HMA Weekly Roundup

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  • This week, our In Focus section reviews Kentucky’s 1115 waiver, Kentucky Helping to Engage and Achieve Long Term Health (KY HEALTH), approved by the Centers for Medicare & Medicaid Services (CMS) on January 12, 2018. The waiver was approved for Read More
    Roundup:

    California Approves Aetna's Entry Into Medi-Cal Market

    Illinois Medicaid Sued Over Low Nursing Home Rates

    Louisiana Considers Medicaid Work Requirements

    Massachusetts Lawmakers Call for Investigation of Kindred Healthcare

    New York Budget Proposal Contemplates For-profit Conversion and MCO Profit Fees

    Pennsylvania Governor Declares Opioid Epidemic a Statewide Public Health Disaster

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states. Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. Read More
    Roundup:

    Mississippi Obtains Approval for First Ever 10-Year Medicaid Waiver

    Arizona Submits Waiver Request for Medicaid Work Requirements, Lifetime Limit.

    California Restores Medi-Cal Coverage of Certain Dental Services

    Illinois Begins Implementing HealthChoice Medicaid Managed Care

    Iowa Considers Adding a Fourth Medicaid Managed Care Plan

    Michigan Seeks Renewal of Medicaid Expansion Waiver

    Molina Confirms Loss of New Mexico Medicaid Managed Care Contract

    South Dakota to Seek Medicaid Work Requirements

    Texas Obtains Five-Year Medicaid Waiver Renewal

  • This week, our In Focus section highlights some of the key findings of the Fiscal Survey of the States Fall 2017 report, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state Read More
    Roundup:

    Alabama, Connecticut Issue CHIP Warnings

    D.C. to Reevaluate Medicaid Managed Care Awards

    Idaho Awards NEMT Contract to MTM

    Maryland to Expand Community Services for Individuals with Disabilities

    Mississippi Medicaid Director Resigns

    Oregon CCO FamilyCare to Close

    CMS will not Approve Medicaid Waivers Seeking Federal Designated state Health Program Funding

    House to Exclude ACA Exchange Stabilization Provisions from Spending Bill

  • This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for beneficiaries dually eligible for Medicare and Medicaid (duals) in 10 states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Read More
    Roundup:

    Michigan Study Finds Half of Medicaid Expansion Enrollees Work

    New York Medicaid MCO Financial Performance Deteriorated in 2016

    Federal Funding for New York’s Essential Plan in Jeopardy

    New Mexico Scales Back, Delays Some Proposed Medicaid Cuts

    Heather Smith Named Wisconsin Medicaid Director

    Hospitals Issue Flood of Bonds Ahead of Tax Overhaul

    Exchange Enrollment Lags Prior Years

  • This week, our In Focus section reviews the Texas STAR+PLUS request for proposals (RFP) issued on December 4, 2017. The STAR+PLUS Medicaid managed care program covers approximately 519, 000 individuals who have disabilities or are aged 65 or older. The Read More
    Roundup:

    Kansas Secretary of Health to Step Down

    Illinois Finalizes Contracts with Seven Medicaid Managed Care Plans

    21 Florida MCOs Submit Bids for Medicaid Managed Care Procurement

    Colorado Expands Access to Hepatitis C Drugs for Medicaid Members

  • This week, our In Focus section examines the 10 states that have not expanded Medicaid under the Affordable Care Act but where citizens can initiate a public vote on the issue. In November, nearly 60 percent of Maine voters approved Read More
    Roundup:

    Arizona Supreme Court Upholds Medicaid Expansion Funding

    Arkansas Approves Gateway-sponsored PASSE

    Florida Gov. Releases Proposed 2018-19 Budget

    Suits Force Florida, Missouri to Expand Hepatitis C Treatment

    Iowa Health Link RFP Attracts LOIs from Centene, Medica

    Iowa Appoints Randol as Medicaid Director

    Massachusetts Seeks Waiver to Negotiate Drug Rebates, Exclude Certain Medications

    OIG Report Says New Jersey Owes $300 Million for Special Education Services

    North Carolina Proposes Medicaid Premiums, Work Requirements in Waiver Amendment

  • This week, our In Focus section reviews the new guidelines issued by the Centers for Medicare & Medicaid Services (CMS) on expediting the approval process for Medicaid waivers and state plan amendments (SPAs) and improving quality, accessibility, outcomes, and transparency. Read More
    Roundup:

    Trump Nominates Alex Azar as Health and Human Services Secretary

    Virginia announces medallion 4.0 Medicaid managed care notices of intent to negotiate

    Texas Names Muth as New Medicaid Director

    New Jersey DHS Expands Behavioral Health Benefits Covered Under NJ Family Care

    West Virginia Considers Medicaid Work Requirements for Expansion Population

    Senate Finance Committee Adds Repeal of Individual Mandate to Tax Bill

    CBO Projects 13 Million Additional Uninsured Following Repeal of Individual Mandate

  • This week, our In Focus section reviews two Medicaid managed care requests for proposals (RFPs) released on November 2, 2017. The Arizona Health Care Cost Containment System (AHCCCS) issued an RFP for the “Complete Care” program, which will integrate Medicaid Read More
    Roundup:

    Maine Voters Approve Ballot Initiative to Expand Medicaid

    CMS Issues New Guidelines to Expedite Medicaid Waiver, State Plan Amendment Approval Process

    Verma Confirms Support for Medicaid Work Requirements

    Florida Medicaid Managed Care ITN Respondents Identified

    Utah Medicaid Expansion Waiver Approved

    Idaho Seeks Waivers to Expand Coverage, Create Complex Needs Program

    New Hampshire Submits 1115 Waiver Application, Includes Medicaid Work Requirements

    North Carolina Releases Managed Care RFIs

    Taylor Named Indiana Medicaid Director

    Pennsylvania Postpones Phase 2 and Phase 3 Rollout of Community HealthChoices

  • This week, our In Focus section reviews the request for proposals (RFP) issued on October 31, 2017, to add one or more Medicaid managed care organizations (MCOs) to the statewide IA Health Link managed care program. It was confirmed this Read More
    Roundup:

    CMS Approves Iowa Request to End Retroactive Coverage

    Kansas Requests Work Requirement Under KanCare Waiver

    Mississippi to Transition Medicaid Eligibility Verification to DHS, Eyes Medicaid Work Requirements

    Veyo Ends Idaho NEMT Contract

    CMS Proposed Rule Provides States Flexibility in Defining Essential Health Benefits

    Exchange Enrollment Numbers Expected to Decline

  • This week, our In Focus section reviews highlights and shares key takeaways from the 17th annual Medicaid Budget Survey conducted by Health Management Associates for the Kaiser Family Foundation (KFF). Survey results were released on October 19, 2017, in three Read More
    Roundup:

    1332 Waiver Update: Oregon Approved, Massachusetts rejected, Iowa Withdrawn

    New Jersey Provides Updates on FamilyCare Program

    Kansas Medicaid Director Steps Down

    Four More Plans to Exit New York FIDA Program

    Maryland Hospital Cost Comparison Website Launched

    Oklahoma to Cut Medicaid Provider Rates

    Wisconsin to increase behavioral health provider rates

    IRS to Enforce Individual Health Insurance Mandate Despite Executive Order

    Federal Judge Allows Administration to Halt CSR Payments

    California Spends Most on Inmate Health Care, Louisiana Spends Least, Report Finds