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- 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
- This week, our In Focus section reviews the policy changes included in the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and LongTerm Acute Care Hospital (LTCH) Final Rule (CMS-1735-F). Read MoreRoundup:
District of Columbia Council Finalizes Medicaid Managed Care Contracts
Florida AHCA Secretary Mary Mayhew to Leave Post October 2
Georgia Submits 1332 Waiver to Abandon ACA Health Insurance Exchanges
Oklahoma to Transition Majority of Insure Oklahoma Members to Medicaid Expansion
Oregon Files Notice of Noncompliance Against Medicaid CCO
- This week, our In Focus section reviews the California request for information (RFI) regarding the Medi-Cal Managed Care Plan (MCP) contract and the upcoming Medi-Cal MCP procurement. The California Department of Health Care Services (DHCS) is seeking information to update Read MoreRoundup:
California Medicaid Drops Proposed LTC At Home Benefit
Medicaid Managed Care RFP News: District of Columbia, Indiana, Louisiana, North Carolina
Medicaid Budget News: Georgia, New Jersey, Wyoming
Illinois to Transition Foster Kids to Medicaid Managed Care
Kentucky Releases RFP for Single PBM
Mississippi Advocates Renew Medicaid Expansion Push
Nevada Releases Medicaid NEMT RFP
Housing Supports News: New York, Utah
Ohio Proposes Rules to Lock In Medicaid Telehealth Changes
States Take Emergency Action on Medicaid Long-Term Care
- This week, our In Focus section reviews Democratic Nominee Joe Biden’s healthcare plan to protect and build on the Affordable Care Act (ACA). On August 18, 2020, Biden was officially nominated as the presidential candidate. Biden vowed at the 2020 Read MoreRoundup:
Florida Says It Has Enough Medicaid Funding for Fiscal 2021
Nevada to Move Forward with Proposed Medicaid Rate Cuts
New Mexico Co-Op Plan Health Connections to Cease Operations in 2021
Oklahoma Will Not Move Forward With Block Grant
Oregon Approves Trillium CCO Expansion Into Portland Area
CMS Fines Nursing Homes More Than $15 Million for Infection Control Noncompliance
- This week, our In Focus section reviews two Medicare fee-for-service (FFS) proposed rules recently issued by the Centers for Medicare & Medicaid Services (CMS). On August 3, 2020, CMS released a proposed rule that includes updates to services furnished under Read MoreRoundup:
Florida Medicaid Plans to Get 1.5 Percent Rate Increase
Kansas Governor Urges Lawmakers to Pass Expansion
New Jersey Proposes $155 Million in Additional LTC Funding
Ohio Medicaid Officials to Address PBM Report Omissions
Oklahoma to Transition to Dental Managed Care in 2021
Oregon Reviews CCO Application to Expand Into Portland
Washington Chooses Five Cascade Care Public Option Plans
- This week, our In Focus section examines how the federal government implemented changes to the Medicare program in response to COVID-19. As the COVID-19 pandemic began in the United States, Congress and the Administration responded with a series of legislative, Read MoreRoundup:
California Medi-Cal to Amend Certain Contracts to Address Racial Disparities
Maine Budget Committee Projects Fiscal 2021 Shortfall
Missouri Voters Approve Medicaid Expansion Ballot Measure
Washington Announces IMC Expanded Access Awards
Trump Administration Moves to Make Certain Medicare Telehealth and Scope of Practice Flexibilities Permanent
- This week, our In Focus section reviews the Hawaii request for information (RFI) regarding reprocurement of the state’s QUEST Integration (QI) Medicaid managed care program, released on July 21, 2020. QI covers approximately 360, 000 individuals, including pregnant women, children, Read MoreRoundup:
California Seeks Section 1115 Medicaid Waiver Extension
Florida Expects ‘Significant’ Fiscal 2020 Medicaid Budget Gap
Georgia Lacks Proper Oversight of Medicaid Plans, Audit Says
Iowa Medicaid Director to Step Down
Medicaid Housing Support: Minnesota, Virginia
New York to Leverage Exchange to Connect Individuals with Home Care Agencies
Ohio Releases Single Pharmacy Benefit Manager RFP
Texas Taps Cecile Young as Executive Commissioner of HHSC
Senate COVID-19 Relief Bill Excludes More Medicaid Funding
- This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state’s Read MoreRoundup:
District of Columbia Announces Medicaid Managed Care Awards
Florida Medicaid Expansion Could Cover Nearly 700,000
Kentucky Medicaid Plans Point to Flaw in Bidding, Awards Process
Montana Announces Behavioral Provider Relief Grants
Nevada Legislature Approves Cuts to Medicaid
Oklahoma Seeks Input for Medicaid Managed Care RFP
South Dakota Medicaid Expansion Advocates Prepare for 2022 Ballot Measures
CMS Issues Medicare Advantage MLR Requirement Guidance
- 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 “March 2020 Medicaid and CHIP Applications, Eligibility Determination, Read MoreRoundup:
Georgia Delays Transition Away from Federal Exchange
Kansas Appoints Sarah Fertig as Medicaid Director
Michigan Plans to Cut Medicaid Rates by 3.3 Percent
Medicaid Expansion News: Missouri, Nebraska, Oklahoma
Nevada Considers Medicaid Reimbursement, Program Cuts
New Jersey Extends Duration of Telehealth Access
North Carolina Governor Signs Medicaid Managed Care Bill
Pennsylvania Announces HealthChoices Awards
Walmart to Sell Medicare Health Insurance in Texas
Number of Uninsured Adults Rises by 5.4 Million, Study Shows
