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- This week, our In Focus section looks at a new Medicare model, Direct Contracting, introduced by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. The new model will build on and continue testing potential reforms to the Medicare Read MoreRoundup:
California Legislative Analyst Projects 14.2 Percent Increase in Fiscal 2022 Medicaid Spending
California Delays Implementation of Medi-Cal Rx
Illinois Unveils Medicaid Transformation Proposal
Kentucky Submits Waiver to Treat SUD in Prisons
Kentucky Judge Orders Mediation of Medicaid Managed Care Procurement Dispute
Missouri to Release Medicaid Managed Care RFP By July 2021
North Carolina Releases RFA for Behavioral, IDD Plans
CMS Releases Final Rule Revising Several Provisions of Medicaid and CHIP Managed Care Regulations
State Tax Revenues Fall $28 Billion, Report Finds
- In this week’s In Focus section, Health Management Associates (HMA) Managing Director MMS Matt Powers, Senior Consultant Kaitlyn Feiock, and Regional Vice President Kathleen Nolan look at the future of the Patient Protection and Affordable Care Act (ACA). Read MoreRoundup:
Hawaii Releases Community Care Services Program RFP
New Jersey to Submit Section 1115 Waiver Renewal
New York Lawmakers Seek To Delay Medicaid Drug Carve-out
North Carolina Launches Medicaid Managed Care Enrollment Website
Neighborhood Health Plan of Rhode Island Signs Three-Year Duals Demo Contract Extension
Tennessee Receives Federal Waiver Approval for Katie Beckett Program for Children with Disabilities
CMS Issues Final Rule on Medicaid Managed Care Changes
- This week our In Focus section highlights a paper by Health Management Associates (HMA) Principal Sarah Barth, JD and Research Assistant Sarina Coates-Golden entitled, Reimbursement for Evidence-Based Health Promotion Programs in the Community – Strategies and Approaches to Medicaid and Read MoreRoundup:
Arizona Is Approved to Increase Hospital Reimbursements
Georgia Receives Federal Approval to Exit ACA Exchanges
Kentucky to Comply With Court Order to Grant Medicaid Managed Care Contract to Anthem
Nebraska Names Kevin Bagley as Medicaid Director
Ohio Releases OhioRISE Managed Behavioral Plan RFA
Texas Republican Lawmakers Consider Medicaid Expansion
CMS Issues Final Rule on Health Plan Price Transparency
Telehealth Flexibilities to Be Permanent for Medicare Home Health Providers
- This week, our In Focus section reviews the statewide Oklahoma Medicaid managed care request for proposals (RFP) released by the Oklahoma Health Care Authority on October 15, 2020, and the North Dakota Medicaid expansion managed care RFP released by the Read MoreRoundup:
California Releases RFI for Dental ASO
Florida Procurement for Canada Drug Importation Program Fails to Attract Any Bidders
Georgia Eyes Privatization of Prison Healthcare Services
Hawaii Tentatively Schedules QUEST Integration RFP Release for December 2020, Community Care Services RFP for November
Indiana Receives 10-Year Extension for HIP Alternative Medicaid Expansion Program
Kentucky Health Plan Appeals Order to Grant Medicaid Managed Care Contract to Anthem
Verma Says CMMI Record on Value-Based Payments ‘Is Deeply Concerning,’ Calls for Change
- This week, our In Focus section shares highlights and key takeaways from the 20th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 14, 2020, in two Read MoreRoundup:
Florida Taps Shevaun Harris for Acting Lead of AHCA
Georgia Receives Approval For Limited Medicaid Expansion
Illinois Integrated Health Homes Program Is Delayed
Nebraska Wins Federal Approval of Two-Tiered Medicaid Expansion Waiver
North Dakota Releases RFP for Medicaid Expansion MCOs
Oklahoma Releases Medicaid Managed Care, Dental RFPs
Ohio MCO to Bid on Oklahoma Medicaid Managed Care RFP
Virginia Budget Agreement Includes Funding for Adult Medicaid Dental Coverage
ACA Exchange Premiums to Decrease 2 Percent in 2021
- This week, our In Focus section reviews UnitedHealth Group’s The Path Forward to a Next-Generation Health System, an outline of policy recommendations to achieve a high-quality, affordable health care system. The paper focuses on four goals: 1) achieve universal coverage; Read MoreRoundup:
Illinois to Offer Health Coverage to Elderly Undocumented Immigrants
Kentucky Is Temporarily Blocked from Moving Ahead with Medicaid Managed Care Contract
Oklahoma Proposal to Transition Medicaid to Managed Care Faces Bipartisan Opposition
Texas Is Hit with Federal Order to Fix Early Childhood Intervention Program
Rate of Uninsured Children Rises, Report Shows
More Medicare Advantage Plans to Cover Home-Based Support Services in 2021
- This week, our In Focus section reviews the Ohio Medicaid Managed Care request for applications (RFA) released by the Ohio Department of Medicaid (ODM) on September 30, 2020. The RFA follows the release of two requests for information (RFIs) in Read MoreRoundup:
D.C. Implements New Medicaid Managed Care Contracts
Kansas Awards Conduent Contract to Handle Medicaid Applications
Kentucky to Relaunch State Exchange for 2022 Coverage
North Carolina Awards EVV Contract to Sandata
Trump Ends COVID-19 Relief Talks Until After Election
Medicaid, CHIP Enrollment Reaches 75 Million Through June
Senate Passes Legislation to Relax Medicare Provider Relief Loans, Delay Medicaid DSH Cuts
- This week, our In Focus section reviews two recent Medicare developments from the Centers for Medicare & Medicaid Services (CMS). On September 24, 2020, CMS released the Medicare Advantage (MA) and Part D landscape files for the 2021 plan year. Read MoreRoundup:
Delaware Medicaid to Add Dental Coverage for Adults
Nebraska Medicaid Expansion Begins October 1
North Carolina PLE Petitions to Reverse Medicaid Managed Care Procurement Ruling
Ohio Releases Medicaid Managed Care RFA
Ohio Announces Creation of Medicaid Managed Care Program for Children with Behavioral Health Needs
Texas Seeks Input On Procuring MCOs for Healthy Texas Women Program
House Democrats Unveil COVID-19 Bill That Includes $50 Billion for Healthcare Providers
Trump Administration Approves Drug Importation Program
CMS Warns of Significant Decrease in Utilization of Health Services Among Children Enrolled in Medicaid, CHIP
- On September 15, 2020, the Centers for Medicare & Medicaid Services (CMS) released State Medicaid Director (SMD) letter #20-004 regarding value-based care (VBC) opportunities in Medicaid. In the letter, CMS lays out a road map for state Medicaid agencies Read MoreRoundup:
Delaware Approves Four ACOs to Serve Medicaid Population in 2021
New York Finds $700 Million in Improper Medicaid Payments
Vermont ACO Pilot Program Failed to Meet Enrollment, Spending Targets
House Passes Federal Funding Bill to Relax Repayment Terms for COVID-19 Medicare Loans
CMS Announces Additional $165 Million MFP Funding for 33 States
Justice Ginsburg’s Death Could Jeopardize the ACA
CMS Innovation Agency Announces Roll Out of Risk-Based Model for Dual Eligibles
- This week, our In Focus sections reviews the Missouri HealthNet Pharmacy and Clinical Services Management Solution request for information (RFI) and the Kentucky Medicaid Managed Care Organization (MCO) Pharmacy Benefit Manager request for proposals (RFP). Read MoreRoundup:
California to Release Medi-Cal Managed Care RFP in Late 2021
Nevada Medicaid Enrollment Increases by 87,000
North Carolina Voters Support Medicaid Expansion, Poll Finds
North Dakota to Release Medicaid Expansion Managed Care RFP in October
CMS Releases Medicaid, CHIP Data Files in Continued Effort to Promote Transparency
CMS Withdraws Medicaid Fiscal Accountability Rule
CMS Issues Guidance on Value-Based Care Arrangements in Medicaid
