HMA Weekly Roundup

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  • This week, our In Focus reviews the Kaiser Health Foundation (KFF) analysis, Fiscal and Enrollment Implications of Medicaid Continuous Coverage Requirement During and After the PHE Ends, published on May 10, 2022. Read More
    Roundup:

    Alabama Medicaid Faces Complaint Against Sobriety Requirement for Hepatitis C Treatment

    Florida Releases Medicaid Managed Care RFI Ahead of Statewide Procurement

    Louisiana Begins Statewide Rollout of Crisis Response Services for Medicaid Members

    Maryland Governor Increases Medicaid Rates to Match Medicare in Fiscal 2023 Budget

    Medicaid Redeterminations: Massachusetts, Texas

    Missouri Awards Medicaid Managed Care Contracts

    New York Governor Hopes to Expand Reach of PACE

    North Carolina Audit Finds Deficiencies in Medicaid Eligibility Process, Provider Payments

    Oklahoma Senate Rejects Medicaid Value-Based Contracting Measures

    Oregon Task Force Meets to Discuss Federal Funding Options for Medicaid Bridge Plan

    Pennsylvania Faces Lawsuit from Hospital Association Over Medicaid Managed Care Contract Language

    Federal Lawmakers Introduce Mental Health Legislation

    Kinderhook Invests in Smoky Mountain Urgent Care as Part of Multi-State, Rural Primary Care Plan

    Medicaid Directors from AZ, CA, IN, NC to Address Redeterminations, FMAP, TeleHealth, Equity, Other Key Topics at HMA Conference in Chicago, October 10-11

  • This year’s event, The New Normal: How Medicaid, Medicare, and Other Publicly Sponsored Programs Are Shaping the Future of Healthcare in a Time of Crisis, features leading experts from across the country. Read More
    Roundup:

    California Medicaid Plan to Pay Providers for Performance for Some Services

    California Exchange Automates Enrollment for Medicaid Members Losing Coverage

    Colorado Bills to Protect Medicaid Behavioral Health Providers from Clawbacks

    District of Columbia Mayor to Apply for Federal Funds for Health Disparities

    Georgia Proposal to Bypass Healthcare.gov Is Rejected by Federal Regulators

    Legislature Approves Bill to Delay Reprocurement of KanCare Contracts Until 2023

    Michigan Launches Initiative to Improve Behavioral Health Services for Children

    Minnesota Submits Request to Expand Self-Directed Personal Care Options

    Nebraska Establishes Advisory Committee for State Medicaid Program

    New Hampshire Legislature Passes Medicaid Adult Dental Bill

    North Carolina HCBS Medicaid Waiver Access Varies by Race, Study Finds

    Ohio Delays Launch of ‘Next Generation’ Medicaid Managed Care Program

    Rhode Island Senate Committee to Hear Medicaid Rate Legislation

    South Carolina Extends Telehealth Flexibilities Beyond PHE

    Tennessee House Panel Clears Bill to Renew D-SNP Contracts with Losing Bidders

    Texas Seeks Comment on Criteria for Selecting Medicaid Managed Care Plans

    Texas 10-Year Medicaid Waiver Extension to Survive

    MACPAC Announces New Executive Director, Member

    Bow River Capital Completes Investment in Amazing Care Home Health Services

    HCA Healthcare to Acquire BetterMed

  • This week, our In Focus section reviews the Nebraska Heritage Health request for proposals (RFP), released by the Nebraska Department of Health and Human Services (DHHS) on April 15, 2022. Read More
    Roundup:

    California Assembly Committee to Hold Hearing on Bill Allowing No-Bid Medi-Cali Contract

    Connecticut Seeks Medicaid Waiver to Address Coverage Gap

    Illinois Senate Passes Automatic Medicaid Renewal Legislation

    Kansas Lacks Effective System for Tracking HCBS Waiver Redeterminations, Audit Finds

    Mississippi Hires Analytics Firm to Investigate PBMs

    Missouri Senate Committee Advances Measure Aimed at Medicaid Expansion Funding

    Pennsylvania Delays Implementation of Modified Medicaid Managed Care Contracts

    Wisconsin Governor Vetoes Bills Aimed at Tightening Medicaid Eligibility Requirements

    CMS Proposes 3.2 Percent Increase to Fiscal 2023 Inpatient Hospital Payments

    Exchange Plan Premiums Fall 1.8 Percent, Study Finds

    FFL Partners Announces Investment in Perlman Clinic

  • This week, our In Focus section reviews the Biden Administration’s proposed rule revising eligibility standards for premium subsidies for families, released on April 5, 20221. Read More
    Roundup:

    Florida Governor Signs Medicaid Managed Care, Nursing Home Legislation

    Illinois Lawmakers Approve Medicaid Bill Expanding Certain Benefits, Coverage

    Louisiana Awards NEMT Contract

    Louisiana Legislature Passes Bill to Provide Medicaid Dental Coverage to Adults

    Massachusetts Releases Medicaid ACO RFR

    New York Files 1115 Waiver Amendment to Address Health Equity

    New York Medicaid Director Brett Friedman Steps Down

    Oregon Governor Establishes Taskforce to Develop Medicaid Bridge Plan

    Rhode Island Names Kristin Pono Sousa Medicaid Director

    HHS Extends Public Health Emergency for 90 Days to July 15

    Genuine Health Group Acquires Accountable Care Medical Group

  • This week, our In Focus section reviews the Texas STAR+PLUS managed care services request for proposals (RFP) released on March 31, 2022, by the Texas Health and Human Services Commission (HHSC). Read More
    Roundup:

    Florida Reaches $484 Million Settlement with Pharmacy Chain Over Opioid Claims

    Georgia Enacts Bill to Implement 85 Percent Minimum MLR Requirement for Medicaid Plans

    BCBS-Illinois Appoints Stephen Harris as President

    Kansas Senate Approves Bill to Extend KanCare Contracts Through 2024

    Minnesota DHS Recommends Actions to Improve Racial Equity, Health Outcomes in Medicaid

    New Mexico HCBS Providers to Receive Temporary 15 Percent Reimbursement Rate Increase

    Oklahoma Names Traylor Rains State Medicaid Director

    Rhode Island Medicaid Managed Care Bid Is Rejected After Missing Submission Deadline

    Biden Proposes Fix to Exchange ‘Family Glitch’ Impacting 5 Million Individuals

    CMS Finalizes 8.5 Percent Rate Increase for Medicare Advantage, Part D Plans

    Intermountain Healthcare, SCL Health Complete Merger

    UnitedHealth/Optum to Acquire Majority Stake in Kelsey-Seybold Clinic

    Federal Judge Dismisses Anthem’s Claims in PBM Lawsuit Against Cigna

  • This week, our In Focus section reviews President Biden’s budget proposal for federal fiscal year 2023, released on March 28, 2022. Read More
    Roundup:

    Arkansas Eligibles Face Barriers Enrolling in Medicaid, Report Finds

    Connecticut Medicaid Enrollment Increases by 120,000 During Pandemic

    Florida Medicaid Plan Has New Enrollment Suspended by State

    Kansas Governor Urges Legislature to Remove Budget Bill Provision to Extend KanCare Contracts

    Michigan Home-Based Care Providers Struggle After Reimbursement Rate Cut

    New Hampshire Hospitals Can Proceed with Lawsuit Over Vermont Over Medicaid Rates

    North Carolina Launches Initiative to Provide Integrated Care for Children On Medicaid, CHIP

    Pennsylvania to Release MMIS RFP in September 2022

    South Carolina Receives CMS Approval of Temporary HCBS Rate Increases

    Health Plan Invests More Than $85 Million to Help Develop Affordable Housing in Texas

    Medicaid Spending Will Exceed $1 Trillion in 2028, CMS Projects

  • This week our In Focus section reviews the issue brief and policymaker playbook that explore the outlook for temporary COVID-19-related changes to the Medicare and Medicaid programs, prepared in partnership with Manatt Health for The SCAN Foundation. Read More
    Roundup:

    California Extends Medi-Cal Assisted Living Waiver Program

    Colorado, Novartis Begin Medicaid Value-Based Drug Pacts

    Illinois to Fund Effort on Social Determinants of Health

    Iowa to Release Medicaid Enterprise Provider Solutions RFI

    NEMT News: Michigan, Utah

    Nevada Releases RFP for Medicaid Dental Benefits Plan

    Medicaid Plans Can Play Important Role in Redeterminations

    CMS Says Medicaid, Exchange Enrollment Is at All-Time High

  • This week our In Focus section highlights HMA’s insights on how stakeholders can prepare for the unwinding of Medicaid’s Public Health Emergency Continuous Eligibility policy. Read More
    Roundup:

    Florida Legislature Passes Bill Reducing Number of Medicaid Managed Care Regions

    Georgia House Passes Bill to Carve-Out Medicaid Pharmacy Benefits

    Iowa Releases Non-Emergency Medical Transportation RFP

    New Jersey Seeks Approval of Adult Continuous Eligibility, Maternal Care Programs in Medicaid 1115 Waiver Extension

    New York Legislature Rejects Competitive Bidding for Medicaid Managed Care

    CMS Must Issue Decision on TX Waiver Programs

    Congress Extends Medicare Telehealth Coverage in Newly Approved Budget

  • This week our In Focus section reviews scenarios in which the federal Public Health Emergency (PHE) may expire. Read More
    Roundup:

    Alaska Releases MMIS RFI

    California Medicaid Telehealth Visits Soar

    Georgia House Approves Minimum MLR for Medicaid Plans

    UCare to Bid on Iowa Medicaid Managed Care Contract

    Kentucky Releases PBM RFP for Fee-For-Service Medicaid

    Nebraska Medicaid Managed Care RFP Is Expected in April 2022

    North Carolina to Launch Medicaid SDOH Pilot

    Ohio Medicaid Managed Care Enrollment Begins

    Oregon Bill Passes to Address Post-PHE Coverage Losses

  • This week our In Focus section reviews the Centers for Medicare & Medicaid Services’ (CMS) Innovation Center’s newly announced model – Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH). Read More
    Roundup:

    Arizona to Prioritize Medicaid Eligibility Redeterminations

    Arkansas Announces HCBS Workforce Stabilization Program

    California to End Child Health and Disability Prevention Program, Expand Presumptive Eligibility

    PBM News: California, Georgia, Michigan, Oregon

    Colorado Pauses Medicaid Prior Authorization Requirements

    Florida Senate Committee Advances Scaled Back Plan to Merge Medicaid Managed Care Regions

    Georgia House Passes Bill to Cover Childless Adults with HIV

    Medicaid Expansion News: Illinois, Wisconsin

    Dental News: New Hampshire, Tennessee

    New York 1199SEIU Home Care Workers to Receive Back Pay