HMA Weekly Roundup

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  • This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “May 2017 Medicaid and CHIP Application, Eligibility Determination, Read More
    Roundup:

    Illinois General Assembly Passes Bill that Could Require Managed Care Rebid

    New York Announces 2018 Exchange Rates

    Ohio Medicaid MLTSS Plans on Hold

    Pennsylvania Governor Appoints Miller as Acting DHS Secretary

    HHS Delays Planned Changes to 340B Program

    Senate HELP Committee to Hear from Governors, Insurance Commissioners After Labor Day

  • This week, our In Focus section is taking a brief summer vacation. Below, we provide our regular HMA Roundups, Industry News, RFP and Duals Calendars, and HMA News sections. We also want to take a moment to remind our readers Read More
    Roundup:

    Illinois Announces Medicaid Managed Care Awards

    Georgia Medicaid Director, Deputy Director Step Down

    Montana to End Medicaid Expansion TPA Contract

    Nebraska Releases Final Medicaid LTSS Redesign Plans

    CBO Releases Score of Exchange CSR Impact

  • This week, our In Focus section reviews “North Carolina’s Proposed Program Design for Medicaid Managed Care, ” a draft proposal published this week for public comment, which provides a detailed overview of the planned statewide Medicaid managed care program to Read More
    Roundup:

    Arkansas Names DMS Director

    Temporary Cuts to Medi-Cal Reimbursements Ruled Improper

    Florida Medicaid Waiver Receives CMS Approval

    New Jersey 1115 Waiver Extension Approved

    New York FIDA Duals Demonstration Expands

    New York Previews CCOs for Individuals with I/DD

    Maine Waiver Calls for Work Requirements, Premiums

    Washington Duals Demo Shows Positive Quality, Cost Results

  • In deference to Miracle Max, after last week’s failed votes on “Repeal and Replace, ” “Straight Repeal, ” and “Skinny Repeal, ” the GOP’s efforts to undo the Affordable Care Act (ACA) through budget reconciliation appear to be at least Read More
    Roundup:

    Alabama to Pursue an Alternative to Regional Care Organizations

    Colorado Issues Regional Accountable Entities RFP

    Florida Releases Medicaid Prepaid Dental Program RFI

    Illinois Begins Making Overdue Payments to Medicaid Plans

    Indiana Issues RFI for FFS Medicaid PBM

    New York Provides DSRIP Year 2 Results

    Pennsylvania Delays HealthChoices Implementation

    Centurion Retains Tennessee Correctional Health Contract

    CMS Outlines DSH Funding Reductions Set to Begin in October

  • This week, our In Focus section reviews the request for proposals (RFP) issued by the Virginia Department of Medical Assistance Services (DMAS) for the Medallion 4.0 Medicaid managed care program. Medallion 4.0 will serve roughly 740, 000 children, including those Read More
    Roundup:

    Mississippi True, Anthem Protest Medicaid MCO Awards

    Nebraska, Montana Propose Medicaid Provider Payment Cuts

    New York Demonstrates Progress in Reducing Avoidable Hospital Use

    New York Awards Contract to Administer Medicaid Insurance Programs

    Medicaid Expansion States See Decline in Unpaid Medical Bills, Higher Financial Satisfaction

  • This week, our In Focus section reviews the Invitations to Negotiate (ITNs) issued on July 14, 2017, by the Florida Agency for Health Care Administration (AHCA) to re-procure its managed care vendors. The ITNs will involve separate and simultaneous regional Read More
    Roundup:

    Virginia Releases Medallion 4.0 Statewide Medicaid Managed Care RFP

    Arkansas Submits Waiver Rolling Back Medicaid Expansion, Adding Work Requirement

    Aetna, CCPN Sign Network Agreement in Rural North Carolina

    Ohio Developing 1332 Innovation Waiver to Eliminate Individual, Employer Mandates

    Texas STAR+PLUS, STAR, CHIP Operational Start Dates Aligned to September 2019

    CMS Proposes to Reduce 340B Drug Payments to Hospitals

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

    CMS Approves Alaska’s 1332 Waiver for Reinsurance Program

    Illinois House Overrides Budget Veto After Two-Year Stalemate

    New York Legislative Session Summary

    New York Releases Draft Application for Care Coordination Organizations for People with I/DD

    Oregon County Sees 17 Percent Drop in Cardiac Arrests After Medicaid Expansion

    Pennsylvania DHS Secretary Leaves Wolf Administration for Geisinger Health

    Texas HHS Deputy Executive Commissioner to Step Down

    Wisconsin Family Care and IRIS Managed Care Contracts for Dane County Awarded

    Study: Medicaid Beneficiaries Satisfied with Coverage, Care

  • This week, our In Focus section comes to us from HMA Senior Fellow Jack Meyer, PhD, and Senior Consultant Rachel Patterson, both of HMA’s Washington, DC office, with contributions from HMA colleagues Eileen Ellis, Melisa Byrd, Kathleen Nolan, Tim Beger, Read More
    Roundup:

    California Single-Payer Bill Dies

    Delaware Identifies RFQ Respondents

    Florida ITN to be Released July 14, 2017

    Massachusetts Co-op Seeks Shift to For-Profit Status

    Texas IDD Managed Care Pilot Contract Awards Announced

    Senate Delays Health Bill Vote Until After July 4 Recess

    CBO Projects 22 Million Would Lose Health Care Coverage under Senate Bill; Federal Deficit Reduced by $321 Billion

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

    MississippiCAN Medicaid MCO Awards Announced

    Virginia Medicaid MCO RFP to be Released Early Summer

    Florida Governor Signs Nursing Home Reimbursement Bill

    MDwise to Exit Indiana Exchange in 2018

    Nevada Governor Vetoes Medicaid-for-All Bill

    Kansas Governor Signs Bill Reversing Some Rate Reductions

    Maryland’s Evergreen Health Approved for Acquisition, For-Profit Conversion

    MACPAC Publishes June 2017 Report to Congress

  • 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
    Roundup:

    Oklahoma Cancels SoonerHealth+ Procurement

    Illinois to Delay Medicaid Managed Care Awards

    Iowa Proposes Waiver to Stablize Exchange Market

    Ohio Senate Proposes Medicaid Cuts To Fill Budget Gap

    States Continue to Lag in Shift to HCBS, Report Says

    AHCA Could Result in 13 Million More Uninsured, Per Actuary Report