HMA Weekly Roundup

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  • This week, our In Focus reviews requests for proposals (RFPs) for Minnesota’s Medicaid managed care programs: 1. Families and Children Medical Assistance and MinnesotaCare; 2. Minnesota Senior Care Plus (MSC+)/Minnesota Senior Health Options (MSHO). The two RFPs were released by Read More
    Roundup:

    Arkansas Providers Ask Judge to Further Delay Transition to Medicaid Managed Care

    California Community Leaders to Pursue Ballot Initiative for Two-Plan Medicaid System in Ventura

    Illinois Lawmakers Introduce Medicaid Managed Care Reform Legislation

    Iowa to Kick Off Medicaid Managed Care Open Enrollment Period

    Louisiana Receives Responses from 3 Drug Makers to Medicaid, Inmate Hepatitis C Treatment Proposal

    Medicaid Expansion News: Missouri, Ohio, Texas, Wisconsin

  • This week, our In Focus summarizes the findings of an HMA Information Services (HMAIS) analysis of Medicaid managed care rates in 2018 versus 2017. The analysis represents HMAIS’ first attempt at what will be an annual tracking of Medicaid managed Read More
    Roundup:

    Alaska Governor Proposes 33 Percent Medicaid Funding Cut

    Georgia Senate Approves Partial Medicaid Expansion

    Louisiana Releases Medicaid Managed Care RFP

    Minnesota Releases Medicaid Managed Care RFPs

    New Jersey Releases Medicaid MCO Contract Updates

    Texas Lawmakers to Introduce Medicaid Overhaul Legislation

    Medicaid Spending Growth to Accelerate, CMS Projects

  • This week, our In Focus reviews the Massachusetts One Care Dual Demonstration 2.0 request for responses (RFR), released by the Massachusetts Executive Office of Health and Human Services (EOHHS). One Care will cover Medicare and Medicaid dual eligible adults with Read More
    Roundup:

    Medicaid Expansion News: AK, GA, ID, NE, OK

    Iowa Senate Democrats Propose Moving Managed LTC Members Back to Fee-for-Service

    New Hampshire Announces Medicaid Managed Care Awards

    North Carolina Releases Scoring of Medicaid Plan Bids

    Oregon Receives 11 Updates to Letters of Intent for CCO 2.0

    Wisconsin Releases Family Care Partnership RFP for Selected Service Areas

  • This week we are providing a brief recap of our January 8th webinar Evolving Integrated Managed Care Models for Medicare-Medicaid Dual Eligible Beneficiaries: Key Considerations for Health Plans presented by Principals Sarah Barth, JD and Ellen Breslin, MPP. Read More
    Roundup:

    Arkansas Provider-Led Entities Move Forward After PASSE Readiness Review

    Medicaid Expansion Updates: FL, GA, LA, NC, UT

    Missouri Medicaid Overhaul Could Save $1 Billion Annually, Report Says

    New York Releases RFAs to Address Opioid Crisis

    North Carolina Faces Appeal from My Health Over Medicaid Managed Care Contract Awards

    Pennsylvania To Expand LIFE Program In Multiple Counties

  • On January 30, 2019, the Centers for Medicare & Medicaid Services (CMS) issued Part II of the Advance Notice of Methodological Changes for Calendar Year (CY) 2020 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies Read More
    Roundup:

    Florida Governor Maintains ‘Status Quo’ on Medicaid Budget

    Kentucky Delays Start Date for Medicaid Work Requirements

    Maine Governor Orders Audit of State Medicaid Program

    North Carolina Announces Medicaid Managed Care Awards

    Ohio Medicaid to Rebid Managed Care Contracts

    Oregon Health Authority Receives 24 Letters of Intent for CCO 2.0 Contracts

    HHS Proposes Overhaul of PBM Drug Rebate Rules

  • This week, our In Focus reviews the Oregon Health Plan’s Coordinated Care Organizations (CCO) 2.0 request for applications (RFA), released by the Oregon Health Authority (OHA) on January 25, 2019. Under CCO 2.0, the CCOs will provide full-risk coordinated care Read More
    Roundup:

    Arizona Behavioral Health Providers Are Owed Millions in Unpaid Medicaid Claims

    Arkansas, Maine Appoint Medicaid Directors

    Florida Judge Rejects State Medicaid Contract in Southwest Region; AHCA Appeals

    Kentucky Medicaid Plan Passport Health Could Face Bankruptcy Given Rate Cuts, CEO Says

    New Jersey Governor Outlines Initiatives to Combat Opioid Epidemic

    Health Share of Oregon to Seek New Medicaid CCO 2.0 Contract

    Medicaid Expansion Developments In Kansas, Montana, Utah, West Virginia, Wyoming

  • This week, our In Focus section reviews Arkansas’ Provider-led Arkansas Shared Savings Entity (PASSE) model, scheduled to transition to full risk capitation in March 2019. The PASSE program provides care coordination to improve the health of Medicaid members with behavioral Read More
    Roundup:

    Arizona Wins Approval for Medicaid Work Requirements

    Georgia Considers Medicaid Waiver to Expand Coverage

    Kansas Governor to Submit Medicaid Expansion Plan to Legislature This Month

    Kentucky Medicaid Plan Passport Health May Exit Market

    Maine Governor Reverses Medicaid Work Requirements

    North Carolina Audit Finds Medicaid LME/MCO Capitation Rates Were Actuarially Sound

    West Virginia Lawmakers Seek Transition to Managed Health Care for Foster Kids

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

    Alabama Releases Coordinated Health Network RFP

    Arkansas Says 3 Provider-Led Entities Will Move to Full Risk in Next Phase of PASSE Program

    Colorado, New York, Ohio Release Budget Proposals

    Kentucky Medicaid Beneficiaries Again File Lawsuit to Block Work Requirements, Premiums

    Louisiana Releases RFP for Subscription-Based Hepatitis C Drug Purchasing Agreement

    Michigan Names Gordon to Lead State Health Department

    Wisconsin Governor to Push for Medicaid Expansion Despite Legislative Opposition

    Trump Administration Is Reportedly Preparing Medicaid Block Grant Guidelines

  • This week, our In Focus section reviews a report recently submitted to the Minnesota Legislature, Accounting for Social Risk Factors in Minnesota Health Care Program Payments. The report delivers Minnesota Department of Human Services (DHS) recommendations to reduce health disparities Read More
    Roundup:

    AZ, FL, NM Name Medicaid Directors

    California Governor Orders Transition of Medicaid Pharmacy Benefit from Managed Care to FFS

    Florida Rejects Rebid of Medicaid Managed Care Contract Award for HIV/AIDS

    Virginia Medicaid Director Calls for Overhaul of Forecasting, Rate-Setting Processes

    CMS Names Chris Traylor Acting Director of Center for Medicaid and CHIP Services

  • This week, our In Focus section is led by Matt Powers, a Principal in our Chicago office, who worked with HMA colleagues to summarize the factors that non-expansion states weigh when considering whether or not to expand Medicaid under the Read More
    Roundup:

    Arkansas Drops Another 4,655 Medicaid Beneficiaries for Failing to Meet Work Requirements

    New York DOH Announces Funding for Community-Based Organizations

    Indiana Releases PBM Administrative Services RFP

    Molina Healthcare to Cut Ties with Golden Shore Medical Group Clinics

    Ohio Medicaid Director Barbara Sears To Step Down

    Oregon Names Lori Coyner Medicaid Director

    Federal Judge Rules ACA Is Unconstitutional

    December MACPAC Meeting Focuses on State Innovations in Drug Pricing, Network Adequacy, DSH Funding