HMA Weekly Roundup

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  • In an issue brief prepared for The Commonwealth Fund and The SCAN Foundation, HMA consultant Jennifer Podulka and Vice President Jonathan Blum, analyze the temporary COVID-19-related changes to Medicare regulations, described the benefits and risks of the changes, and offered Read More
    Roundup:

    Florida Medicaid Providers Lag in EHR ‘Meaningful Use’

    Georgia Is Likely to Extend Existing Medicaid Managed Care Contracts, Eyes Potential Clawbacks

    Medicaid Expansion News; Mississippi, Missouri, North Dakota, Wisconsin

    Oklahoma Legislature Approves Bill to Place Guardrails on Medicaid Managed Care Transition

    Washington Medicaid Director MaryAnne Lindeblad to Step Down Effective July 31

    ACA Exchange Premiums Decline for the Third Straight Year

    CMS to End Next Generation ACO Model

  • This week, our In Focus section reviews California’s May Revision to the Governor’s Budget, which proposes a $267.8 billion budget (with $196.8 billion General Fund) for fiscal year 2021-22. The revised budget includes $24.4 billion in reserves, the largest in Read More
    Roundup:

    Connecticut Releases RFP for Behavioral Health ASO

    Delaware to Implement Medicaid ACO Contracts in January

    Minnesota Reaches Decision on Likely Medicaid MCO Winners

    Missouri Lawmakers Fail to Renew Medicaid Provider Tax

    Missouri Courts Likely to Decide Fate of Medicaid Expansion

    Nevada Budget Panel Approves Roll Back of Provider Cut

    New Jersey Releases RFA for Burlington County PACE

    North Carolina Extends Medicaid Plan Open Enrollment

    Texas to Resubmit 1115 Medicaid Waiver Extension Application

    SAMHSA to Offer State Block Grants for Behavioral Health

  • This week, our In Focus section reviews the key provisions of the Centers for Medicare & Medicaid (CMS) Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (CMS-1752-P), which includes Read More
    Roundup:

    Arkansas Releases MMIS Fiscal Agent RFP

    California DHCS Announces Counties That Intend to Transition to Local Medi-Cal Managed Care Plan Model

    Hawaii Awards MMIS Contract to Conduent

    Medicaid Expansion News: Missouri, Montana, South Dakota, Wisconsin, Wyoming

    Ohio Health Plan Files Lawsuit to Access Medicaid Procurement Documents

    Texas House Passes Bill to Contract with Baylor Scott & White Health in Central RSA

    PBM Pricing Practices Under Scrutiny by Attorneys General in Eight States

    U.S. Senate Confirms Andrea Palm as HHS Deputy Secretary

  • This week, our In Focus section examines differences in Medicare Advantage (MA) churn rates among select provider-sponsored plans (PSPs) and nonPSPs. Enrollee churn rates, or rates at which enrollees switch plans, may be an indicator of enrollee satisfaction. In the Read More
    Roundup:

    Indiana Medicaid NEMT Company Faces Criticism

    Iowa Medicaid Director to Focus on Social Determinants

    Kentucky to Rebid Medicaid Managed Care Contracts Again

    Mississippi Is Likely to Extend Centene Medicaid Contract

    Medicaid Expansion News: Mississippi, Missouri, National

    New Jersey Budget Proposal Includes Wage Increases for Critical Care Workers

    GAO Names Melanie Bella Chair of MACPAC

  • This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for individuals dually eligible for Medicare and Medicaid (dual eligibles) in nine states: California, Illinois, Massachusetts, Michigan, New York, Read More
    Roundup:

    Georgia Wins Approval to Extend Medicaid Postpartum Coverage to Six Months

    Iowa Governor Appoints Matney as Medicaid Director

    Medicaid Expansion News: Missouri, Texas

    Nevada Medicaid Home Care Bill Addresses Quality, Working Conditions

    Ohio Health Plans Protest Medicaid Managed Care Awards

    Molina to Acquire Cigna’s Texas Medicaid, MMP Contracts

    CMS to Ease Medicare Price Transparency Requirements for Hospitals, Raise Payment Rates Under Proposed Rule

  • This week, our In Focus reviews the fiscal year (FY) 2022 skilled nursing facility (SNF) proposed payment rule, released by the Centers for Medicare & Medicaid Services (CMS) on April 8, 2021. If the proposals contained in the rule are Read More
    Roundup:

    Arkansas House Approves Medicaid Budget

    Florida Senate Budget Bill Rolls Back Medicaid Cuts

    Georgia Releases NEMT RFP

    Missouri Accepts Resignations of Two Top Health Officials

    Missouri House Passes Budget Without Medicaid Expansion

    Oklahoma House Moves to Halt Medicaid MCO Transition

    Texas Medicaid Waiver Extension Is Rescinded

    CMMI Director Discusses Alternate Payment Models

    CMS Issues Guidance on Pricing Transparency Rule

  • This week, our In Focus section reviews federal enacted and proposed investments in home and community-based services (HCBS). HCBS are critically important for millions of Americans with disabilities and older adults, assisting them to remain in their homes and participate Read More
    Roundup:

    Medicaid Expansion News: Arkansas, Mississippi, Montana

    Arkansas PASSE Program Is Eyed By CareSource

    Medicaid Postpartum Coverage: Florida, Illinois

    North Carolina Falls Short in Medicaid Oversight Audit

    Ohio Awards Medicaid Managed Care Contracts

    Oklahoma House Committee Advances Bill Challenging State’s Planned Medicaid Managed Care Transition

    South Carolina Nominates Robert Kerr as Medicaid Director

    Biden Is Expected to Sign Bill Extending Moratorium on Medicare Provider Cuts

    CMMI Names New Model Winners

  • The COVID-19 pandemic highlighted nursing home safety and infection control as critical public health issues. A new report authored by HMA colleagues found compelling evidence that single rooms in nursing homes have numerous benefits for both public health and residents’ Read More
    Roundup:

    Leavitt Partners Becomes Part of HMA

    Arkansas Names Elizabeth Pitman Medicaid Director

    Medicaid Expansion News: Indiana, North Carolina, Georgia, Missouri, Wyoming

    Iowa Senate Approves Medicaid Primary Care Capitation Pilot

    Michigan Medicaid Work Requirements Waiver Is Rescinded

    Missouri Taps Kirk Mathews as Interim Medicaid Director

    New York to Delay Medicaid Pharmacy Carve-Out Until 2023

    Ohio Awards OhioRISE Managed Behavioral Plan Contract

    South Carolina Awards Medicaid RAC Contract to HMS

  • This week, our In Focus section highlights changes that may affect the Centers for Medicare & Medicaid Services (CMS) Medicare Advantage Star Rating program and how these changes impact future summary Part C & D Star Rating scores. As the Read More
    Roundup:

    Arkansas Medicaid Work Incentive Bill Heads to Governor

    California Panel Advances Inmate Medicaid Eligibility Bill

    Florida Medicaid Plan Simply Healthcare Purchases Medicaid Business of Miami Children’s Health Plan

    Florida House Budget Plan Includes Nursing Home Pay Cut

    Expansion News: Georgia, Missouri, Wyoming

    Illinois Looks to Cover CHIP Under Medicaid Expansion

    Iowa Seeks Waiver on Medicaid Dental Benefits for Children

    Mississippi Fails to Extend Medicaid Postpartum Coverage

    Rhode Island State-Run Hospital to Restart Billing Medicaid

  • This week, our In Focus section reviews the Nevada Medicaid and Child Health Insurance Program (CHIP) managed care request for proposals (RFP) released by the Nevada Department of Health and Human Services, Division of Health Care Financing and Policy (DHCFP) Read More
    Roundup:

    Medicaid Expansion News: Alabama, Florida, South Dakota, Tennessee, Wyoming

    Arkansas House Panel Clears Medicaid Work Incentive Bill

    Florida Lawmaker Introduces Legislation to Extend Medicaid Postpartum Coverage to Full Year

    Hawaii Awards Medicaid Managed Care Contracts

    Michigan Medicaid Expansion Impacts Dental Health

    Mississippi Medicaid Plan, Others Face Investigation Over Pharmacy Benefits

    Ohio Medicaid Plan to Invest $18 Million to Foster Telehealth

    Utah Names Emma Chacon Interim State Medicaid Director

    Pierce County, WA, Council to Vote on Medicaid Overhaul

    Medicaid HCBS Would Be Mandatory Under Proposed Bill