HMA Weekly Roundup

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  • This week, our In Focus provides a brief review of State- and Medicaid-related updates from for-profit and publicly traded health care companies’ third quarter earnings reports and conference calls. Read More
    Roundup:

    Alameda Dropped from California Duals Demonstration

    California Awards Prison Health Contract to Health Net

    Illinois Suspends Auto-Assignment for Harmony, Family Health Network

    Illinois Medicaid Director Announces Departure

    UnitedHealth Withdraws from Michigan Duals Demo

    Montana Governor Unveils New Medicaid Expansion Proposal

    Hospital Consolidation Continues in New York

    New York Duals Demonstration Contracts Announced

    September CMS Report Counts 68 Million Enrolled in Medicaid

    HRSA Withdraws 340B Drug Program Regulations

    Louisiana to Carve-in Behavioral Health Benefits

    Insurance Exchanges Launched on November 15

  • This week, our In Focus section comes to us from HMA Boston’s Rob Buchanan. Rob provides background and overview on the recently approved 1115 Waiver in Massachusetts. Read More
    Roundup:

    California Releases GMC RFA for Comment

    Delaware Releases Program Integrity RFP

    Georgia Releases Care Management Organization RFQC

    Steward Health Care System to Close Quincy Medical Center

    New Mexico Human Services Secretary Squire to Step Down

    Post-Election Medicaid Expansion Updates in Arkansas, Ohio, Pennsylvania, Tennessee

    Oregon Releases Care Coordination RFP

    Haley Selects Soura as South Carolina Medicaid Director

    Supreme Court to Hear Challenge to ACA Insurance Subsidies

    HealthCare.gov Opens for Window Shopping Ahead of Open Enrollment

  • This week, our In Focus section reviews the request for proposal (RFP) issued by Missouri’s HealthNet Medicaid managed care program to rebid contracts across all three managed care regions. Read More
    Roundup:

    Election Results Unlikely to Affect Medicaid Expansion Outlook

    CMS Approves Massachusetts Medicaid 1115 Waiver

    Colorado ACC Achieves Savings and Improved Outcomes

    Kansas Releases MMIS RFP

    Michigan Enrollment Update

    New Jersey MLTSS Contract Provisions Released

  • This week our In Focus section reviews the Department of Health and Human Services (HHS) Office of Inspector General (OIG) report. Read More
    Roundup:

    Louisiana DHH Recommends Five Bayou Health Plan Awards

    BCBS of Western NY Reverses Decision to Exit Medicaid

    States Ask Congress to Intervene on Drug Prices

    CMS Provides Extension of Higher Matching Funds

    NAMD to Host Fall Conference in Washington, D.C: Nov. 3-5

    MACPAC to Hold Meeting in Washington D.C: Oct. 30-31

  • This week our In Focus section reviews updated end-of-August 2014 enrollment reports issued by the Department of Health and Human Services (HHS) on Medicaid expansion enrollment. Read More
    Roundup:

    Puerto Rico Announces Mi Salud RFP Awards to Five Plans

    Delaware Reaches Agreement with United, Negotiations Continue with Highmark on Medicaid Managed Care RFP

    Massachusetts Awards MMIS Contract Extension to HP

    Colorado Issues RFI on Future of Medicaid Accountable Care Collaborative

    California Ballot Initiative Would Allow Insurance Commissioner to Deny Rate Increase Requests

  • This week, our In Focus sections looks at the Medicaid redesign waiver, submitted by New Mexico to the Centers for Medicare & Medicaid Services (CMS) on April 25, 2012. New Mexico is proposing to consolidate the numerous federal waiver populations, Read More
    Roundup:

    Health Net wins Central California RFP

    California "May Revise" to be released May 14

    New York scales back, refines dual eligible demonstration proposal

    Georgia announces, but Texas cancels, RAC awards

    Pennsylvania Medicaid MCO awards protested

    CMS refines dual eligible application requirements, announces first wave of innovation awards, and releases proposed rule on Medicaid primary care rate increases

  • This week, our In Focus section reviews recent Medicaid MCO enrollment trends in 13 states. Many state Medicaid agencies elect to post to their website monthly enrollment figures by health plan for their Medicaid managed care population. Read More
    Roundup:

    New York revises dual integration proposal

    Illinois dual integration RFP delayed until May 4

    Incumbent ValueOptions wins Massachusetts Medicaid behavioral health RFP

  • This week, our In Focus section briefly reviews the flurry of dual eligible integration proposals released for public comment in the past week. Arizona, South Carolina, Tennessee, Texas, and Virginia have all unveiled their plans to bring a combined 590, Read More
    Roundup:

    Ohio protests filed by five of six unsuccessful MCO bidders

    CareSource to sell Michigan plan

    New York Governor Cuomo signs executive order for health insurance exchange

    Georgia Medicaid MCO RFP timeline under evaluation

    Colorado update on ACC program

    Illinois Governor to unveil budget proposal tomorrow

    MACPAC meeting tomorrow

  • This week, our In Focus section addresses Medicaid program integrity, highlighting two recent Federal commission recommendations on the topic. In the March 2012 report from the Medicaid and CHIP Payment and Access Commission (MACPAC), the Commission dedicated a chapter to Read More
    Roundup:

    Ohio Medicaid MCO awards announced

    Updated timeline for Illinois delivery system reforms

    Georgia expects to release a draft RFP for eligibility system redesign

    New York releases successful health home applicants

  • This week, our In Focus section looks at the updated guidance on dual eligible integra-tion, released March 29, 2012 by the Centers for Medicare & Medicaid Services (CMS). In January 2012, CMS released an initial round of guidance regarding dual Read More
    Roundup:

    CALIFORNIA DEMONSTRATION SITES ANNOUNCED, DUAL INTEGRATION PROPOSAL RELEASED; ILLINOIS RELEASES MMIS, ENROLLMENT BROKER PROCUREMENTS; PENNSYLVANIA NEW EAST AND NEW WEST MANAGED CARE AWARDS STILL PENDING; FLORIDA TO EVALUATE SHIFTING TO DRG-BASED REIMBURSEMENT SYSTEM FOR HOSPITALS; COLORADO LAUNCHES TELEHEALTH INITIATIVE