HMA Weekly Roundup

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  • 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:

    Medicaid Expansion News: Arkansas, North Carolina, Oklahoma

    California Delays CalAIM Implementation

    Illinois Foster Families Worry Transition to Managed Care Will Disrupt Care

    Oklahoma Submits HAO Waiver for Federal Approval

    Washington Releases Medicaid Integrated Managed Care RFP for Additional Service Areas

    Trump Administration Lacks Details on Plan to Cover Treatment of Uninsured COVID-19 Patients

  • This week, our In Focus section examines the extensive scope of flexibilities Federal and State governments have made to Medicare and Medicaid telehealth coverage in response to the COVID-19 national emergency. In March and April 2020, federal and state policymakers Read More
    Roundup:

    Medicaid Expansion News: Florida, Nebraska

    Oregon Could See Medicaid Enrollment Increase by 320,000

    Health Systems Criticize HHS for Tying Emergency COVID-19 Funding to Medicare Billings

    Many ACOs May Leave Medicare Shared Savings Program

    Molina, NextLevel Health Break Off Merger Talks

    Blue Shield of California Affiliate to Buy Brown & Toland

  • A model developed by Health Management Associates (HMA) assesses COVID-19’s potential impact on health insurance coverage for each state and forecasts Medicaid enrollment could increase by 11 to 23 million across all states over the next several months. Read More
    Roundup:

    Medicaid Expansion News: Alabama, Tennessee, Texas

    Louisiana Medicaid Director Ruth Johnson Takes Office

    Missouri FQHCs Face Financial Hardship as COVID-19 Keeps Patients Home

    New York Reaches Final Budget for Fiscal 2021

    CMS to Raise Medicare Advantage Plan Payment Rates by 1.66 Percent in 2021

    CMS Delivers $34 Billion to Medicare Providers, Suppliers Through Accelerated and Advance Payment Program

  • This week, our In Focus section comes from HMA Principals Ellen Breslin (MA) and Sharon Lewis (OR). In direct response to COVID-19, the Centers for Medicare & Medicaid Services (CMS) has encouraged states to maximize Medicaid flexibilities to protect people Read More
    Roundup:

    Medicaid Dental Managed Care News: Florida, Louisiana

    Hawaii Postpones Implementation of New Medicaid Managed Care Contracts Amid COVID-19 Outbreak

    Navajo Nation President Vetoes New Mexico Medicaid Managed Care Initiative

    New York Governor to Refuse Federal Medicaid Aid

    South Carolina Puts Limit on Medicaid Mental Telehealth

    Texas Cancels STAR, CHIP Procurement, Scraps STAR+PLUS Awards

    Wisconsin Expects Medicaid Expenditures to Surge

    Healthcare.gov Will Not Have Special Enrollment Period

  • This week, our In Focus section provides an overview of new requirements and opportunities for states and Medicare Advantage (MA) Dual Eligible Special Needs Plans (D-SNPs) to increase Medicare and Medicaid coordination in plan year 2021. Specifically, states and health Read More
    Roundup:

    1135 Waiver News: Arizona, California, Illinois, Iowa, Massachusetts, Minnesota, New York, North Carolina, Oklahoma, Washington

    Alaska to Ration Medicaid Payments

    Arizona Legislature Passes Hospital Fee

    Missouri Medicaid Expansion Initiative Has Enough Signatures for November Ballot, Backers Say

    Oklahoma Health Care Authority Releases HAO Waiver for Public Comment

    CMS Issues Guidance on 6.2 Percent Medicaid FMAP Increase

  • This week, our In Focus comes from HMA Vice President Kathleen Nolan and Managing Principal Jon Blum. On March 13, 2020, President Trump declared a national emergency due to the rapid spread of COVID-19 virus. This declaration provides Health and Read More
    Roundup:

    Florida Receives Federal Approval for 1135 Medicaid Waiver to Help Address COVID-19

    Florida Lawmakers Agree on Budget Without Cuts To Medicaid Supplemental Payments

    Illinois Bill Would Further Delay Transition to Managed Care for Foster Children

    New Jersey Seeks to Re-open ACA Enrollment

    New York Medicaid Redesign Team to Recommend Cuts

    House Passes FMAP Increase as Part of COVID-19 Relief Bill

    Medicare to Cover In-Home Telehealth Visits Nationwide in Response to COVID-19

  • This week, our In Focus section examines Medicare Advantage (MA) enrollment changes resulting from the 2020 Annual Election Period (AEP). The AEP takes runs from October 15 to December 7 each year, and provides an opportunity for Medicare beneficiaries to Read More
    Roundup:

    Arizona High Court Voids State Balance Billing Law

    Colorado Submits Prescription Drug Importation Proposal

    Florida Nursing Homes to See Medicaid Payments Increase

    Medicaid Expansion News: Idaho, Kansas, Oklahoma

    Michigan Seeks Funds for Medicaid Transformation Office

    New Jersey Governor Again Proposes Tax on Companies With 50 or More Employees on Medicaid

    North Carolina Official Does Not Rule Out Late 2020 Transition to Medicaid Managed Care

    Vermont Protesters Question OneCare’s Use of Funds

    CMS Issues Guidance to Medicare Plans on COVID-19

  • This week, our In Focus section comes from HMA Principal Eric Hammelman and Senior Consultant Narda Ipakchi. Today, Medicare beneficiaries with EndStage Renal Disease (ESRD) are only eligible to enroll in Medicare Advantage (MA) plans if they select a MA Read More
    Roundup:

    California Revises Medicaid Managed Care RFP Schedule

    Delaware Awards Two Corrections Contracts to Centene

    Georgia Lawmaker Sponsors Medicaid Buy-in Bill

    Medicaid Expansion News: Kansas, Oklahoma, Texas

    Michigan Work Requirements Are Struck Down

    Minnesota Issues Special Needs BasicCare RFP

    Tennessee Names Stephen Smith as Medicaid Director

    Washington Issues Exchange Public Option Plan RFA

    West Virginia Senate Approves Medicaid Dental for Adults

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 29 states.i Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This Read More
    Roundup:

    Colorado Releases Proposed Public Option Hospital Rates

    Illinois Lawmaker Introduces Bill to Study Medicaid Buy-In

    Kentucky Senate Passes Revised Bill to Establish Single PBM, Formulary for Medicaid Managed Care

    Louisiana to Decide on Medicaid Managed Care Contract Awards Protest by March 17 at Earliest

    New York Medicaid DSRIP Waiver Extension Is Denied by CMS

    Vermont OneCare ACO Spends More Than Expected

    West Virginia Senate Passes Medicaid Trust Fund Bill

    CMS to Increase Oversight of Accrediting Organizations

  • This week, our In Focus section examines President Trump’s budget for fiscal year (FY) 2021. The budget includes a number of legislative and administrative proposals related to Medicare that are estimated to reduce net Medicare spending by $872 billion over Read More
    Roundup:

    Washington Medicaid Rate Increase Bill Passes State Senate

    Texas Health Plans Point to Scoring Inconsistencies in STAR+PLUS Contract Awards

    Medicaid Work Requirements News: Arkansas, Iowa

    California Exchange Sees Big Increase in New Enrollees

    District of Columbia Further Extends Medicaid Managed Care RFP Deadline

    Expansion News: Kansas, Wyoming

    Missouri Lawmakers Seek Halt to Medicaid Disenrollments

    South Dakota Issues Medicaid Job Training RFP