HMA Weekly Roundup

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  • This week, our In Focus section shares HMA’s takeaways from the Centers for Medicare & Medicaid Services (CMS) white paper on the CMS Innovation Center Strategy Refresh: Driving Health System Transformation – A Strategy for the CMS Innovation Center’s Second Read More

    Arkansas Governor Expects Approval of Expansion Waiver

    alifornia Medicare Plan Faces Whistleblower Lawsuits

    District of Columbia to Increase Procurement Oversight

    Maryland Announces Medicaid Rate Increases for HCBS

    Minnesota Names Medicaid Managed Care Award Winners

    New Hampshire Releases MMIS RFI

    Ohio Official Says PBMs are Improperly Collecting Clawbacks

    Oregon Publishes Concept Papers for 1115 Waiver Renewal

    Jefferson Health Buys Stake in Health Partners Plans

    Wisconsin Transitions Medicaid NEMT Business to Veyo

    Democrats Agree to Let Medicare Negotiate Some Drug Prices

    Centene Sells Majority Stake in U.S. Medical Management

    Centene to Put PBM Business Out to Bid

  • This week, our In Focus highlights a recent issue brief, Center for Medicare and Medicaid Innovation: Recommendations for Future Direction, which revisits questions raised in a previous HMA report and offers potential answers to guide progress and changes for demonstrations Read More

    Arizona Medicaid Plans Bid to Integrate Individuals With SMI

    Florida May Realign Medicaid Districts in Next Procurement

    Illinois Official Urges Action on Nursing Home Payments

    Iowa Releases Medicaid NEMT RFP

    Massachusetts, Plans Sign One Care Dual Demo Contracts

    Montana Seeks Waiver to Address Substance Abuse

    Ohio Medicaid Managed Care Trial Continues

    Oregon to Release Medicaid Waiver Renewal Draft

    CMS Aims to Move Medicaid Members to Accountable Care

    BrightSpring Health Services Files for IPO

    Commonwealth Care Signals National Expansion

  • This week, our In Focus provides an analysis of 2022 Medicare Advantage (MA) Star Ratings, including a look at how regulatory changes during the COVID-19 pandemic resulted in a record number of Medicare plans receiving historically high scores. HMA Read More

    California Moves Medi-Cal RFP Release Date to February 2022

    Delaware Releases RFP Seeking HCBS Providers

    District of Columbia Releases Health Home Care Services RFQ

    Long-term Care News: Illinois, Minnesota, Pennsylvania

    AmeriHealth Caritas Launches NC Exchange Plans

    Ohio Trial Over Medicaid Managed Contract Awards Begins

    Oregon CCOs to Receive a 4.2 Percent PMPM Rate Increase

    Tennessee Delays Medicaid Managed Care Contract Awards

    Virginia to Release Draft Contract for Planned Medicaid Managed Care Program Consolidation

    Washington Eyes Use of Medicaid Funds for Medical Respite

    MACPAC Reports 8 Percent Medicaid, CHIP Churn Rate in 2018

    Best Buy to Acquire Remote Monitoring Technology Company

    Molina Healthcare Acquires LTC Business of AgeWell

  • This week, our In Focus highlights the issue brief, Strategic Approaches to Utilization of American Rescue Plan Act Funds to Support Older Adults, written by HMA Principal Madeleine Shea, PhD and Senior Consultant Aaron Tripp, MSW and distributed by Milbank. Read More

    Iowa Medicaid Managed Care Contract Is Eyed by CareSource

    Medicaid Expansion News: Missouri, Nebraska, South Dakota

    New York Seeks Applicants for Transformation Grants

    North Carolina Strengthens Regulation of PBMs

    Ohio to Increase Medicaid Provider Rates for HCBS

    Oklahoma Isn’t Reducing HCBS Wait List Enough, Report Says

    Oregon Eyes Giving CCOs More Flexibility to Cover SDOH

    Texas Releases STAR Health Foster Care RFP

    Wisconsin Chooses Veyo for Medicaid NEMT Services

    CMMI Eyes More Mandatory Payment Models

    Medicare Advantage Premiums to Decline 10 Percent in 2022

    Sun Life Financial to Acquire DentaQuest

  • This week, our In Focus reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 33 states. Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This Read More

    California Governor May Veto PACE Telehealth Bill

    Colorado Begins Scaling Back Medicaid NEMT Contract

    Florida Officials Expect ‘Imminent’ Federal Approval of HCBS Spending Plan

    Minnesota to Waive Premiums for Certain Expansion Members

    New Jersey Hospital System to Exit Medicaid Plan Network

    New York Appoints Mary Bassett Commissioner of Health

    Vermont Hospital to Be Sole Parent of OneCare Vermont

    Most Medicaid Members Face Inadequate Housing, Study Says

    AmeriHealth Caritas Forms Subsidiary to Address Social Determinants of Health

    Wayspring Receives Investment to Expand Substance Use Disorder Treatment Model

  • Aimed at shifting and improving the delivery of addiction treatment within county jails, Health Management Associates (HMA) will partner with the Washington/Baltimore High Intensity Drug Trafficking Area (W/B HIDTA) and Fairfax County Sheriff’s Office to deliver a novel Project ECHO Read More

    Connecticut to Combine Medicaid, Housing Services

    Florida Approves Exchange Premiums Hike of 6.6 Percent

    Michigan to Continue Expanded Medicaid Program in Flint

    Mississippi Economist Says Uncompensated Care Savings Would Cover State Cost of Medicaid Expansion

    Oklahoma Fails to Win HCBS Residency Requirement Approval

    Oregon to Seek Federal Funding for Health Equity

    Puerto Rico Secures $2.9 Billion in Federal Medicaid Funding

    CMS to Include Dual-Eligible Plan Features in Medicare Plans

    Exchange Plan Enrollment Hits All Time High at 12.2 Million

    Molina to Bid on 40 Percent of Medicaid Procurements

    Intermountain Healthcare, SCL Health to Merge

  • This week, our In Focus reviews the the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) draft proposal for the renewal of its 1115 Comprehensive Demonstration Waiver, released on September 10, 2021. The Read More

    Colorado to Address Maternal Health Disparities

    District of Columbia Delays MedStar Contract Extension

    Georgia to Begin Bidding Process for Medicaid Plans in 2022

    Louisiana Appoints Medicaid Executive Director

    Michigan to Hold Hearings on Carving Behavioral Health Into Medicaid Managed Care

    New Hampshire Renews MMIS Contract with Conduent

    Ohio Medicaid Plan Faces 600 Layoffs Without State Contract

    Tennessee Sees Opposition to Block Grant Waiver

    Democrats Detail Plan to Close Medicaid Coverage Gap

    HHAeXchange Secures Investment from Hg

    Health Plans to Expand Exchange Offerings in 2022

  • This week, our In Focus reviews the Texas Health and Human Services Commission (HHSC) draft request for proposals (RFP) for Texas STAR Health, the state’s Medicaid managed care program for foster care kids. The state is also seeking public input Read More

    California Launches Enhanced Care Management Program

    California Awards EVV Contract to Sandata

    District of Columbia Extends MedStar Medicaid Contract; To Release Medicaid Managed Care RFP in November

    Idaho Awards Correctional Health Contract to Centurion

    Maine Medicaid To Raise Residential SUD Treatment Rates

    Ohio ACO to Serve 100,000 CareSource Medicaid Members

    Vermont All-Payer System Achieves Medicare Savings

    CMS Gives 13 States $452 Million for Reinsurance Programs

    LHC Group to Acquire Brookdale Health Agencies

    Highmark Health Acquires Remaining Stake in Gateway

  • This week, our In Focus section reviews key takeaways from the report, Medicaid Non-Emergency Transportation Benefit: Stakeholder Perspectives on Trends and Innovations, prepared by Health Management Associates (HMA) for the Medicaid and CHIP Payment and Access Commission (MACPAC). The report Read More

    MedStar Health May Drop CareFirst, AmeriHealth Caritas Medicaid Plans from Network

    Illinois Medicaid to Expand Maternal, Child Health

    Missouri Medicaid Expansion Applications Hit Snag

    Missouri Medicaid Director Slated to Return in September

    New York Seeks Medicaid Waiver to Improve Health Disparities

    Texas Medicaid Waiver Extension Is Upheld by Federal Judge

    Wisconsin Releases Draft RFP for Medicaid Managed LTC

    GuideWell to Acquire Triple-S Management

    Independent Living Systems Completes Stock Buyback

    Cityblock to Serve BCBS-NC Medicaid, Medicare Members

  • This week, our In Focus section reviews the Arizona Health Care Cost Containment System (AHCCCS) Competitive Contract Expansion (CCE) request for proposals (RFP), released on August 4, 2021. The procurement will expand the current AHCCCS Complete Care (ACC) Medicaid contracts Read More

    Colorado to Continue Exchange Reinsurance Program

    Illinois Enacts Medicaid Behavioral Network Adequacy Law

    Kansas to Investigate Pharmacy Benefit Managers

    Massachusetts to Submit MassHealth 1115 Waiver Extension

    Missouri Looks to Release Medicaid Managed Care RFP in Fall

    New York Auditors Question $1.5 Billion in Medicaid Payments

    North Carolina Clears Mecklenburg County to Switch Managed Care Plans for Behavioral, IDD Beneficiaries

    Ohio Awards Medicaid Managed Care Contract to Centene

    Medicare Plan Is Subject to Overpayment Rule, Court Says