HMA Weekly Roundup

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  • This week, our In Focus section releases a new brief from Health Management Associates, Medicare-Medicaid Integration: Essential Program Elements and Policy Recommendations for Integrated Care Programs for Dually Eligible Individuals. The authors are Sarah Barth, Ellen Breslin, Samantha DiPaola and Read More
    Roundup:

    HCBS Spending Plans: Arizona, Florida, New York

    Iowa to Release Medicaid Managed Care RFP in December

    Medicaid Expansion News: Mississippi, Missouri, Montana

    Missouri Supreme Court Hears Medicaid Expansion Case

    New Jersey Enacts ‘Cover All Kids’ Universal Care Initiative

    Ohio Medicaid Readies New Nursing Home Rates

    Vermont Proposes Risk-Bearing, State-Run Medicaid Managed Care Entity

  • This week, our In Focus section reviews the Minnesota Integrated Health Partnerships (IHP) Program request for proposals (RFP) released by the Minnesota Department of Human Services (DHS), Health Care Administration on July 6, 2021. Minnesota will contract with provider organizations Read More
    Roundup:

    Arkansas Approves CareSource to Participate in PASSE Program

    California Submits CalAIM Waivers for Federal Approval

    State Budget News: California, Maine, New Jersey

    Guam Could Transition Thousands from Medically Indigent Program to Medicaid

    Missouri Legislature Renews Medicaid Hospital Tax

    Ohio Governor Vetoes Medicaid Procurement Changes

    Oklahoma Medicaid to Provide Adult Preventative Dental Services

    CMS Appoints Meena Seshamani as Medicare Director

  • This week, our In Focus section reviews a new paper from Health Management Associates, State Efforts to Integrate Care Across Medicaid Fee-forService Long-Term Services and Supports and Medicare Advantage Dual Eligible Special Needs Plans by Sarah Barth, Rachel Deadmon and Read More
    Roundup:

    Georgia to Delay Limited Medicaid Expansion Roll Out

    Minnesota Releases IV&V RFP

    Missouri Supreme Court to Hear Medicaid Expansion Case

    Ohio Bill Scraps Medicaid Managed Care Procurement Redo

    Lawmakers in 42 States Introduce Bills to Regulate PBMs

    CMS to Expand Home Health Value-Based Purchasing Model

    CMS Names Daniel Tsai Director for Medicaid, CHIP Services

  • This week, our In Focus section reviews a new report from Health Management Associates, COVID-19 Policy Flexibilities Affecting Children and Youth with Special Health Care Needs: What to Keep, Modify, or Discard?. In response to the COVID19 pandemic, the federal Read More
    Roundup:

    HCBS Spending Plans: California, Pennsylvania

    Florida to Roll Back Medicaid Flexibilities on July 1

    Georgia Department of Community Health Chief to Retire

    Dental News: Illinois, New Hampshire, Virginia

    Kentucky Must Rebid Medicaid Managed Care Contracts

    Mississippi Investigates Health Plan, Medicaid PBM

    Missouri Judge Rules Against Medicaid Expansion

    Pennsylvania Law to Expand Caregivers Eligibility, Support

    Ohio Denies Medicaid Managed Care Award Protest

    Vermont Audit Says Medicaid ACO Missed Financial Targets

    CMS Announces Grants to Improve State-based Marketplaces

  • This week our In Focus reviews the Tennessee Medicaid managed care request for proposals (RFP) released on June 11, 2021, by the State of Tennessee, Division of TennCare. Tennessee will select three plans to provide physical services, behavioral services, and Read More
    Roundup:

    Florida Releases Medicaid Dental Plan ITN for Healthy Kids

    Florida Seeks Extension on Enhanced Medicaid HCBS Funds

    Illinois Statewide Dual Demo Plan Receives Approval

    Missouri House Leader Sees Progress on Medicaid Hospital Tax

    Nevada to Award Medicaid Plan Contracts

    North Carolina Residents Are Unaware of Planned Medicaid Managed Care Transition, Poll Shows

    Ohio Senate Clears Rebid of Medicaid MCO Contracts

    Medicaid Plan Settles Ohio PBM Lawsuit

    Oregon Medicaid Director Steps Downs

    Tennessee Releases Medicaid Managed Care RFP

    Exchange Premiums Fall 26 Percent for New Enrollees

  • This week, our In Focus section reviews the Indiana Medicaid managed care request for proposals (RFP) for health plans serving beneficiaries enrolled in Hoosier Healthwise and Healthy Indiana Plan (HIP) programs. Contracts will be worth over $6 billion annually. The Read More
    Roundup:

    Arizona Looks to Improve Health Outcomes for Homeless

    Georgia Is Asked for New Study on Exchange Waiver Impacts

    Illinois Awards MMIS Contract to CNSI

    Iowa Auto-Assigns Children to Medicaid Dental Plans

    Medicaid Expansion News: Nebraska, Montana, North Dakota, Oklahoma

    Ohio Lawmakers Seek Redo of Medicaid Plan Procurement

    Vermont Medicaid Director Resigns

    Lawmakers Seek More Transparency from CMMI on Value-Based Care Models

  • This week, our In Focus section reviews the draft Medi-Cal Managed Care Plans (MCPs) request for proposals (RFP) released on June 1, 2021, by the California Department of Health Care Services (DHCS). California will procure MCPs for the Two-Plan Model, Read More
    Roundup:

    Florida Names Tom Wallace Medicaid Director

    Illinois Legislature Passes Bill to Enhance Medicaid Benefits

    Missouri Medicaid Expansion Court Trial to Begin June 18

    Nevada Senate Passes Public Option Proposal

    New Jersey Bill Would Facilitate Certification of Family Caregivers as Nursing Assistants, Raise Payments

    New York Home Care Providers Worry About New Medicaid Application Process

    New York Medicaid Director to Resign Effective August 11

    North Carolina Completes Medicaid Plan Auto-Enrollment

    Oklahoma Supreme Court Rules Against Transition to Medicaid Managed Care

  • In an issue brief prepared for The Commonwealth Fund and The SCAN Foundation, HMA consultant Jennifer Podulka and Vice President Jonathan Blum, analyze the temporary COVID-19-related changes to Medicare regulations, described the benefits and risks of the changes, and offered Read More
    Roundup:

    Florida Medicaid Providers Lag in EHR ‘Meaningful Use’

    Georgia Is Likely to Extend Existing Medicaid Managed Care Contracts, Eyes Potential Clawbacks

    Medicaid Expansion News; Mississippi, Missouri, North Dakota, Wisconsin

    Oklahoma Legislature Approves Bill to Place Guardrails on Medicaid Managed Care Transition

    Washington Medicaid Director MaryAnne Lindeblad to Step Down Effective July 31

    ACA Exchange Premiums Decline for the Third Straight Year

    CMS to End Next Generation ACO Model

  • This week, our In Focus section reviews California’s May Revision to the Governor’s Budget, which proposes a $267.8 billion budget (with $196.8 billion General Fund) for fiscal year 2021-22. The revised budget includes $24.4 billion in reserves, the largest in Read More
    Roundup:

    Connecticut Releases RFP for Behavioral Health ASO

    Delaware to Implement Medicaid ACO Contracts in January

    Minnesota Reaches Decision on Likely Medicaid MCO Winners

    Missouri Lawmakers Fail to Renew Medicaid Provider Tax

    Missouri Courts Likely to Decide Fate of Medicaid Expansion

    Nevada Budget Panel Approves Roll Back of Provider Cut

    New Jersey Releases RFA for Burlington County PACE

    North Carolina Extends Medicaid Plan Open Enrollment

    Texas to Resubmit 1115 Medicaid Waiver Extension Application

    SAMHSA to Offer State Block Grants for Behavioral Health

  • This week, our In Focus section reviews the key provisions of the Centers for Medicare & Medicaid (CMS) Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (CMS-1752-P), which includes Read More
    Roundup:

    Arkansas Releases MMIS Fiscal Agent RFP

    California DHCS Announces Counties That Intend to Transition to Local Medi-Cal Managed Care Plan Model

    Hawaii Awards MMIS Contract to Conduent

    Medicaid Expansion News: Missouri, Montana, South Dakota, Wisconsin, Wyoming

    Ohio Health Plan Files Lawsuit to Access Medicaid Procurement Documents

    Texas House Passes Bill to Contract with Baylor Scott & White Health in Central RSA

    PBM Pricing Practices Under Scrutiny by Attorneys General in Eight States

    U.S. Senate Confirms Andrea Palm as HHS Deputy Secretary