HMA Weekly Roundup

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  • This week, our In Focus section reviews Virginia’s Section 1115 demonstration waiver, which is currently posted for stakeholder review and a public comment period. The 1115 waiver seeks approval from the Centers for Medicare & Medicaid Services (CMS) to implement Read More
    Roundup:

    New York Announces FIDA Reforms

    Michigan Legislature to Vote on Health Insurer Tax

    Florida Posts MLTC Waiver Amendment for Public Comment

    Oklahoma Medicaid Approves 3 Percent Rate Reduction

    Oregon Appoints Coyner as New Medicaid Director

    Utah Medicaid Director to Step Down

    North Carolina Health Systems to Form Managed Care Entity

    Federal Budget Deal Suspends Health Insurer Fee for 2017

  • This week, our In Focus section reviews the annual Medicaid health plan ratings released in September by the National Committee for Quality Assurance (NCQA). NCQA has previously provided annual rankings and quality scores of private commercial health plans serving employers Read More
    Roundup:

    EmblemHealth Leaving New York’s MLTC Market

    Update on Coordinated Care Organizations in Oregon

    California AG Approves Daughters of Charity Deal

    FTC Rejects Hershey-Pinnacle Merger in Pennsylvania

    South Dakota Governor Proposes Medicaid Expansion

    Non-profit Hospital Financials Improved following ACA

  • This week, our In Focus section reviews the decision announced this week by the Oklahoma Health Care Authority (OHCA) on the care coordination model selected to serve the aged, blind, and disabled (ABD) Medicaid population. OHCA has selected a fully Read More
    Roundup:

    Valence Health Awarded CountyCare Medicaid Contract

    Corizon Cancels Florida Prison Health Contract

    Iowa Judge Recommends WellCare’s Contract Award be Rescinded

    Kentucky Governor Plans to Close Kynect, Shift Consumers to Federal Exchange

    Empire Announces Exit from New York FIDA Program

    Eleven Companies Respond to Pennsylvania Medicaid MCO RFP

    Washington Announces Apple Health Contract Awards

  • This week, our In Focus section reviews the draft request for proposals (RFP) for the Pennsylvania Community HealthChoices (CHC) program, which will coordinate physical health services and long term services and supports (LTSS) under a new statewide managed care program. Read More
    Roundup:

    Michigan Medicaid MCO Award Recommendations Approved

    Updates from Georgia DCH Board Meeting

    California to Begin Paying Overtime for Home Care Workers

    Connecticut Nursing Home Wages Agreement Reached

    New York Co-Op to Cease Operations at End of Month

  • 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 nine states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Read More
    Roundup:

    New York, CMS agree on plan to Develop I/DD Duals Demo

    South Dakota, Nebraska, Virginia Considering Expanding Medicaid

    Colorado to Vote on Universal Healthcare Proposal

    CMS Warns States on Hepatitis C Treatment Restrictions

  • This week, our In Focus section reviews the request for proposal (RFP) issued by the State of Nebraska on October 21, 2015, for the statewide rebid of their Medicaid managed care programs, integrating physical and behavioral health for nearly all Read More
    Roundup:

    California, CMS Agree on Conceptual Framework for 1115 Waiver Renewal

    Maryland Healthy Smiles Contract Awarded to Scion Dental

    CMS Approves Montana Medicaid Expansion Proposal

    Six MCOs Protest Michigan Contract Awards

    Pennsylvania Pushes Back MLTSS Procurement

    Jessee Named Texas Medicaid Director

    Wallack Named Rhode Island Medicaid Director

  • This week, our In Focus section reviews key findings and recommendations from a report released this month by Health Management Associates (HMA), with funding from the Robert Wood Johnson Foundation (RWJF). The report, “Making Affordable Care Act Coverage a Reality: Read More
    Roundup:

    California Survey Reveals Potential Duals Demo Opt-Out Reasons

    Florida Issues ITN for Florida Healthy Kids Dental Services

    New Jersey Reports on MLTSS Transition Progress

    Pennsylvania Issues Medical Transport RFI, MRT RFP

  • This week, our In Focus section reviews highlights and shares key takeaways from the new Kaiser Commission on Medicaid and the Uninsured (KCMU) report, Medicaid Reforms to Expand Coverage, Control Costs and Improve Care: Results from a 50-State Medicaid Budget Read More
    Roundup:

    Nebraska Releases Medicaid MCO RFP

    Louisiana Gubernatorial Candidates Willing To Expand Medicaid

    Protests Submitted Over Michigan Medicaid Contract Awards

    Ohio Releases Revised HCBS Transition Plan for Public Comment

    Pennsylvania Issues Procurement for Enrollment Assistance Broker

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated risk-based managed care in 23 states. Many state Medicaid agencies elect to post to their websites monthly enrollment figures by health plan for their Medicaid managed Read More
    Roundup:

    Michigan Medicaid Managed Care Results Announced

    Arkansas Consultant’s Report Offers Medicaid Expansion Alternatives

    Kentucky Health Cooperative Ending Business Dec. 31

    Health Alliance to Withdraw from Illinois Duals Demo

    Utah Medicaid Expansion Bill Fails House, Senate

    Washington Releases RFP for Behavioral Health-Administrative Services Organization

  • This week, our In Focus section reviews the request for proposals (RFP) released this week by the Indiana Family and Social Services Administration (FSSA) to rebid the Hoosier Healthwise and Healthy Indiana Plan (HIP) Medicaid managed care programs. Combined, the Read More
    Roundup:

    Florida Granted Fourth Temporary Extension for LIP Program

    Kansas Delays Medicaid Waiver Integration

    New Jersey Evaluator Releases MLTSS Implementation Report

    New York Dual Demonstration Enrollment Dips

    Utah Lawmakers Consider Medicaid Expansion Proposal