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- 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 MoreRoundup:
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 MoreRoundup:
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 MoreRoundup:
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
- This week, our In Focus section reviews the statewide North Carolina request for proposals (RFP) for the new Children and Families Specialty Plan (CFSP), which the North Carolina Department of Health and Human Services (DHHS) released on February 7, 2024. Read MoreRoundup:
Florida Delays Awards for Medicaid Managed Care ITN
Georgia Proposes Bill to Establish Study Committee to Examine Private Option Medicaid Expansion Waiver
Iowa Senate Advances Bills Altering Postpartum Medicaid Coverage, MOMS Program
Kentucky Senate Advances Bill to Cover Midwife Services Under Medicaid
Maryland Awards Behavioral Health ASO Contract to Elevance
Missouri Supreme Court Rules Against Blocking Medicaid Payments to Planned Parenthood
Nebraska Legislature Considers Bill to Expand Medicaid Coverage of Anti-obesity Medications
Pennsylvania Submits Section 1115 Waiver Application Addressing Health-related Social Needs
CMS Issue Brief Finds Doulas, Community Health Workers Improve Postpartum Outcomes
CMS Releases Preliminary CMS-64 2023 Medicaid, CHIP Expenditure Report
CMS Issues Final Rule Imposing Restrictions on DSH Payments
Point32Health to Acquire Health New England
Bon Secours Mercy Health Enters Joint Venture with Compassus
Brightside Announces New Medicaid, Medicare Partnerships to Expand Telehealth for Mental Health Services
- This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule, published on January 17, 2024. Read MoreIn Focus:Roundup:
HMA Keynote Speakers Preview Themes, Imperatives for March 5-6 Value Based Care Workshop
Arizona Releases Housing, Health Opportunities Services Program Administrator RFP
Arizona Selects 57 Providers to Extend Medicaid Services to Incarcerated Individuals Prior to Release
Connecticut Governor Calls for Increased Hospital, Pharmaceutical Oversight in Fiscal 2025 Spending Plan
Florida Announces Intent to Award Florida Community Care Comprehensive IDD Managed Care Pilot Program Contract
Georgia Governor’s Budget Proposal Increases Health Services Spending by $485 Million
Kansas Governor Proposes $23 Million for IDD, Physical Disability Waiver Waitlists
Minnesota Announces $8 Million RFP for Live Well At Home Program
Mississippi Medicaid Requesting $83 Million Increase in State Support in Fiscal 2025
Montana Grant Program to Increase Residential Bed Capacity for Individuals with SMI, Developmental Disability
Pennsylvania Extends Medicaid to Cover Perinatal Doula Care
Oregon Receives Federal Approval for HRSN Benefits Framework Under Section 1115 Waiver
HHS Partners with Eight States, District of Columbia to Address Homelessness
States Continue to Impose Regulations Around Prior Authorization Practices
BCBS-LA Withdraws from Planned Merger with Elevance
KKR to Buy Stake in Cotiviti from Veritas Capital
- This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS) Calendar Year (CY) 2025 Advance Notice for the Medicare Advantage (Part C) and Part D Prescription Drug Programs published on January 31, 2024. Read MoreRoundup:
Colorado Hospital Transparency Reports Reveal Increased Operating Expenses, Reimbursements
Florida House, Senate Consider Bills to Establish Rural Emergency Hospitals
Georgia Releases PBM RFP in Partnership with Alaska, Montana, and Vermont
Hawaii Requests Five-year Extension of Hawaii QUEST Integration Waiver
Iowa Lawmakers Advance Bill to Extend Postpartum Medicaid Coverage to 12 Months
Minnesota Seeks Section 1115 Medicaid Waiver Amendments to Expand Eligibility for Children
Mississippi Senate Passes Bill to Streamline Prior Authorization Requests
Montana Releases Medicaid NEMT Program RFI
Nevada Medicaid Managed Care RFP Release Expected by January 2025
New Mexico Receives Federal Approval for Use of Mobile Crisis Intervention Teams
Cityblock, Fidelis Care Form Partnership to Increase Health Services For New York Medicaid Members
North Carolina Releases Foster Care Specialty Plan RFP
North Carolina Medicaid to Launch Behavioral Health IDD Tailored Plans on July 1
Several States Direct Medicaid Funding to Provide Housing Aid Amidst Disenrollments
HHS Issues Final Rule Permitting Use of Telehealth for Opioid Treatment Programs
CMS Outlines Guidelines for Use of Artificial Intelligence in Medicare Advantage
Cigna Indicates Plans to Grow its Evernorth Health Services Unit
- This week, our In Focus section highlights a new report released on January 25, 2024, Analyzing the Expanded Landscape of Value-Based Entities: Implications and Opportunities of Enablers for the CMS Innovation Center and the Broader Value Movement. The second In Read MoreRoundup:
HMA Press Release: Nine States to Participate in Children’s Behavioral Health Policy Lab
California Plan Offers Medi-Cal Enrollees GED Services
Colorado Legislative Committee Approves Increase in Medicaid Reimbursement for Pediatric Behavioral Care
Indiana Intellectual, Developmental Disabilities Task Force Calls for Pause to Proposed Aged, Disabled Waiver Cuts
Kentucky House Passes Bill Requiring Medicaid to Cover At-home Blood Test Kits
Minnesota Releases Medicaid Dental Administrator RFI
New Jersey Enacts Law to Expand Hospital at Home Services to Medicaid Beneficiaries
New York Legislature Considers Bill to Transition Home Care Services From Managed Medicaid to Fee-For-Service
Federal Government Issues Lawsuit to Block Novant Health’s Acquisition of North Carolina Hospitals
South Dakota to Include Doula Services in New Medicaid Pregnancy Health Home
Vermont Releases MMIS Procurement Assistance Vendor RFP
Wisconsin Releases IRIS Self-Directed Personal Care Services RFP
Medicaid Redetermination Updates: Louisiana, Ohio
Medicare ACO Shared Savings Program Participation Increases in 2024
CMS Cell and Gene Therapy Access Model to Focus on Sickle Cell Disease
MACPAC Releases Medicaid Payment Policies Report for Home and Community-based Services
Health Care Services Corporation to Acquire Cigna Medicare, CareAllies Businesses
- This week, our In Focus section highlights the Innovation in Behavioral Health (IBH) model, which the Centers for Medicare & Medicaid Services (CMS) announced January 18, 2023. Read MoreRoundup:
Connecticut Proposes to Extend Medicaid Services to Incarcerated Individuals Prior to Release
Florida to Submit Section 1115 Waiver Request to Expand CHIP Eligibility
Florida Senate Passes Bill to Expand Healthcare Access, Resources
Idaho House Committee Proposes Bill Setting Requirements on Medicaid Expansion
Indiana Alters Waivers, Enhances Budget Monitoring to Address Medicaid Budget Shortfall
Kansas Governor’s Proposed Fiscal 2025 Budget Includes Medicaid Expansion Funds
Kentucky Senate Advances Bill to Limit Number of Managed Care Organizations
Michigan Extends Due Date for Medicaid Managed Care Proposals
New Hampshire Awards Medicaid Managed Care Contracts to Incumbents
New York MCOs Oppose Proposed Competitive Medicaid Managed Care Procurement Process
North Carolina Medicaid Expansion Enrollment Surpasses 314,000
Rhode Island Medicaid State-directed Payments Approved by CMS
Texas Extends Medicaid Postpartum Coverage to 12 Months
Washington Updates State Action Plan to Remove Barriers to Health Services
Medicaid Redetermination Updates: Florida, Georgia, Indiana, Mississippi, New Hampshire, Oklahoma, Vermont
More Than 21.3 Million Have Selected ACA Marketplace Plans Since Enrollment Period Began
Combined Medicaid, Medicare Spending on Dual Eligibles was $493.4 Billion in 2021, MACPAC, MedPAC Report Finds
Centene Names Michael Carson as President, CEO of Medicare Business
- This week, our In Focus section describes New York State’s Medicaid Section 1115 waiver amendment authorizing at least $6.7 billion in funding for new programs and initiatives in the state’s Medicaid program. Read MoreRoundup:
Driving Change in Healthcare Delivery: HMA Spring Workshop Provides Deep Dive into Metrics, Coordination, and Partnerships for Value-based Care
Health Management Associates Successfully Completes SOC 2 Type 2 Examination
Medicaid Redetermination Updates: Arizona, Minnesota, Missouri
California Proposes CalAIM Amendment to Provide Continuous Medicaid, CHIP Coverage for Children
Florida Proposed Bills Would Boost Physician Workforce, Develop Advanced Birth Centers
Iowa Legislature Considers Bill to Create Tiered Medicaid Reimbursement System for Children’s Mental Health
Kentucky Submits Medicaid Section 1115 Amendment to Improve Care for Individuals Leaving Public Institutions
Kentucky State Bill Would Reduce Maximum Number of Medicaid Managed Care Contracts
Mississippi Hospital Directed Payments Bring in Additional $658.2 Million Under New Program
New Mexico Governor’s Fiscal 2025 Budget Proposes Additional Medicaid Funding For Rural Hospitals, Provider Reimbursement
New York Grants More Than $950 Million to Fund Healthcare Facility Upgrades, Technological Modernization
West Virginia Selects Highmark as Fourth Medicaid Managed Care Organization
Wisconsin Releases Medicaid Managed LTC RFP
CMS Releases Final Rule Aimed At Improving Electronic Exchange of Health Information, Prior Authorization Processes
MedPAC Meeting Highlights Overpayments in Medicare Advantage
Health Plans Seek Increased Medicaid Rates Amid Rising Costs
Elevance Launches Program to Provide Smartphones to Medicaid Beneficiaries in 21 States
- This week our In Focus section reviews the Rhode Island statewide, capitated risk-bearing Medicaid managed care program request for proposals (RFP), which the Rhode Island Executive Office of Health and Human Services (EOHHS) released December 15, 2023. Read MoreRoundup:
Elizabeth Mitchell to Keynote HMA’s Spring Workshop on Value-based Care March 5-6 in Chicago
Alabama Releases Medicaid Enterprise System Provider Management Services RFP
Arizona Receives 3 Protests Against Medicaid ALTCS Awards
California Medi-Cal MCO Tax Receives Federal Approval
Florida Announces List of Bidders for Statewide Medicaid Prepaid Dental Program ITN
Illinois to Release Medicaid Managed Care RFP in Spring 2024
Iowa Lawmaker Files Bill to Extend Postpartum Medicaid Coverage to 12 Months
Kansas Announces List of Bidders for Medicaid Managed Care RFP
Missouri Lawmakers to Consider Medicaid Provider Tax Renewal
Nebraska Lawmakers File Bill to Increase Medicaid Hospital Payment Rates
New York Receives Federal Approval for Medicaid Section 1115 Waiver Amendment to Support Health Equity, Health-related Social Needs
Oregon Medicaid CCOs to Invest $25 Million to Support Youth Behavioral Health Projects
Washington Behavioral Health-related Outcomes Remain Similar Between Integrated, Carve-out Models, Study Finds
West Virginia Medicaid Beneficiaries Face Barriers to Dental Care Access, Stakeholder Analysis Finds
CMS Releases ARPA State Spending Plan Summaries
Health Insurance Marketplace Enrollment Exceeds 20 Million for 2024
CVS Invests in WellBe Senior Medical
Elevance Sues CMS Over Medicare Advantage Star Ratings System
CMS to Terminate Medicare Advantage Plans in Arizona, North Carolina