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 the Centers for Medicare & Medicaid Services’ (CMS) Innovation Center’s newly announced model – Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH). Read MoreRoundup:
Arizona to Prioritize Medicaid Eligibility Redeterminations
Arkansas Announces HCBS Workforce Stabilization Program
California to End Child Health and Disability Prevention Program, Expand Presumptive Eligibility
PBM News: California, Georgia, Michigan, Oregon
Colorado Pauses Medicaid Prior Authorization Requirements
Florida Senate Committee Advances Scaled Back Plan to Merge Medicaid Managed Care Regions
Georgia House Passes Bill to Cover Childless Adults with HIV
Medicaid Expansion News: Illinois, Wisconsin
Dental News: New Hampshire, Tennessee
New York 1199SEIU Home Care Workers to Receive Back Pay
- This week, our In Focus section reviews the Iowa Health Link request for proposals (RFP) for Medicaid managed care organizations (MCOs) to serve the state’s traditional Medicaid program, the Children’s Health Insurance Program (CHIP) known as Healthy and Well Kids Read MoreRoundup:
Colorado RAE Improperly Denies Claims Due to System Issue
District of Columbia Awards District Dual Choice Contract
Florida House Considers Bill to Carve-in Medicaid Dental
Iowa Releases Medicaid Managed Care RFP
Massachusetts to Release Medicaid ACOs RFR
Medicaid Expansion News: Missouri, North Carolina, Wyoming
Michigan Legislature Passes PBM Transparency Bill
Nevada Medicaid Providers Are Under-Prescribing MAT
Oregon Focuses on Equity in Medicaid 1115 Waiver Renewal
Rhode Island Denies Proposed Hospital Systems Merger
Wisconsin Senate Passes Bills to Tighten Medicaid Eligibility
CMS Ends Program to Develop Rural ACOs
- This week, our In Focus section reviews the California Medicaid (Medi-Cal) managed care request for proposals (RFP) released by the California Department of Health Care Services (DHCS) on February 9, 2022. Read MoreRoundup:
Florida Lawmaker Proposes Statewide Medicaid Managed Care Procurement, Cap on Market Share
Indiana Bill May Upend Move to Medicaid Managed LTSS
Medicaid Expansion News: Kansas, Missouri, North Carolina, South Dakota, Wyoming
Louisiana Awards Medicaid Managed Care Contracts
Michigan Governor Allocates $243.3 Million to Procure Single Dental Medicaid Managed Care Plan
Mississippi Bill that Would End Contract With Medicaid Managed Care Plan Moves to Senate
Eligibility Redetermination News: Oregon, Utah
West Virginia Legislators Consider Medicaid Buy-in Program
- This week our In Focus section reviews the Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies issued by the Centers for Medicare & Read MoreIn Focus:Roundup:
Arizona to Offer HCBS Providers Incentive for EVV Use
Arkansas PASSE Gets Investment from Trive Capital
California Releases Medicaid Managed Care RFP
California Medicaid Members Struggle to Fill Prescriptions
California Plan Gets Medicaid Pact Ahead of Procurement
Florida Senator Looks to Raise Nursing Home Employee Wages
Kansas Bill to Extend Medicaid Plan Contracts Is Questioned
Missouri Medicaid Recipients May Wrongly Lose Coverage
New Mexico To Releases Medicaid Plan RFP in September 2022
North Carolina to Join Medicaid Alternative Payment Pilot
Texas Releases Draft of STAR+PLUS Medicaid Plan RFP
- This week our In Focus section reviews the Delaware request for proposals (RFP) for Diamond State Health Plan (DSHP) and Diamond State Health Plan Plus (DSHP Plus), the state’s Medicaid managed care programs. Read MoreRoundup:
California Delays Medi-Cal Managed Care RFP By One Week
Colorado Eyes Reform of Medicaid Behavioral Health System
Delaware Selects Sandata Technologies for EVV Program
Georgia Bill Would Set Minimum MLR for Medicaid Plans
Kansas Lawmakers Look to Extend Medicaid Plan Contracts
Massachusetts Community Behavioral Health Centers RFP
Minnesota Governor Seeks MinnesotaCare Buy-In
South Dakota House OKs Higher Medicaid Dental Rates
CMS Releases 2023 Medicare, Part D Advance Notice
Hospital Readmission Rates for Dual Eligibles Are Only Mildly Impacted by Social Determinants of Health, Study Says
Participation in Medicare Shared Savings ACOs to Rise in 2022
- This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state’s traditional Medicaid managed care program, and MinnesotaCare, the state’s Basic Health Program (BHP), in 80 counties outside of Read MoreRoundup:
Arkansas Budget Proposal Assumes Rising Medicaid Costs
Georgia Seeks to Reinstate Medicaid Work Requirements
Indiana Delays Release of MLTSS RFP Until May 2022
Maryland Senators Seek Enhanced Adult Dental Coverage
Montana Lawmakers Consider CCBHCs
New York Expects Savings from Medicaid Plan Procurement
Wyoming Medicaid Administrator Teri Green Retires
Medication Assisted Treatment Use for SUD Rises, CMS Reports
States Prepare to Restart Medicaid Redeterminations
Exchange Plan Offerings Increase in 2021
- This week, our In Focus section highlights the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) and Part D programs for contract year 2023 and how these changes may impact plan applications, bid submissions, Read MoreRoundup:
Florida Governor Snubs Federal COVID-19 Vaccine Mandate
Georgia Budget Proposal to Fund New Insurance Exchange
Louisiana Releases Medicaid PBM Services RFP
Minnesota Releases Medicaid Managed Care, MinnesotaCare RFP Covering 80 Counties
Missouri Receives 3 Bids for Medicaid Managed Care Program
New Mexico to Extend Medicaid Postpartum Coverage
New York Eyes Competitive Bidding for Medicaid Plans
New York Governor Proposes Medicaid Rate Increases
Wisconsin Releases HCBS Care Management System RFP
Behavioral Health Group Buys Center for Behavioral Health
- This week, our In Focus section highlights a Wakely white paper titled, CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings. Read MoreRoundup:
Arkansas Reaches Settlement with Empower Healthcare
California FQHCs to Receive Less 340B Funding
Florida Bill Would Reshape Medicaid Managed Care Regions
Indiana Awards Medicaid Managed Care Contracts
Expansion News: Kansas, Missouri, South Dakota, Wyoming
Minnesota Seeks Models that Increase HCBS Provider Wages
New York Looks to Rebuild State Healthcare Economy
Oregon Clears Centene/Trillium to Enroll New Members
CMS Looks to Partnerships to Address Costs, Disparities
- This week, our In Focus highlights a new report prepared by Health Management Associates (HMA) on the potential for Medicaid Managed Care to enable states to address social determinants of health (SDOH) and health equity above and beyond what’s possible Read MoreRoundup:
California Receives Approval for CalAIM Demonstration
Georgia Must Remove Medicaid Expansion Work Requirements
Idaho Seeks Offers to Administer Behavioral Health Plan
Iowa Delays Release of Medicaid Managed Care RFP
Montana Must Wind Down Medicaid Expansion Premiums Above 2 Percent of Income, CMS Says
Anthem Acquires Ohio Medicaid Contract from Paramount
South Dakota Voters to Decide on Medicaid Expansion
CMS Proposes Rule to Standardize Exchange Plans
- This week, our In Focus reviews the Mississippi request for qualifications (RFQ) for the state’s traditional Mississippi Coordinated Access Network (MississippiCAN) Medicaid program and the state Children’s Health Insurance Program (CHIP). Read MoreIn Focus:Roundup:
Arkansas Is Cleared to Continue Covering Medicaid Expansion Eligibles Through Exchange Plans
California to Tighten Medicaid Plan Subcontracting Rules
District of Columbia Delays Carve-In of Medicaid Behavioral
Louisiana Is Cleared to Launch Medicaid Coverage for Children with Disabilities
Montana to Increase Income Eligibility Limit for Medically Needy Program
Utah Appoints Jack Szczepanowski as Medicaid Director
Individual Health Plans Pay $1.3 Billion in MLR Rebates
CMS to Investigate PBM Fees Charged to Pharmacies
CMMI to Launch New Payment Models in 2023 at the Earliest
