HMA Weekly Roundup

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  • Among the biggest challenges facing clinicians today is keeping up to date with the latest medical advances, care models, and delivery system redesign efforts. The need for ongoing learning is especially true for safety net providers, where new approaches to Read More
    Roundup:

    Florida Closes ITN for Regions 3-7 of SMMC MMA PSN

    Maine Governor to Implement Medicaid Expansion Upon Taking Office

    Montana Voters Reject Tobacco Tax to Fund Medicaid Expansion

    New Jersey Creates Consumer Portal to Facilitate ACA Open Enrollment

    CMS Considers Allowing Hospitals to Use Medicaid Funds for Housing

    CMS Announces Short-Term IMD Exclusion Waivers for Serious Mental Illness

    CMS to Propose Rule Allowing States to Limit NEMT Services

  • This week, our In Focus section comes to us from Principal Elaine Peters (HMA– Florida), who reviews the recent re-procurement by the Florida Agency for Health Care Administration (AHCA) of its Statewide Medicaid Managed Care (SMMC) health and dental plans. Read More
    Roundup:

    Idaho, Nebraska, Utah Voters Approve Medicaid Expansion Ballot Measures

    New York Publishes Inpatient and Nursing Home Medicaid Rate Increase

    Texas-Based Scott and White Health Plan to Acquire FirstCare Health Plans

    California Faces Investigation Following Report of Inadequate Prison Mental Health Care

    Colorado To Tighten Limits on Opioid Prescriptions

    Midterm Election Results Are Boost for Medicaid Expansion

  • This week, our In Focus section reviews highlights and shares key takeaways from the 18th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 25, 2018, in Read More
    Roundup:

    North Carolina Receives CMS Approval for Medicaid Managed Care Transition

    Montana Voters Divided on Taxing Tobacco to Fund Medicaid Expansion

    Pennsylvania Governor Vetoes Medicaid Work Requirements Bill

    Wisconsin Receives Federal Approval for Medicaid Work Requirements

    Texas Drug Utilization Review Board Seeks to Expand Medicaid Opioid Treatment

    New York Officials Holding Statewide Forums on IDD Transition to Managed Care

    President Trump Signs Opioid Legislation

    CMS Proposes Payment Changes to Physician-Administrated, Medicare Part B Drugs

  • This week, our In Focus section comes to us from Principal Nora Leibowitz, reviewing the Centers for Medicare & Medicaid Services (CMS) guidance on Section 1332 waivers. The State Relief and Empowerment Waivers guidance, published in the Federal Register on Read More
    Roundup:

    Minnesota to Release Medicaid Managed Care RFPs in 2019

    Missouri Names State House Speaker Todd Richardson Medicaid Director

    North Carolina Receives 8 Bids for Medicaid MCO Procurement

    Pennsylvania Announces New Program to Support Housing Needs of Individuals with OUD

    Texas Releases RFI for Program Improvements to STAR Health

    Medicaid Enrollment Drops as Economy Improves, According to Report

  • This week, our In Focus section highlights HMA Medicaid Market Solutions’ (MMS) efforts to support state flexibility in designing and implementing Section 1115 Demonstration Waivers promoting member engagement and personal responsibility. Over the coming weeks, HMA MMS will present a Read More
    Roundup:

    Former Maine Health Commissioner Appointed Federal Medicaid Director

    Arkansas Drops 4,100 More Medicaid Beneficiaries for Failing to Meet Work Requirements

    Four Plans to Exit New York Fully Integrated Duals Advantage Program

    Texas Reports ‘Significant Progress’ In System Redesign for IDD Population

  • This week, our In Focus section comes to us from Senior Consultant Ryan Mooney, reviewing the Texas Medicaid and Children’s Health Insurance Program (CHIP) Evaluation report. The 85th Legislature of the State of Texa required the Texas Health and Human Read More
    Roundup:

    Arizona Awards MMIS Contract to CNSI

    Massachusetts to Release One Care Duals RFP in 1-2 Months

    Montana Lawmakers Seek Medicaid Work Requirements

    Arizona, Hawaii Release Joint RFP for EVV Vendor

  • This week, our In Focus section provides a recap of the third annual HMA Conference, The Rapidly Changing World of Medicaid: Opportunities and Pitfalls for Payers, Providers and States, held this Monday, October 1, and Tuesday, October 2, in Chicago, Read More
    Roundup:

    Texas Cancels, Re-Issues Medicaid, CHIP Solicitations

    Tennessee Releases Medicaid Work Proposal for Public Comment

    Alabama Receives CMS Approval for ICN Long-term Care Program

    CMS Administrator Defends Medicaid Work Requirements, Highlights New Initiatives

    Supreme Court to Hear Medicare DSH Payment Cas

  • This week, our In Focus section reviews Medicare-Medicaid integration opportunities through Dual Eligible Special Needs Plans (D-SNPs). States are motivated to expand their capacity to address the needs of dually eligible beneficiaries through integrated care. They are increasingly requiring health Read More
    Roundup:

    Hawaii Releases RFI for QUEST Integration Medicaid Managed Care Program

    New Mexico to Transition to State-based Health Insurance Exchange in 2021

    Virginia Files Waiver Request for Medicaid Work Requirements, Monthly Premiums

    Alabama Medicaid Work Requirement Proposal to Be Reviewed by CMS

    Medicaid Spending Rose 2.6 Percent to $592 Billion in 2017

    DHHS Awards More Than $1 Billion to Combat Opioid Crisis

  • This week, our In Focus section reviews Texas’ biennial legislative appropriations request (LAR) for fiscal years 2020-21, submitted by the Texas Health and Human Services Commission (HHSC). The document, which totals 1, 358 pages, includes summary program data as well Read More
    Roundup:

    Arkansas Drops 4,300 Medicaid Expansion Members for Failing to Meet Work Requirements

    Michigan Medicaid Expansion Improved Health, Finances of Low-Income Adults, Study Finds

    Pennsylvania-based Jefferson Health, Einstein Healthcare Network to Merge

    Colorado to Treat 2,000 Prisoners With Chronic Hepatitis C

    Wisconsin Transitions to Maximus for Medicaid HMO Enrollment Broker Services

    Uninsured Rate Unchanged at 8.8 Percent in 2017

  • 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:

    Arkansas Work Requirements Result in 4,600 Losing Coverage

    California Allows State Regulators to Veto Proposed Health Plan Mergers

    Massachusetts Releases Duals Demo 2.0 RFI

    Michigan Seeks Federal Approval for Work Requirements

    Tennessee Rereleases Pharmacy Claims Processing System RFP

    ACA Exchange Plan Premiums to Rise 3.6% in 2019