HMA Weekly Roundup

Need to round out your collection of Weekly Roundups?

Access pdfs of this weekly newsletter’s archived issues.


  • This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a freedom of information act request to CMS, we have received a draft version of the CMS-64 report that is Read More

    Texas Releases MCO RFP for STAR, CHIP

    Texas Cancels Rural CHIP MCO Contract Awards

    Pennsylvania Court Rules in Favor of MCO Award Protest

    New Hampshire Releases MLTSS Implementation Plan

    New Jersey Outlines Anti-Addiction Program Spending Plans

    New York Legislature Approves Final SFY 2018-19 Budget

    Ohio Medicaid To Investigate PBM Pricing

    Virginia Moves Closer to Medicaid Expansion

    CMS Issues Final Rule Allowing States Flexibility in Defining ‘Essential Health Benefits’

    Study: Medicaid Enrollees Have Better Access to Care Than Uninsured

  • This week, our In Focus section reviews Alabama’s Integrated Care Network (ICN) program, based on a concept paper released by the Alabama Medicaid Agency in March 2018. The ICN program will establish a new Medicaid long-term care program focusing on Read More

    Arkansas, Kentucky Implement Medicaid Work Requirements

    California Files Antitrust Lawsuit Against Sutter Health

    Kansas Rejects Proposed Medicaid Expansion Amendment

    Louisiana Rejects Bill to Transition LTSS to Managed Care

    New York Reaches Deal with Fidelis, Centene

    Admissions, ER Visits Lower Among Duals Who Receive Home-Delivered Meals, Study Says

    ACA Exchange Enrollment Falls 3 Percent in 2018

  • This week, our In Focus section, written by HMA Principal Denise Soffel, reviews New York’s Medicaid Redesign Team Structural Roadmap: Roles and Responsibilities in a Value Based Payment World, released by the state’s Department of Health on March 19, 2018. Read More

    Utah Passes Partial Medicaid Expansion; Awaits CMS Approval

    Nebraska Nursing Facilities Put Into Receivership

    Community Health Systems to Sell Three Tennessee Hospitals

    New York Governor Proposes Budget Strategy to Take Medicaid Health Plan Reserve Funds

    OIG Claims California Enrolled 450,000 Ineligible Medicaid Expansion Members

    Sendero Health Plans to Exit Texas STAR Medicaid, CHIP Programs

    CMS Proposal Would Roll Back Certain Medicaid Access to Care Monitoring Requirements

  • This week’s In Focus section highlights four briefs written by Health Management Associates (HMA) in collaboration with the National Council on Assisted Living that address key areas of compliance with the Centers for Medicare & Medicaid Services (CMS) home and Read More

    Florida Governor Scott Signs Opioid Bill

    Michigan Awards Behavioral Carve-In Contracts

    Montana Medicaid Expansion Boosts Economy, Report Says

    New York Senate, House Respond to Governor’s Executive Budget Proposal

    New York Names Frescatore Medicaid Director

    Exchange Stabilization Efforts Stall in House

    MACPAC Calls for Streamlining Medicaid Managed Care Authority

  • This week’s In Focus section reviews the recent Bipartisan Budget Act of 2018 (the Act), which adopts policies aimed at improving care for Medicare beneficiaries with chronic conditions, including individuals dually enrolled in Medicare and Medicaid (dual eligible individuals). The Read More

    Florida, New Jersey FY 2019 Budgets Include Key Healthcare Provisions

    CMS Denies Idaho Plan to Skirt ACA Requirements

    Illinois Passes Hospital Assessment Plan

    Iowa Announces Medicaid Managed Care RFP Respondents

    Minnesota Releases Special Needs BasicCare RFP

    Nebraska Medicaid Expansion Advocates Launch Ballot Initiative

    New York FQHCs Plan Merger

    Texas Awards CHIP Rural and Hidalgo Service Areas Contracts

  • This week’s In Focus highlights a recently released report written by Health Management Associates colleagues Sharon Silow‐Carroll, Diana Rodin, and Anh Pham, titled “Interagency, Cross-Sector Collaboration to Improve Care for Vulnerable Children: Lessons from Six State Initiatives.” Prepared for the Read More

    Arizona Awards Medicaid Managed Care Contracts

    CMS Approves Arkansas Medicaid Work Requirements Waiver

    Hawaii Awards Community Care Services Contract to Ohana Health Plan

    Massachusetts Providers Expect Confusion as State Rolls Out ACO Networks

    Quality Performance Results Published for New Jersey Nursing Facilities

    New York Announces Care Coordination Organizations for People with I/DD

    North Carolina Releases Enrollment Broker Services RFP

    South Carolina Awards Multi-Vendor Integrator Award to Cognosante

    HHS Secretary Says Changes Coming to Provider Reimbursements

  • This week’s In Focus section, written by HMA Principal Juan Montanez, reviews the request for proposals (RFP) issued by Puerto Rico earlier this month to deliver managed care services to the territory’s Government Health Plan (GHP) members. The government of Read More

    Colorado, Florida, Missouri, Consider Work Requirements

    Michigan Receives Bids for Behavioral Health Carve-In

    New Jersey Medicaid MCOs Expand Service Areas

    New Mexico Judge Denies Injunction in Medicaid MCO Awards Dispute

    Wisconsin Legislature Passes Exchange Reinsurance Bill

    Justice Department to Support Local Officials in Lawsuits Against Opioid Distributors

    FDA to Allow Drugs that Reduce Opioid Craving

  • This week’s In Focus section reviews Washington’s 2019/2020 Integrated Managed Care (IMC) request for proposals (RFP) issued by the Washington State Health Care Authority (HCA) on February 15, 2018 to provide 1.6 million Medicaid enrollees with both physical and behavioral Read More

    New York Medicaid Director Jason Helgerson to Step Down

    Virginia House Budget Plan Includes Medicaid Expansion with Work Requirements

    Michigan To Consider Transitioning Long-Term Care wnto Managed Care

    Molina, United Allege Bias in New Mexico Medicaid Contract Awards, State Responds

    Kansas Hit with Lawsuit Over Medicaid Denials of Hepatitis C Drugs

    New York Catholic Diocese Opposes Governor's Proposal for Fidelis Proceeds

    Nebraska Names Matthew Van Patton Medicaid Director

    Ohio Medicaid Agency Releases Draft 1115 Waiver with Work Requirements

    Alaska State Senators Introduce Medicaid Work Requirements Bill

  • This week, our In Focus, written by HMA Principals Nora Leibowitz and Donna Laverdiere, reviews Section 1332 State Innovation Waivers. Section 1332 of the Affordable Care Act allows states to apply for State Innovation Waivers to pursue innovative ways of Read More

    Puerto Rico Releases Medicaid Managed Care RFP

    Florida Receives Bids from 8 Medicaid Dental Plans

    Mississippi House Passes Bill to Rebid Medicaid Managed Care Program

    Missouri Hospitals Win Lawsuit Over DSH Allotment Rule

    New Jersey Provides MLTSS Update

    New York Senate Opposes Governor’s Proposed Health Insurance Tax

    Virginia Awards NEMT Contract to LogistiCare

    CMS Is Developing Medicaid Scorecard

    Budget Deal Further Extends CHIP Funding

  • Texas Lawmaker Calls for Investigation of Medicaid Managed Care Contract Oversight Wisconsin Moves to Mandatory Enrollment for Certain SSI Beneficiaries Trusted Health Plan Responds to Iowa RFP Molina Protests New Mexico Contract Loss, Is Invited to Negotiate in Florida Region Read More

    Texas Lawmaker Calls for Investigation of Medicaid Managed Care Contract Oversight

    Wisconsin Moves to Mandatory Enrollment for Certain SSI Beneficiaries

    Trusted Health Plan Responds to Iowa RFP

    Molina Protests New Mexico Contract Loss, Is Invited to Negotiate in Florida Region 11 Only

    Tennessee Wins Federal Approval for Drug Management Pilot

    Trump Administration Considers Lifetime Coverage Limits for Medicaid

    Republicans Abandon ACA Repeal and Replace For Now

    CMS to Release Rural Health Strategy for Providers