HMA Weekly Roundup

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  • 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

  • This week, our In Focus reviews Texas’ draft STAR and CHIP managed care services request for proposals (RFP) issued by the state’s Health and Human Services Commission (HHSC) on January 29, 2018. The STAR program is Texas’ Medicaid managed Read More

    Alabama to Release RFP for Medicaid LTSS Integrated Care Networks

    Arizona Attracts 7 Bidders for Medicaid Managed Care RFP

    Florida Budget Proposal Calls for Redistribution of Hospital Funding

    Kansas Governor Scraps KanCare 2.0

    Mississippi Reconsiders Medicaid Provider Cuts

    Governor Cuomo Announces $700 Millions Award for One Brooklyn Health

    Utah Release Medicaid Dental Managed Care RFP

    Virginia Considers Medicaid Expansion with Work Requirements

  • This week, our In Focus section reviews Texas’ 1115 Medicaid waiver renewal. After more than a year of negotiations, on December 21st the Texas Health and Human Services Commission (HHSC) received CMS approval to extend the state’s 1115 waiver. Read More

    CHIP Reauthorized for Six Years

    Senate Approves Azar as HHS Secretary

    CMS Deputy Administrator Brian Neale To Resign

    New Mexico Awards Centennial Care MCO Contracts

    Oregon Voters Approve Tax on Hospitals, Insurers To Fund Medicaid Expansion

    Alabama, Ohio Consider Medicaid Work Requirements

    Louisiana Health Secretary Opposes Medicaid Work Requirements

    Mississippi Medicaid Reauthorization Bill to Cut Provider Reimbursement By 5 Percent

    North Carolina Releases List of Managed Care RFI Respondents

  • This week, our In Focus section reviews Kentucky’s 1115 waiver, Kentucky Helping to Engage and Achieve Long Term Health (KY HEALTH), approved by the Centers for Medicare & Medicaid Services (CMS) on January 12, 2018. The waiver was approved for Read More

    California Approves Aetna's Entry Into Medi-Cal Market

    Illinois Medicaid Sued Over Low Nursing Home Rates

    Louisiana Considers Medicaid Work Requirements

    Massachusetts Lawmakers Call for Investigation of Kindred Healthcare

    New York Budget Proposal Contemplates For-profit Conversion and MCO Profit Fees

    Pennsylvania Governor Declares Opioid Epidemic a Statewide Public Health Disaster

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states. Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. Read More

    Mississippi Obtains Approval for First Ever 10-Year Medicaid Waiver

    Arizona Submits Waiver Request for Medicaid Work Requirements, Lifetime Limit.

    California Restores Medi-Cal Coverage of Certain Dental Services

    Illinois Begins Implementing HealthChoice Medicaid Managed Care

    Iowa Considers Adding a Fourth Medicaid Managed Care Plan

    Michigan Seeks Renewal of Medicaid Expansion Waiver

    Molina Confirms Loss of New Mexico Medicaid Managed Care Contract

    South Dakota to Seek Medicaid Work Requirements

    Texas Obtains Five-Year Medicaid Waiver Renewal

  • This week, our In Focus section highlights some of the key findings of the Fiscal Survey of the States Fall 2017 report, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state Read More

    Alabama, Connecticut Issue CHIP Warnings

    D.C. to Reevaluate Medicaid Managed Care Awards

    Idaho Awards NEMT Contract to MTM

    Maryland to Expand Community Services for Individuals with Disabilities

    Mississippi Medicaid Director Resigns

    Oregon CCO FamilyCare to Close

    CMS will not Approve Medicaid Waivers Seeking Federal Designated state Health Program Funding

    House to Exclude ACA Exchange Stabilization Provisions from Spending Bill

  • This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for beneficiaries dually eligible for Medicare and Medicaid (duals) in 10 states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Read More

    Michigan Study Finds Half of Medicaid Expansion Enrollees Work

    New York Medicaid MCO Financial Performance Deteriorated in 2016

    Federal Funding for New York’s Essential Plan in Jeopardy

    New Mexico Scales Back, Delays Some Proposed Medicaid Cuts

    Heather Smith Named Wisconsin Medicaid Director

    Hospitals Issue Flood of Bonds Ahead of Tax Overhaul

    Exchange Enrollment Lags Prior Years