HMA Weekly Roundup

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  • This week, our In Focus section shares highlights and key takeaways from the 20th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 14, 2020, in two Read More
    Roundup:

    Florida Taps Shevaun Harris for Acting Lead of AHCA

    Georgia Receives Approval For Limited Medicaid Expansion

    Illinois Integrated Health Homes Program Is Delayed

    Nebraska Wins Federal Approval of Two-Tiered Medicaid Expansion Waiver

    North Dakota Releases RFP for Medicaid Expansion MCOs

    Oklahoma Releases Medicaid Managed Care, Dental RFPs

    Ohio MCO to Bid on Oklahoma Medicaid Managed Care RFP

    Virginia Budget Agreement Includes Funding for Adult Medicaid Dental Coverage

    ACA Exchange Premiums to Decrease 2 Percent in 2021

  • This week, our In Focus section reviews UnitedHealth Group’s The Path Forward to a Next-Generation Health System, an outline of policy recommendations to achieve a high-quality, affordable health care system. The paper focuses on four goals: 1) achieve universal coverage; Read More
    Roundup:

    Illinois to Offer Health Coverage to Elderly Undocumented Immigrants

    Kentucky Is Temporarily Blocked from Moving Ahead with Medicaid Managed Care Contract

    Oklahoma Proposal to Transition Medicaid to Managed Care Faces Bipartisan Opposition

    Texas Is Hit with Federal Order to Fix Early Childhood Intervention Program

    Rate of Uninsured Children Rises, Report Shows

    More Medicare Advantage Plans to Cover Home-Based Support Services in 2021

  • This week, our In Focus section reviews the Ohio Medicaid Managed Care request for applications (RFA) released by the Ohio Department of Medicaid (ODM) on September 30, 2020. The RFA follows the release of two requests for information (RFIs) in Read More
    Roundup:

    D.C. Implements New Medicaid Managed Care Contracts

    Kansas Awards Conduent Contract to Handle Medicaid Applications

    Kentucky to Relaunch State Exchange for 2022 Coverage

    North Carolina Awards EVV Contract to Sandata

    Trump Ends COVID-19 Relief Talks Until After Election

    Medicaid, CHIP Enrollment Reaches 75 Million Through June

    Senate Passes Legislation to Relax Medicare Provider Relief Loans, Delay Medicaid DSH Cuts

  • This week, our In Focus section reviews two recent Medicare developments from the Centers for Medicare & Medicaid Services (CMS). On September 24, 2020, CMS released the Medicare Advantage (MA) and Part D landscape files for the 2021 plan year. Read More
    Roundup:

    Delaware Medicaid to Add Dental Coverage for Adults

    Nebraska Medicaid Expansion Begins October 1

    North Carolina PLE Petitions to Reverse Medicaid Managed Care Procurement Ruling

    Ohio Releases Medicaid Managed Care RFA

    Ohio Announces Creation of Medicaid Managed Care Program for Children with Behavioral Health Needs

    Texas Seeks Input On Procuring MCOs for Healthy Texas Women Program

    House Democrats Unveil COVID-19 Bill That Includes $50 Billion for Healthcare Providers

    Trump Administration Approves Drug Importation Program

    CMS Warns of Significant Decrease in Utilization of Health Services Among Children Enrolled in Medicaid, CHIP

  • On September 15, 2020, the Centers for Medicare & Medicaid Services (CMS) released State Medicaid Director (SMD) letter #20-004 regarding value-based care (VBC) opportunities in Medicaid. In the letter, CMS lays out a road map for state Medicaid agencies Read More
    Roundup:

    Delaware Approves Four ACOs to Serve Medicaid Population in 2021

    New York Finds $700 Million in Improper Medicaid Payments

    Vermont ACO Pilot Program Failed to Meet Enrollment, Spending Targets

    House Passes Federal Funding Bill to Relax Repayment Terms for COVID-19 Medicare Loans

    CMS Announces Additional $165 Million MFP Funding for 33 States

    Justice Ginsburg’s Death Could Jeopardize the ACA

    CMS Innovation Agency Announces Roll Out of Risk-Based Model for Dual Eligibles

  • This week, our In Focus sections reviews the Missouri HealthNet Pharmacy and Clinical Services Management Solution request for information (RFI) and the Kentucky Medicaid Managed Care Organization (MCO) Pharmacy Benefit Manager request for proposals (RFP). Read More
    Roundup:

    California to Release Medi-Cal Managed Care RFP in Late 2021

    Nevada Medicaid Enrollment Increases by 87,000

    North Carolina Voters Support Medicaid Expansion, Poll Finds

    North Dakota to Release Medicaid Expansion Managed Care RFP in October

    CMS Releases Medicaid, CHIP Data Files in Continued Effort to Promote Transparency

    CMS Withdraws Medicaid Fiscal Accountability Rule

    CMS Issues Guidance on Value-Based Care Arrangements in Medicaid

  • This week, our In Focus section reviews the policy changes included in the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and LongTerm Acute Care Hospital (LTCH) Final Rule (CMS-1735-F). Read More
    Roundup:

    District of Columbia Council Finalizes Medicaid Managed Care Contracts

    Florida AHCA Secretary Mary Mayhew to Leave Post October 2

    Georgia Submits 1332 Waiver to Abandon ACA Health Insurance Exchanges

    Oklahoma to Transition Majority of Insure Oklahoma Members to Medicaid Expansion

    Oregon Files Notice of Noncompliance Against Medicaid CCO

  • This week, our In Focus section reviews the California request for information (RFI) regarding the Medi-Cal Managed Care Plan (MCP) contract and the upcoming Medi-Cal MCP procurement. The California Department of Health Care Services (DHCS) is seeking information to update Read More
    Roundup:

    California Medicaid Drops Proposed LTC At Home Benefit

    Medicaid Managed Care RFP News: District of Columbia, Indiana, Louisiana, North Carolina

    Medicaid Budget News: Georgia, New Jersey, Wyoming

    Illinois to Transition Foster Kids to Medicaid Managed Care

    Kentucky Releases RFP for Single PBM

    Mississippi Advocates Renew Medicaid Expansion Push

    Nevada Releases Medicaid NEMT RFP

    Housing Supports News: New York, Utah

    Ohio Proposes Rules to Lock In Medicaid Telehealth Changes

    States Take Emergency Action on Medicaid Long-Term Care

  • This week, our In Focus section reviews Democratic Nominee Joe Biden’s healthcare plan to protect and build on the Affordable Care Act (ACA). On August 18, 2020, Biden was officially nominated as the presidential candidate. Biden vowed at the 2020 Read More
    Roundup:

    Florida Says It Has Enough Medicaid Funding for Fiscal 2021

    Nevada to Move Forward with Proposed Medicaid Rate Cuts

    New Mexico Co-Op Plan Health Connections to Cease Operations in 2021

    Oklahoma Will Not Move Forward With Block Grant

    Oregon Approves Trillium CCO Expansion Into Portland Area

    CMS Fines Nursing Homes More Than $15 Million for Infection Control Noncompliance

  • This week, our In Focus section reviews two Medicare fee-for-service (FFS) proposed rules recently issued by the Centers for Medicare & Medicaid Services (CMS). On August 3, 2020, CMS released a proposed rule that includes updates to services furnished under Read More
    Roundup:

    Florida Medicaid Plans to Get 1.5 Percent Rate Increase

    Kansas Governor Urges Lawmakers to Pass Expansion

    New Jersey Proposes $155 Million in Additional LTC Funding

    Ohio Medicaid Officials to Address PBM Report Omissions

    Oklahoma to Transition to Dental Managed Care in 2021

    Oregon Reviews CCO Application to Expand Into Portland

    Washington Chooses Five Cascade Care Public Option Plans