HMA Weekly Roundup

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  • 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

  • This week, our In Focus section reviews New York’s dual eligible integration proposal. The New York State Department of Health has proposed a fully-integrated managed care program, which will be known as the Fully-Integrated Duals Advantage (FIDA) pro-gram. Read More
    Roundup:

    Site Selection for California Dual Eligible Demonstration Delayed

    Florida Long-Term Care Rate Book Released

    Georgia, New York Budgets Finalized

  • This week, our In Focus section highlights key provisions of the federal final rule on Med-icaid eligibility and enrollment, released last Friday, March 16, by the Centers for Medi-care & Medicaid Services (CMS). The final rule provides the standards for Read More
    Roundup:

    Florida Extends Implementation Timeline for Acute and Long-Term Care ITNS

    Indiana Selects Medicaid PBM

    Medicaid Spending Cuts Debated in Illinois

    CMS Comment Period for Massachusetts Dual Eligible Proposal Ends

  • This week, our In Focus section reviews the state of Washington’s proposal to integrate care for dual eligible individuals. Washington was one of fifteen states to receive dual el-igible demonstration grant funding from the Centers for Medicare and Medicaid Services Read More
    Roundup:

    Dual Eligible Integration Developments In New York, Colorado

    Georgia Medicaid Redesign Decisions Expected Late April

    Pennsylvania Contract Awards Still Pending

  • This week, our In Focus section reviews Michigan’s proposal to integrate care for dual el-igible Medicare-Medicaid beneficiaries. Unlike other state dual eligible integration pro-posals that limit the population included either geographically or by age (including Ohio, Michigan and Illinois), Michigan Read More
    Roundup:

    New York to Release Dual Integration Proposal March 22

    Florida Hospital Rate Cuts Finalized

    California Dual Integration Applications Released

    Texas Pharmacy Carve-In Implemented

    HMA Records GLG Webcast on State Budgets, MCO Expansion, and California Duals RFS