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- This week, our In Focus section revisits three specific aspects and implications for regional and local managed care organizations of the proposed Medicaid and Children’s Health Insurance Program (CHIP) managed care access, finance, and quality rule published by the Centers Read MoreRoundup:
Florida Disenrolls Some Children with Complex Medical Needs During Redeterminations
Idaho Faces Lawsuits Over Medicaid Behavioral Plan Award
Iowa Medicaid Managed Care Contracts Begin July 1
UCare Names Former Kansas Medicaid Director Jon Hamdorf Market President
Louisiana Governor Vetoes Part of Legislature’s Proposed Budget, Reinstates Health Spending Increase
Maryland Extends Pregnancy, Postpartum Medicaid Benefits to Undocumented Individuals
Massachusetts Made $85 Million in Capitation Payments on Beneficiaries Living Out of State, Audit Finds
Minnesota Releases Medicaid, MinnesotaCare IHP RFP
Minnesota Provides One Month Grace Period to Reenroll in Medicaid Following June Redeterminations
Nevada Allows Medicaid to Cover Behavioral Health Services in Schools
New Hampshire Medicaid Beneficiaries Struggle to Find Dental Care
North Carolina Governor Urges Lawmakers to Separate Medicaid Expansion from Budget
Oklahoma Disenrolls 54,000 Medicaid Enrollees During May Redeterminations
South Dakota Implements Medicaid Expansion on July 1
Washington Receives Federal Renewal of Medicaid Transformation Project Section 1115 Waiver
Washington Disenrolls 116,000 Medicaid Beneficiaries During May Redeterminations
Home Health Providers Face Proposed 2.2 Percent Medicare Rate Cut in Fiscal 2024
Molina to Acquire Bright Health Medicare Advantage Subsidiaries
- C-suite executives from AmeriHealth Caritas, Centene, Community Health Choice of California, Health Care Service Corp., Humana, UnitedHealthcare, and UMPC Health Plan are scheduled to speak on trends in publicly sponsored healthcare at HMA’s Sixth Annual Conference, October 30-31 in Chicago. Read MoreRoundup:
Medicaid, CHIP Enrollment is Nearly 93.9 Million in March 2023
Medicaid Disenrollment News: Connecticut, Michigan, North Carolina, Oregon, South Carolina
California Renews Managed Care Tax, With Funds to Bolster Medicaid, Hospitals
Georgia Directs $118 Million to Medicaid Expansion in Fiscal 2024
Idaho Awards Centene/Magellan Healthcare Behavioral Health Plan Contract
Illinois Governor Creates State-based Insurance Exchange
Illinois Requests Extension for Behavioral Health Transformation Section 1115 Waiver
New Hampshire Extends Postpartum Medicaid Coverage
Washington Extends Family Planning Only Demonstration Waiver by One Year
Wisconsin to Renew Family Care, Family Care Partnership Waivers
Wisconsin Launches Independent Living Supports Pilot Program
MACPAC Projects Medicaid Managed Care Directed Payment Spending to Be $69.3 Billion Annually
Drug Makers File Federal Lawsuit to Block Medicare From Negotiating Drug Prices
UnitedHealth Group Wins Bidding Showdown to Acquire Amedisys
CareSource to Acquire Radiant Alliance
- This week, our In Focus section reviews the projected healthcare expenditure and enrollment data from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary, published June 14, 2023. The Office of the Actuary provides annual updates to Read MoreRoundup:
May Medicaid Redeterminations Update: Arizona, Illinois, Indiana, Iowa, West Virginia
California Lawmakers Introduce Bills to Modernize State Mental Health Services Act
Florida to Pilot Medicaid Managed Care for Individuals with Developmental Disabilities in 7 Counties
Idaho Releases EQRO RFP
Illinois Pauses Enrollment in Health Benefits for Immigrant Adults Program
Indiana Names Cora Steinmetz as Medicaid Director
Iowa Contracts With HMA to Study Service Delivery for New Health, Human Services Department
Kentucky to Study Potential HCBS Waiver Program For Children with Severe Emotional, Intellectual Disabilities
Montana Disenrolls 15,500 Medicaid Beneficiaries During April Redeterminations
New Mexico Awards General Dynamics Information Technology $39 Million Contract to Update Medicaid Provider Enrollment System
Oklahoma Closed Loop Electronic Referral System for SDOH RFP Responses Are Due June 19
Tennessee Releases Medicaid, CHIP Eligibility Determination System RFI
Enhanced Medicaid Funds to States for Pausing Disenrollment Top $117 Billion, KFF Finds
Pennant Group Acquires Bluebird Home Health, Hospice, Home Care Provider
- This week, our In Focus section highlights a Health Affairs Forefront post, “To Treat Residents With OUD, Nursing Facilities Must Improve Practices and Reduce Stigma, ” published June 8, 2023. Read MoreRoundup:
Medicaid Disenrollment News: Arkansas, Georgia, Kansas, Maryland, Nebraska, New Hampshire, South Carolina
Florida Raises KidCare Income Eligibility to 300 Percent of Poverty
CareSource Files Protest Against Iowa Medicaid MCO Awards
CareSource Forms Alliance with Three Organizations to Bid on Upcoming Kansas Procurement
New York to Form Healthcare Commission to Improve Medicaid Quality, Reduce Costs
North Carolina Enacts Law Allowing BCBS-NC, Delta Dental to Shift Assets to Holding Companies
North Dakota Names Sarah Aker Medicaid Director
Oklahoma Awards Medicaid Managed Care Contracts to Three Plans
Pennsylvania Receives 67 Responses to Community HealthChoices RFI
Texas Awards EVV System Management Services Contract to Accenture, HHAeXchange
Health Plans Must Pay for Preventive Care Under Temporary Agreement
CMS Announces New Primary Care Payment Model
Center for Autism Files for Chapter 11, Assets To Be Acquired by Founder, Former CEO
Walgreens Sells Remaining Shares of Option Care Health for $330 Million
- This week our In Focus checks in on the Medicaid unwinding work and key issues HMA experts are watching as more states resume their normal policies and processes for determining eligibility. Read MoreRoundup:
Medicaid Redeterminations New: Arizona, California, Colorado, Idaho, Indiana, Iowa, Kentucky, Louisiana, Michigan, Nevada, North Carolina, North Dakota. Texas, West Virginia, Wyoming
Arkansas Submits Request for Medicaid Expansion Work Requirements
Georgia Cancels RFQC for Medicaid Managed Care Plans
Iowa Enacts Legislation Tightening Medicaid Eligibility Verification
Nevada Medicaid Drug Spending Rose 126 Percent from 2017 to 2022
New Mexico to Extend Medicaid Managed Care Contracts Additional 6 Months
New Mexico to Expand Access to Medicaid Payments for Medical, Behavioral Health Services in Schools
Pennsylvania Seeks to Implement Selective Contracting for IDD Residential, Supports Coordination Services
South Dakota Receives Federal Approval to Implement Medicaid Expansion in July
Elevance Health Names Natalie Cooper President of Amerigroup Tennessee
Texas Names Emily Zalkovsky as State Medicaid Director
Merck Seeks Injunction to Block Medicare Drug Negotiation Program
UnitedHealth/Optum Makes Unsolicited $3.26 Billion Bid for Amedisys
- This week, our In Focus section describes a new collaboration between Health Management Associates and the California Department of Health Care Services (DHCS). Read MoreRoundup:
Arizona Delays Implementation of Housing, Health Opportunities Waiver to October 2024
California Individual Mandate Generates $1.1 Billion in Fines Since 2020
Georgia Disenrolls 2,200 Medicaid Beneficiaries During April Redeterminations
Indiana Disenrolls 53,000 Medicaid Beneficiaries During First Month of Redeterminations
Kentucky Subcommittee Again Finds Deficiencies in Rules Extending Dental, Vision, Hearing Benefits to Medicaid Beneficiaries
Minnesota Enacts Legislation to Provide Comprehensive Dental Benefits to All Medicaid Beneficiaries
Missouri Uses Ex Parte Renewal Process for 47 Percent of April Medicaid Eligibility Redeterminations
Oregon to Disenroll 8,000 Medicaid Beneficiaries Following April Redeterminations
Rhode Island Releases Medicaid Managed Care RFI; New Procurement Expected Fall 2023
Wisconsin Could Disenroll Up to 300,000 Medicaid Beneficiaries During Redeterminations, Report Finds
Medicaid Disenrollments to Date Are Largely for Administrative Reasons, CMS Says
Medicaid Enrollment to Decrease by More Than 12 Million by 2025, CBO Projects
CVS/Oak Street Health to Expand Into Arkansas, Iowa, Kansas, Virginia
AHIP President, CEO to Step Down in October
Medicaid Directors to Discuss Challenges, Opportunities at HMA Conference in Chicago
- Health Management Associates has announced the preliminary lineup of speakers for its sixth annual conference, Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth. Read MoreRoundup:
California Proposes Increasing Medicaid Reimbursement Rates for Providers
Florida Disenrolls 250,000 Medicaid Beneficiaries Since Redeterminations Began
Iowa Releases Dental RFP for Iowa Dental Wellness Plan, Hawki
Iowa Expects 3,000 Individuals to Lose Medicaid Coverage by June 1
Massachusetts Considers Increasing Medicaid Reimbursement Rates for Substance Use Disorder Treatment Providers
Minnesota Legislature Passes Bill to Set Minimum Wages, Benefits for Nursing Home Staff
Nebraska Passes Certified Community Behavioral Health Clinic Act
Nevada to Transition to Medicaid Managed Care in Rural Areas
Nevada Senate Considers Bill to Reimburse Rural Hospitals at Cost for Outpatient Services
New Hampshire House Committee Subdivision Votes to Hold Medicaid Reauthorization Bill for a Year
Texas Senate Passes Bill to Extend Postpartum Medicaid Coverage
Vermont Lawmakers Approve 50 Percent Increase in Fiscal 2024 Medicaid Reimbursement Rates for Dental Services
Washington Legislature to Increase Medicaid Reimbursement Rates for Nursing Homes by 14 Percent for Two Years
CMS Releases Regulatory Requirements for State MES Modules
HCA Healthcare Acquires TX Urgent Care Centers from FastMed
- This week our In Focus section reviews the Illinois Healthcare Transformation 1115 Waiver Extension request, posted for review on May 12, 2023. Read MoreIn Focus:Roundup:
Arkansas Is Urged by Healthcare Groups to Pause Medicaid Redeterminations
Delaware Medicaid Expenses Are Projected to Increase Despite Redeterminations
Florida Releases Medicaid Prepaid Dental Program RFI, To Release RFP Summer 2023
Florida Releases D-SNP RFI, Considers Moving 300,000 Medicaid Members from D-SNPs to SMMC
Illinois to Address Social Determinants of Health in 1115 Behavioral Health Waiver Amendments
Indiana Enacts Legislation to Reform Long-term Care
North Dakota Releases Medicaid Enterprise Technical Systems Integrator RFP
Ohio Releases PACE Expansion RFP
Virginia to Release Medicaid NEMT RFP in September 2023
Virginia Disenrolls 20,000 Medicaid Beneficiaries During Redeterminations
Federal Appeals Court Temporarily Blocks Overturning of ACA Preventive Services Requirement
Wisconsin Approves Humana’s Proposed Purchase of Inclusa
Sentara to Consolidate Medicaid Plans in Virginia
- This week’s In Focus is the second in a two-part look at the Centers for Medicare & Medicaid Services’ (CMS’s) recently proposed changes to the Medicaid program. Last week we covered CMS’s proposed changes to the federal Medicaid managed care Read MoreRoundup:
Arizona Legislature Approves $3.4 Billion for Fiscal 2023 Medicaid Managed Care Payments
Arkansas Disenrolls Almost 73,000 Medicaid Beneficiaries During April Redeterminations
Georgia Community Health Commissioner to Step Down Summer 2023
Idaho Finds 29,000 Ineligible Medicaid Beneficiaries During Redeterminations Healthy Blue
Kansas Hires President Ahead of Bid on Medicaid Contract
HAP, CareSource Form Partnership to Serve Michigan Medicaid Beneficiaries
Rhode Island Senate Passes Bill to Use Medicaid Funds to Help Homeless Beneficiaries Find Housing
Virginia Plan to Cut Medicaid Payments for Preventable ER Visits Is Vacated by Federal Judge
1.7 Million Medicaid Beneficiaries Could Lose Coverage if Work Requirements are Implemented, KFF Projects
Option Health Care To Acquire Amedisys
Cano Health Looks to Sell Non-core Assets, Focus on Medicare Advantage
- This week, our In Focus section reviews CMS’s proposed changes to the federal Medicaid managed care access, finance, and quality regulation (CMS-2439-P). Read MoreRoundup:
Alabama Releases Integrated Care Network Program RFP
Arkansas Proposes Medicaid Work Requirements for Expansion Program
Florida Legislature Passes Bill to Regulate PBMs
Florida House Passes Bill to Create Pilot Program Providing Medicaid Managed Care Coverage to Individuals with IDD
Georgia Enacts Law to Create State-based Insurance Exchange
Louisiana Candidates for Governor Promise to Keep Medicaid Expansion
Mississippi Medicaid Beneficiaries Are No Longer Responsible for Copays
Nevada Expands Dental Services for Medicaid Beneficiaries with IDD
Nevada Releases Baseline Medicaid Enrollment Report Ahead of Redeterminations
New York to Gradually Redirect Medicaid Funding from Counties
Tennessee Medicaid to Cover Cost of Diapers for First Two Years
Washington Publishes Plan to Remove Barriers to Access for Health, Human Services Benefits
Medicare Advantage Enrollment Surpasses Traditional Medicare in January
Centene to Sell Apixio to New Mountain Capital
BCBS-MI, BCBS-VT to Pursue Affiliation
