HMA Weekly Roundup

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  • This week, our In Focus section reviews the new 1332 State Relief and Empowerment Waiver resources released by the Centers for Medicare & Medicaid Services (CMS) on July 15, 2019. The new resources, intended to help states better understand regulations Read More
    Roundup:

    Florida Announces Healthy Kids Awards

    Georgia Convenes Advisory Council to Discuss Medicaid, Exchange Waivers

    Idaho Seeks Waiver to Allow Medicaid Expansion Eligibles to Remain in Exchange Plans

    Massachusetts Lawmakers Advance Drug Pricing Plan

    Study: Mortality Rates Lower in Medicaid Expansion States

    Senate Finance Committee Drafts Drug Pricing Legislation

  • This week, our In Focus section reviews the four new payment models addressing radiation oncology, kidney care, and end-stage renal disease released by the Centers for Medicare & Medicaid Services (CMS), through the Center for Medicare and Medicaid Innovation (CMMI) Read More
    Roundup:

    Arizona Releases RFP for Managed Foster Care ASO

    Indiana Implements Medicaid Work Requirements

    Iowa Medicaid Plans to Receive 8.6 Percent Rate Increase

    Minnesota Commissioner of Health Services Resigns

    New Mexico to Overhaul Developmental Disabilities Program

    New York Uses Budget Maneuver to Keep Medicaid Spending Within Global Cap

    North Carolina Begins Transition to Medicaid Managed Care

    West Virginia Delays CHIP Transition to Managed Care

  • This week, our In Focus section reviews the California fiscal 2019-20 budget. California Governor Gavin Newsom signed his first budget, and much of its related legislation on June 27, 2019. The budget appropriates $214.8 billion ($147.8 billion General Fund) in Read More
    Roundup:

    Centene Subsidiary Takes Over Health Care Services In Arizona Prisons

    California Exchange Premiums to Rise 0.8 Percent in 2020, Lowest Since 2014

    California to Pay Off $58.6 Million in Medical School Student Loans for 247 Physicians Serving Medi-Cal Patients.

    Iowa, Medicaid Plans Continue to Negotiate Fiscal 2020 Payment Rates

    Kansas Expands Medicaid Services for Brain Injuries

    Louisiana Medicaid MCO Awards Are Delayed

    New Hampshire Announces Delay of Medicaid Expansion Work Requirements

    North Carolina Could Delay Medicaid Managed Care Implementation if State Budget is Not Signed

    Oregon Announces CCO 2.0 Contract Awards

    Texas Delays STAR+PLUS Implementation

    West Virginia Releases Managed Foster Care RFP

  • 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 Medicaid Work Requirements Raised Uninsured Rate, Study Finds

    Georgia to Reinstate Medicaid Benefits to 17,000 Elderly, Disabled Medicaid Members After Disenrollment Backlash

    Louisiana Receives CMS Approval for Hepatitis C Subscription Drug Model

    Maine Enrolls 26,000 Medicaid Expansion Members, Far Fewer than Expected

    New Jersey Proposes Legislation to Increase HMO Annual Assessment

  • This week, our In Focus section section highlights some of the key findings of the Spring 2019 Fiscal Survey of States, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state budget Read More
    Roundup:

    Arkansas Medicaid Corruption Probe Widens

    California Approves Plan to Allow Some Undocumented Immigrants to Enroll in Medicaid

    Expansion News: Florida, Oklahoma

    Georgia Addresses Backlash Over Elderly, Disabled Medicaid Members Slated for Disenrollment

    Kentucky Waiver to Expand Treatment for Substance Abuse

    New Hampshire Legislature Nears Agreement to Suspend Medicaid Work Requirements

    Ohio Releases RFI for Medicaid Managed Care Reprocurement

    Oregon Subcommittee Advances Plan to Cut CCO Allowable Inflation Rate to 3.3 Percent

  • This week, our In Focus section provides a high-level overview and an analysis for how health plans should consider two related and significant policy statements from the Centers for Medicare & Medicaid Services (CMS) about opportunities to further integrate care Read More
    Roundup:

    Alaska Awards Contract to Evaluate Medicaid Block Grant

    California Lawmakers Agree to Allow Undocumented Immigrants Ages 19 to 25 to Enroll in Medicaid

    Florida Governor Signs Prescription Drug Importation Bill

    Health Alliance Plan to Acquire Trusted HP-Michigan

    New Hampshire Proposal to Raise Medicaid Reimbursement Rates Faces Opposition

    Virginia Is Cited for Inadequate Oversight of Medicaid Eligibility Determinations

  • This week, our In Focus section reviews the Texas 2020-21 biennium budget. The Texas Legislature adjourned its biennial legislative session on May 27, 2019, after adopting a $250.6 billion budget (all funds). The total budget is 6.3 percent higher than Read More
    Roundup:

    Arizona to Allow Rideshare Companies to Provide NEMT

    Florida Medicaid Expansion Ballot Measure Goes to State Supreme Court for Review

    Louisiana Announces Medicaid Managed Care RFP Bidders

    Nebraska Announces Fiscal 2020 MLTC Rate Increase for Nursing Homes

    Ohio Releases Draft Medicaid Managed Care Procurement Timeline

    Texas Releases STAR Health Draft RFP Committee

    Wisconsin Approves Health Care Budget Without Medicaid Expansion

  • This week, our In Focus reviews the Pathways HUB model, an approach designed to help coordinate outreach by specialized community health workers who are incentivized to engage high-need populations. An HMA webinar, held May 9, 2019, with Mark Redding, co-developer Read More
    Roundup:

    Arizona Budgets Funds to Eliminate KidsCare Freeze

    Kentucky Medicaid Plan To Be Acquired By Evolent Health

    Kentucky Schools To Use Medicaid Dollars For Physical, Behavioral Health

    Massachusetts Extends Deadline For One Care Procurement

    Nebraska Senate Approves Bill To Delay Transition of Long-Term Care, HCBS Beneficiaries to Managed Care

    New Hampshire to Delay Start Date for New Medicaid Managed Care Contracts

    New York Begins Electronic Visit Verification Implementation

    Texas Lawmakers Pass Medicaid Patient Protection Bills

    CMS Finalizes Rule to Update, Modernize PACE

  • This week, our In Focus section reviews the Kentucky Medicaid managed care organizations (MCOs) request for proposals (RFP), issued by the Kentucky Finance and Administration Cabinet on May 16, 2019. The Kentucky Cabinet for Health and Family Services (CHFS), Department Read More
    Roundup:

    Alaska Issues RFP for Help Evaluating Medicaid Redesign

    Indiana Seeks Financial Bridge for Individuals Leaving Medicaid Expansion

    Maine Lawmakers Propose Task Force to Review Mental Health System

    Michigan Appoints Kate Massey as Medicaid Director

    New Jersey Releases Medicaid Managed Care, MLTSS Quality Technical Report for 2018

    New Mexico Proposes Increase In Medicaid Rates

    Chris Traylor to Step Down as Director of Center for Medicaid and CHIP Services

  • This week, our In Focus summarizes the findings of an HMA Information Services analysis of Medicaid managed care plan profitabilty, based on data from annual statutory filings made with the National Association of Insurance Commissioners (NAIC). Read More
    Roundup:

    Arkansas Medicaid Plans Are Questioned About Reimbursement Rates to Pharmacies

    Delaware Prison Medical Contractor Faces Investigation

    Medicaid Expansion News: Florida, Georgia, Kansas, Mississippi, Montana, Wisconsin

    Maryland Allows Individuals to Apply for Medicaid, Exchange Plan on Income Tax Form

    New Mexico Medicaid Information System Upgrade Is Endangered by Delays, Analysts Say

    Washington Enacts Law to Widen Exchange Plan Options