Pennsylvania Releases Electronic Visit Verification Module RFP Jump to section

    Tennessee to Release Pharmacy Benefits Administrator RFP in Fourth Quarter of 2024 Jump to section

    Virginia Announces Awards for Statewide Medicaid Managed Care Procurement Jump to section

    Biden Administration Takes Steps to Prevent Corporate Overcharging of Consumers, Government Programs Jump to section

    Federal Regulators Launch Investigation into Private Equity Healthcare Deals Jump to section

    United Health Group Provides Temporary Funding, Pharmacy System During Cyber Attacks Jump to section

    The Ensign Group Acquires Skilled Nursing Facilities in Colorado, Kansas Jump to section

  • Last chance to register! Online registration closes February 28. Federal policy frameworks establishing alternative payment models in Medicare and Medicaid have been the kick-starter of value-based care (VBC) innovation in healthcare delivery. Read More
    Roundup:

    Wakely, an HMA Company, White Paper: Shadow Bundles are Coming Soon to MSSP and ACO REACH

    Alaska Receives CMS Approval to Extend Postpartum Medicaid Coverage to 12 Months

    California Awards More Than $10 Million to Residential SUD Treatment Facilities

    Florida House Agrees to Boost Physician Workforce, Increase Healthcare Innovation Grants, and Hospital At Home

    Indiana Plans to Transition 1,600 Children to Structured Family Caregiving Program

    Mississippi House Committee Advances Medicaid Expansion Bill with Work Requirement

    Montana Proposes Housing Assistance, Incentives, Re-entry Services for Medicaid Beneficiaries with Mental Health Disorders

    New Mexico Names Dana Flannery Medicaid Director

    North Carolina Legislators Push to Re-examine Law Granting Special Privileges to Hospital Authorities

    Ohio Nursing Home Associations Sue Medicaid Program Over Alleged Underfunding

    Oregon Receives Federal Approval for Limited HCBS for Seniors, Adults with Disabilities

    Texas Releases STAR Kids Draft RFP

    Washington House Considers Bill that Would Place Greater Oversight on Provider Consolidations

    Redetermination Updates: Arkansas, Iowa, Mississippi

    CMS Releases Second Evaluation of Integrated Care for Kids Model

    CareSource Seeks to Enter Wisconsin Marketplace, Acquire Local ACA Co-op Plan