HMA Weekly Roundup

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  • This week, our In Focus section reviews the Pennsylvania HealthChoices Physical Health Medicaid managed care request for applications (RFA), issued by the Pennsylvania Department of Human Services on October 15, 2019. Medicaid managed care organizations (MCOs) will serve the five Read More
    Roundup:

    California Wholesale Drug Prices Rise 26 Percent, Study Says

    Georgia Readies Expansion, Reinsurance Waiver Proposals

    Louisiana to Resume Medicaid Auto-Disenrollment

    New York Nursing Homes Expect Reimbursement Cuts

    North Carolina Disputes ‘Conflict of Interest’ Concerns in Medicaid Managed Care Contract Awards

    Oklahoma Medicaid Expansion Advocates Gather Enough Signatures for 2020 Ballot Initiative

    Texas Submits DSRIP Draft Transition Plan to CMS

    Public Charge Rule Change Is Impacting Medicaid Enrollment

  • This week, our In Focus section reviews the Utah Medicaid Section 1115 Demonstration Waiver amendment Fallback Plan, released for public comment on September 27, 2019. The Fallback Plan would raise Utah’s Medicaid expansion income limit to 138 percent of the Read More
    Roundup:

    Colorado Issues Draft Report on State Option Exchange Plan

    Illinois Medicaid Auto-Enrollments Favor Low-Rated Plan

    Iowa to Issue RFP for Third Medicaid Plan

    Michigan Announces Plan to Carve Out Medicaid Pharmacy Benefits from Managed Care

    Missouri House Committee Holds Medicaid Expansion Hearing

    New York Health + Hospitals Expands Program for Uninsured

    North Carolina Awards Centene Additional Medicaid Region

    Appeals Court To Hear Arguments in KY Medicaid Work Requirements Case

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 29 states.i Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This Read More
    Roundup:

    Florida Recommends Redesign of HCBS Program

    Foster Care News: Illinois, West Virginia

    Michigan Lawmakers Hope to Move Ahead With Medicaid Managed Care Physical, Behavioral Integration

    Expansion News: Idaho, North Carolina, Utah, Virginia

    Texas to Get Boost in Federal Funds for Uncompensated Care

    Texas to Announce STAR+PLUS Awards in October

    Skilled Nursing Facilities Transition to New Payment Model Leads to Layoffs

  • This week, our In Focus section reviews the Medicare Advantage (MA) and Part D landscape files for the 2020 plan year released by the Centers for Medicare & Medicaid Services (CMS) on September 24, 2019. These files include information on Read More
    Roundup:

    Arkansas Families, Provider Say PASSE Is Still Falling Short

    Florida Disability Advocates Seek Additional HCBS Funding

    Hawaii Medicaid Enrollment Falls 7 Percent After State Institutes Wage Verification Process

    Michigan Eases Member Reporting Rules for Medicaid Work Requirements

    North Carolina Faces Renewed Legal Challenge to Medicaid Managed Care Contract Awards

    Medicaid Health Plans of America Names Craig Kennedy CEO

    NCQA Releases 2019-20 Quality Rankings of Medicaid Plans

  • This week, our In Focus section reviews Texas v. United States., the most recent legal challenge to the Affordable Care Act (ACA). In July 2019, the United States Court of Appeals for the 5th Circuit heard oral arguments in the Read More
    Roundup:

    Arkansas PASSE Market to Consolidate

    Connecticut Releases RFP for Person-Centered Medical Home Plus Program

    District of Columbia to Rebid Medicaid Plan Contracts

    Medicaid Expansion News: Idaho, North Carolina

    Medicaid Work Requirements News: Michigan, Pennsylvania

    Missouri Democrats Seek Answers for Medicaid Disenrollment

    New York Releases DSRIP Medicaid Waiver Amendment Draft

    Tennessee Releases Medicaid Block Grant Proposal

    West Virginia Issues Request for Quotation for NEMT Services

  • This week, our In Focus section provides a recap of the fourth annual HMA Conference, The Next Wave of Medicaid Growth and Opportunity: How Payers, Providers, and States are Positioning Themselves for Success, held this Monday, September 9, and Tuesday, Read More
    Roundup:

    L.A. Care Health Plan, Blue Shield-California to Jointly Operate 14 Community Resource Centers

    Florida State Senator Introduces Resolution to Put Medicaid Expansion Back onto 2020 Ballot

    Georgia Providers Oppose Centene, WellCare Merger

    Michigan Medicaid Work Requirements May Impact 270,000 Beneficiaries

    Mississippi Mental Health System Is Discriminatory, Judge Rules

    Nevada Returns to State-Run Exchange Website After Five Years

    Oklahoma Work Group Considers Medicaid Managed Care

  • This week, our In Focus section reviews the Hawaii QUEST Integration (QI) Medicaid Managed Care request for proposals (RFP), issued by the Hawaii Department of Human Services (DHS) on August 26, 2019. DHS intends to contract with four health plans. Read More
    Roundup:

    Arizona Releases RFI for Integrated Foster Care ASO

    California to Carve Long-Term Care into Medicaid Managed Care Statewide in 2021

    Louisiana to Seek Emergency Contracts with Current Medicaid Managed Care Plans

    Minnesota Cancels Medicaid MCO, MSHO, MSC+ RFPs

    New Jersey to Carve Long-Term Residential Services into Managed Care for DDD, MLTSS, FIDE-SNP Enrollees

    North Carolina Delays Medicaid Managed Care Rollout

    Medicare Advantage Plans Oppose Proposed Changes to CMS Audit Methodology

  • This week, our In Focus section comes from HMA Community Strategies (HMACS) Senior Associate Diana Rodin and HMA Managing Principal Sharon Silow-Carroll who authored a recent article in the Journal of Women’s Health drawing on data from the recently completed Read More
    Roundup:

    Medicaid Foster Care RFP News: Arizona, Virginia

    California Hospitals See Charity Care Expenses Fall by Half

    Delaware Received IMD Exclusion Waiver

    Florida CHIP Costs to Rise as Enrollment Increases

    Georgia Is Still Failing on Mental Health Care, Report Says

    Kansas Asks Aetna to Submit New Corrective Action Plan

    Centene, Aetna Protest Louisiana Medicaid Awards

    New Hampshire Medicaid to Expand Telehealth Coverage

    CareOregon to Become Subsidiary of Providence Health

    Portland Hospitals Urged to Contract with Centene-Trillium

    Texas Delays STAR, CHIP ImplementationWest

  • This week, our In Focus section reviews the new Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service FY 2020 proposed rules: the Physician Fee Schedule (PFS), released on July 2019, and Home Health prospective payment system, released on July Read More
    Roundup:

    Florida to Raise Medicaid Managed Care Rates 0.2 Percent

    Illinois Enacts Law to Address Medicaid Applications Backlog, Require Health Plans to Pay Providers Promptly

    Kentucky Launches Medicaid Program to Help Cover Cost of Employer-Sponsored Insurance Premiums

    Louisiana Announces Medicaid MCO Awards

    Missouri Health Care Task Force to Consider Medicaid Expansion Waiver

    New York Is Actively Pursuing DSRIP Waiver Renewal

  • This week, our In Focus section reviews the new Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service FY 2020 proposed rules. On July 29, 2019, CMS issued the Calendar Year (CY) 2020 proposed rules for the Physician Fee Schedule Read More
    Roundup:

    MCO Withdraws Florida Healthy Kids Award Protest

    Illinois Governor Vetoes Bill Aimed at Limiting His Administration's Ability to Seek Medicaid Waivers

    Kentucky AG Clears Evolent Acquisition of Passport

    Missouri Names Chief of Medicaid Transformation

    New Hampshire Medicaid Work Requirements Are Blocked

    Ohio Medicaid Enrollment Declines, Uninsured Rate Rises

    Oklahoma Lawmakers to Reconsider Medicaid Expansion

    Utah Faces Rejection of Partial Medicaid Expansion Waiver Proposal