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- This week, our In Focus section reviews the Arizona Long Term Care System (ALTCS) Elderly and Physically Disabled (EPD) Program request for proposals (RFP), which the Arizona Health Care Cost Containment System (AHCCCS) released on August 1, 2023. Read MoreRoundup:
Colorado Hospitals Continue to Post Operating Losses
Florida Projects $600 Million Medicaid Budget Deficit for Fiscal 2024
Medicaid Eligibility Redeterminations News: Florida, Illinois, Massachusetts, Michigan, Nevada, Rhode Island, Wyoming
Idaho Medicaid Managed Care Task Force Holds Second Hearing
Illinois Governor Signs Law Increasing Oversight of Healthcare Mergers
Indiana Parents, Advocates Call on Governor to Reconsider Funding Cut for Autism Therapy
Massachusetts to Raise Income Eligibility Limits for ConnectorCare
Nebraska to Lift $750 Cap on Medicaid Dental Benefits
New Mexico to Award Previously Announced Medicaid Plan Contracts in Defeat for Governor
New York City Cannot Switch Retirees to Aetna Medicare Advantage Plan, Judge Rules
North Carolina Medicaid Behavioral Health Plans Sandhills Center, Eastpointe to Merge
Vermont All-Payer ACO Model Lowers Medicare Spending, Hospitalizations, Analysis Finds
CMS Launches Changes to Encourage Participation in Medicare ACO REACH
4.8 Million Medicaid Beneficiaries Are Disenrolled from Medicaid Following Redeterminations, Analysis Finds
5.6 Million Medicaid Enrollees Utilize Long-term Services, Supports in 2020, KFF Finds
U.S. Appeals Panel Rules False Claims Lawsuit Against Walgreens Can Proceed
- This week, our In Focus section continues analysis and insights from Health Management Associates (HMA) and its affiliate The Moran Company on recent Medicare payment and policy developments. Read MoreIn Focus:Roundup:
Arizona Releases Long Term Care System RFP
Arkansas Releases Medicaid Enterprise Pharmacy System and Services RFP
Medicaid Eligibility Redeterminations News: Arkansas, California, Idaho, Illinois, Kansas, Louisiana, Maine, Minnesota, Pennsylvania, West Virginia
California Releases Medi-Cal Dental Managed Care RFP for Los Angeles, Sacramento Counties
Massachusetts Releases Section 1115 Waiver Amendment for Public Comment
New York To Continue Coverage of Extended Medicaid Telehealth Services Through 2024
North Carolina State Budget May Stall Until September, Delay Medicaid Expansion Until At Least December
Utah Requests Three 1115 Demonstration Amendments for Chronic Conditions, Dental Services, Family Planning
Virginia to Release NEMT RFP September 1
Washington Requests Section 1115 Medicaid Waiver Amendment To Cover Former Foster Care Youth, CHIP Children
Wyoming Releases Draft Section 1115 Medicaid Waiver to Expand Income, Asset, Need Eligibility for Existing HCBS Waiver Services
CMS Extends HCBS Flexibilities Granted During COVID-19 Until November 11
OIG Finds High Rates of Prior Authorization Denials Among Medicaid MCOs
Health Connect America Acquires Specialized Youth Services of Virginia
- This week, our In Focus section reviews the new Guiding an Improved Dementia Experience (GUIDE) Model, announced by the Centers for Medicare & Medicaid Services (CMS) Center for Medicaid and Medicare Innovation (the Innovation Center) on July 31, 2023. Read MoreRoundup:
Alabama Seeks Medicaid Waiver to Cover Opioid, SUD Services for Individuals in IMDs
Alaska Medicaid to Cover Assisted Living Services in At-home Settings
California Receives Approval to Lift the Medicaid Asset Test in 2024
Florida Seeks Waiver to Pilot Managed Care Program for Individuals with IDD
Medicaid Eligibility Redeterminations News: Louisiana, Michigan, Minnesota, Missouri, New Hampshire
North Carolina Reaches Agreement with CMS in Hopes of Launching Medicaid Expansion by October
Virginia Medicaid Managed Care RFP Release Delayed to Mid to Late August
CMS Releases Final Medicare Inpatient, Long Term Care Prospective Payment System Rule
CMS Increases Medicare Reimbursement Rates for Skilled Nursing Facilities by 4 Percent in Fiscal 2024
CMS Projects 1.8 Percent Decrease in Medicare Part D Premiums in 2024
CMS Increases Medicare Hospice Rates by 3.1 Percent in Fiscal 2024
Medicaid, CHIP Enrollment Is Nearly 94.2 Million in April 2023
Medicaid Disenrollments Near 4 Million Following Redeterminations
The Ensign Group Acquires Skilled Nursing Facilities in Colorado, Washington
Help at Home Acquires IN-based My Care at Home, OH-based Berkshire Homecare
- This week’s In Focus section is the second in a summer series of analysis and insights from Health Management Associates (HMA) on recent Medicare payment and policy developments. Read MoreRoundup:
California Exchange Plan Premium Hikes Softened by State Financial Support
Medicaid Eligibility Redeterminations News: Indiana, Massachusetts, Minnesota, Montana, Washington, West Virginia, Wisconsin
Molina Healthcare Names Aaron Dunkel as President of Kansas Operations
Michigan Ends Cost Sharing in Medicaid Expansion Program
Nevada Releases Medicaid Managed Care RFI
Oklahoma Health Care Authority CEO Kevin Corbett to Resign
Medicaid Disenrollment Rates Vary Widely Among States, Report Finds
Community Health Systems to Sell Three Hospitals to Tampa General Hospital in $290 Million Deal
United’s Optum Health Names Amar Desai as CEO
- This week, our In Focus section is the first in a summer series of analysis and insights from Health Management Associates (HMA) on recent Medicare payment and policy developments. Read MoreRoundup:
Redeterminations News: Arkansas, Connecticut, Georgia, Iowa, Kentucky, North Carolina, North Dakota, Texas, Wyoming
California Health Plan to Provide $46 Million in Grants for Housing, Other Services
Colorado Medicaid, CHIP Are Among Payers Most Likely to Reimburse for Unnecessary Health Services, Study Finds
Florida Is Ordered to Amend Medicaid Program to Prevent Institutionalization of Children with Complex Needs
Hawaii to Seek Medicaid Services for Justice-involved Populations Prior to Release
Illinois Provides $75 Million in Funding to Address Health Disparities, Housing
Medicaid Disenrollments Top 3 Million Following Redeterminations
MTM Acquires Medical Transportation Brokerage of Arizona
- This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS) report to Congress on Non-emergency Medical Transportation (NEMT) in Medicaid, released June 20, 2023. Read MoreRoundup:
Medicaid Eligibility Redeterminations News: Arizona, District of Columbia, Florida, Idaho, Maryland, Michigan, Mississippi, New Jersey, Tennessee, Wyoming
Florida Extends Deadline for Medicaid Managed Care ITN Responses
Georgia Launches Partial Medicaid Expansion Program With Work Requirements
Idaho Medicaid Managed Care Task Force Holds Hearing on Structure of Program Funding
New Jersey Will Allocate $5 Million to Improve Housing for Individuals with Disabilities, Acute Medical Needs
New York Releases Third-Party Liability Match, Recovery Services RFP
North Carolina Further Delays Implementation of Behavioral Health IDD Tailored Plans
Ohio Releases RFP for Medicaid Enterprise System Alternate Payment Model Logic, Reporting Tool
Pennsylvania Medicaid to Cover Care Delivered on Streets to Homeless
ACA Risk Adjustment Pool to Redistribute $15.2 Billion to Individual Plans
AmeriHealth Caritas CEO Paul Tufano to Step Down
- This week, our In Focus section revisits three specific aspects and implications for regional and local managed care organizations of the proposed Medicaid and Children’s Health Insurance Program (CHIP) managed care access, finance, and quality rule published by the Centers Read MoreRoundup:
Florida Disenrolls Some Children with Complex Medical Needs During Redeterminations
Idaho Faces Lawsuits Over Medicaid Behavioral Plan Award
Iowa Medicaid Managed Care Contracts Begin July 1
UCare Names Former Kansas Medicaid Director Jon Hamdorf Market President
Louisiana Governor Vetoes Part of Legislature’s Proposed Budget, Reinstates Health Spending Increase
Maryland Extends Pregnancy, Postpartum Medicaid Benefits to Undocumented Individuals
Massachusetts Made $85 Million in Capitation Payments on Beneficiaries Living Out of State, Audit Finds
Minnesota Releases Medicaid, MinnesotaCare IHP RFP
Minnesota Provides One Month Grace Period to Reenroll in Medicaid Following June Redeterminations
Nevada Allows Medicaid to Cover Behavioral Health Services in Schools
New Hampshire Medicaid Beneficiaries Struggle to Find Dental Care
North Carolina Governor Urges Lawmakers to Separate Medicaid Expansion from Budget
Oklahoma Disenrolls 54,000 Medicaid Enrollees During May Redeterminations
South Dakota Implements Medicaid Expansion on July 1
Washington Receives Federal Renewal of Medicaid Transformation Project Section 1115 Waiver
Washington Disenrolls 116,000 Medicaid Beneficiaries During May Redeterminations
Home Health Providers Face Proposed 2.2 Percent Medicare Rate Cut in Fiscal 2024
Molina to Acquire Bright Health Medicare Advantage Subsidiaries
- C-suite executives from AmeriHealth Caritas, Centene, Community Health Choice of California, Health Care Service Corp., Humana, UnitedHealthcare, and UMPC Health Plan are scheduled to speak on trends in publicly sponsored healthcare at HMA’s Sixth Annual Conference, October 30-31 in Chicago. Read MoreRoundup:
Medicaid, CHIP Enrollment is Nearly 93.9 Million in March 2023
Medicaid Disenrollment News: Connecticut, Michigan, North Carolina, Oregon, South Carolina
California Renews Managed Care Tax, With Funds to Bolster Medicaid, Hospitals
Georgia Directs $118 Million to Medicaid Expansion in Fiscal 2024
Idaho Awards Centene/Magellan Healthcare Behavioral Health Plan Contract
Illinois Governor Creates State-based Insurance Exchange
Illinois Requests Extension for Behavioral Health Transformation Section 1115 Waiver
New Hampshire Extends Postpartum Medicaid Coverage
Washington Extends Family Planning Only Demonstration Waiver by One Year
Wisconsin to Renew Family Care, Family Care Partnership Waivers
Wisconsin Launches Independent Living Supports Pilot Program
MACPAC Projects Medicaid Managed Care Directed Payment Spending to Be $69.3 Billion Annually
Drug Makers File Federal Lawsuit to Block Medicare From Negotiating Drug Prices
UnitedHealth Group Wins Bidding Showdown to Acquire Amedisys
CareSource to Acquire Radiant Alliance
- This week, our In Focus section reviews the projected healthcare expenditure and enrollment data from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary, published June 14, 2023. The Office of the Actuary provides annual updates to Read MoreRoundup:
May Medicaid Redeterminations Update: Arizona, Illinois, Indiana, Iowa, West Virginia
California Lawmakers Introduce Bills to Modernize State Mental Health Services Act
Florida to Pilot Medicaid Managed Care for Individuals with Developmental Disabilities in 7 Counties
Idaho Releases EQRO RFP
Illinois Pauses Enrollment in Health Benefits for Immigrant Adults Program
Indiana Names Cora Steinmetz as Medicaid Director
Iowa Contracts With HMA to Study Service Delivery for New Health, Human Services Department
Kentucky to Study Potential HCBS Waiver Program For Children with Severe Emotional, Intellectual Disabilities
Montana Disenrolls 15,500 Medicaid Beneficiaries During April Redeterminations
New Mexico Awards General Dynamics Information Technology $39 Million Contract to Update Medicaid Provider Enrollment System
Oklahoma Closed Loop Electronic Referral System for SDOH RFP Responses Are Due June 19
Tennessee Releases Medicaid, CHIP Eligibility Determination System RFI
Enhanced Medicaid Funds to States for Pausing Disenrollment Top $117 Billion, KFF Finds
Pennant Group Acquires Bluebird Home Health, Hospice, Home Care Provider
- This week, our In Focus section highlights a Health Affairs Forefront post, “To Treat Residents With OUD, Nursing Facilities Must Improve Practices and Reduce Stigma, ” published June 8, 2023. Read MoreRoundup:
Medicaid Disenrollment News: Arkansas, Georgia, Kansas, Maryland, Nebraska, New Hampshire, South Carolina
Florida Raises KidCare Income Eligibility to 300 Percent of Poverty
CareSource Files Protest Against Iowa Medicaid MCO Awards
CareSource Forms Alliance with Three Organizations to Bid on Upcoming Kansas Procurement
New York to Form Healthcare Commission to Improve Medicaid Quality, Reduce Costs
North Carolina Enacts Law Allowing BCBS-NC, Delta Dental to Shift Assets to Holding Companies
North Dakota Names Sarah Aker Medicaid Director
Oklahoma Awards Medicaid Managed Care Contracts to Three Plans
Pennsylvania Receives 67 Responses to Community HealthChoices RFI
Texas Awards EVV System Management Services Contract to Accenture, HHAeXchange
Health Plans Must Pay for Preventive Care Under Temporary Agreement
CMS Announces New Primary Care Payment Model
Center for Autism Files for Chapter 11, Assets To Be Acquired by Founder, Former CEO
Walgreens Sells Remaining Shares of Option Care Health for $330 Million
