HMA Weekly Roundup

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  • This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “January 2019 Medicaid and CHIP Applications, Eligibility Determination, Read More
    Roundup:

    Arkansas Reschedules PASSEs Open Enrollment to October

    Illinois Medicaid Eligibility Backlog Leaves Thousands Without Coverage

    Kansas Legislature Fails to Advance Medicaid Expansion

    Nebraska Releases RFQ For Families First Prevention Services Act Providers

    New Hampshire Lawmaker Proposes 12 Percent Raise in Medicaid Rates for Clinicians

    Pennsylvania Counties Push Back Against Behavioral Health Integration Bill

    Tennessee to Seek Federal Approval for Medicaid Block Grant

  • This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS)-issued Fiscal Year (FY) 2020 Medicare Part A proposed rules. Between April 17 and April 23, 2019, the CMS issued the proposed rules for general acute Read More
    Roundup:

    California Dual Eligibles Program Is Extended Through 2022

    Florida Legislature Approves Bill to Import Prescription Drugs from Canada

    Missouri Medicaid Enrollment Falls by 70,000 in 2018 Partly from Renewal Processing Errors

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

    Texas House Committee Passes Bill Requiring Independent Review of Medicaid Managed Care Denials

    Washington Legislature Passes Public Option Exchange Plan

  • On April 22, 2019, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced the Primary Cares Initiative (PCI), which will present eligible providers and other entities with the opportunity to engage in value-based payment and direct contracting Read More
    Roundup:

    Colorado Senate Tentatively Endorses Study of State-Run Public Option Health Plan

    Federal Judge Orders Florida to Expand Hepatitis C Treatment for Inmates

    Medicaid Expansion News: Montana, Oklahoma

    Oregon Receives 19 Applications for CCO 2.0 Contracts

    Texas Children Are Improperly Losing Medicaid Coverage, State Data Show

  • This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a Freedom of Information Act request to the Centers for Medicare & Medicaid Services (CMS), we have received a draft Read More
    Roundup:

    Alaska House Committee Considers Bill to Shift Medicaid Expansion Members to Private Insurance

    Arkansas Reports Increase in Medicaid Enrollment

    District of Columbia to Award Medicaid Managed Care Contracts to Amerigroup, AmeriHealth Caritas, Trusted

    Iowa to Evenly Distribute Medicaid Members Among 2 Plans

    Michigan Considers Options for MLTSS System Revamp

    Montana Senate Fails to Renew Medicaid Expansion

    New Jersey Child Enrollment Declines

    Foster Care News: New York, Oregon

  • This week, our In Focus reviews the Calendar Year (CY) 2020 Medicare Advantage (MA) and Part D Flexibility Final Rule (Final Rule) issued by the Centers for Medicare & Medicaid Services (CMS) on April 5, 2019. The Final Rule implemented Read More
    Roundup:

    Alaska Pushes Ahead With Medicaid Block Grant Proposal

    Medicaid Expansion News: Idaho, Kansas, Maine, North Carolina, North Dakota

    Louisiana Medicaid Is Under Scrutiny Over Improper Enrollments

    BCBS-Minnesota Posts Profit in Medicaid, MNCare Lines

    CMS Approves New York Children’s HCBS Waiver

    Texas Legislative Agency Reports Medicaid Quality Problems

    CMMI Director Considers Bundled Payments for Post-Acute Care

  • This week, our In Focus reviews the Announcement of Calendar Year (CY) 2020 Medicare Advantage (MA) Capitation Rates and Medicare Advantage and Part D Payment Policies (Rate Announcement) and Final Call Letter, issued by the Centers for Medicare & Medicaid Read More
    Roundup:

    Medicaid Expansion News: Arkansas, Kansas, Montana, Nebraska, Utah, West Virginia

    Florida Is Approved for Behavioral Health Housing Pilot

    Iowa Medicaid Plan UnitedHealthcare to Exit Market

    Louisiana Is No Longer Pursuing Medicaid Work Requirements

    Minnesota Individual Plans Post Strong 2018 Financials

    North Carolina Audit Finds Behavioral Health LME/MCOs Had $440 Million in Excess Savings

    Tennessee Medicaid Program Cuts 128,000 Kids over Past Two Years

  • This week, our In Focus reviews the implications of the new federal guidance for state waivers with community engagement, premiums, non-eligibility periods, and other personal responsibility provisions. Read More
    Roundup:

    Medicaid Expansion News: Alabama, Colorado, Georgia, Idaho, Kansas, North Carolina

    Arizona Announces DDD Health Plan Awards

    Kentucky Attorney General Launches PBM Investigation

    Louisiana Awards Hepatitis C Pact to Asegua Therapeutics

    New Jersey Releases 2018 Medicaid Plan CAHPS Results

    New Mexico to Develop Medicaid Home and Community Supports Waiver Program

    Ohio Medicaid to Release Managed Care Procurement RFI

  • Register now for HMA’s fourth annual conference on Trends in Publicly Sponsored Healthcare, September 9-10 at the Chicago Marriott Downtown Magnificent Mile. Register here: https://conference.healthmanagement.com/. The theme of this year’s event is The Next Wave of Medicaid Growth and Opportunity: Read More
    Roundup:

    Florida House Panel Votes to Make 30-Day Retroactive Medicaid Eligibility Permanent

    Illinois Governor Proposes Medicaid MCO Tax to Improve Care, Reduce Cost to Taxpayer

    Kansas Senate, House Committees Remove Medicaid Expansion Funding From Proposed Budget

    Pennsylvania Experiences Bumpy Transition to Community HealthChoices Dual Eligible Program

    Texas Releases Outline of IDD Strategic Plan

    Medicaid Drug Spending Grows 14.8 Percent from 2013-17

  • This week, our In Focus reviews the Louisiana Medicaid managed care organizations (MCOs) request for proposals (RFP), released by the Louisiana Department of Health (LDH) on February 25, 2019. Selected MCOs will manage health care services for more than 1.5 Read More
    Roundup:

    California Releases Revised Medi-Cal Managed Care RFP Schedule

    Kentucky Medicaid Plan Passport Health May Face Bankruptcy Despite Cuts, CEO Says

    New Jersey Governor Proposes Increase in Funds for Community-Based Services

    New York Revises Children’s Managed Care Transition Timeline

    West Virginia Senate Passes Bill to Transition Health Care Services for Foster Children to Managed Health Care

  • This week, our In Focus reviews requests for proposals (RFPs) for Minnesota’s Medicaid managed care programs: 1. Families and Children Medical Assistance and MinnesotaCare; 2. Minnesota Senior Care Plus (MSC+)/Minnesota Senior Health Options (MSHO). The two RFPs were released by Read More
    Roundup:

    Arkansas Providers Ask Judge to Further Delay Transition to Medicaid Managed Care

    California Community Leaders to Pursue Ballot Initiative for Two-Plan Medicaid System in Ventura

    Illinois Lawmakers Introduce Medicaid Managed Care Reform Legislation

    Iowa to Kick Off Medicaid Managed Care Open Enrollment Period

    Louisiana Receives Responses from 3 Drug Makers to Medicaid, Inmate Hepatitis C Treatment Proposal

    Medicaid Expansion News: Missouri, Ohio, Texas, Wisconsin