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