HMA Weekly Roundup

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  • This week, our In Focus highlights the report, Advancing Health Justice Using Medicaid Data: Key Lessons from Minnesota for the Nation. This report was produced by AcademyHealth in partnership with the Disability Policy Consortium (DPC), a Massachusetts-based cross-disability advocacy and Read More
    Roundup:

    Florida Healthy Kids Suffers Data Breach

    Georgia House Passes Bill for Auto Medicaid Enrollment of Children Eligible for Food Stamps

    Hawaii Awards Community Care Services Contract to Centene/WellCare

    Chicago’s Oldest Hospital Files For Chapter 11 Bankruptcy

    Nevada Issues PBM RFP For Medicaid FFS, Ryan White

    Medicaid Expansion News: North Dakota, Tennessee, Texas

    WI Governor Proposes Public Option With Medicaid Buy-in

    Biden to Revoke Rules Allowing Medicaid Work Requirements

    CMS Faces Calls to Delay Geographic Direct Contracting

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 33 states. Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This Read More
    Roundup:

    California May Make Some Telehealth Flexibilities Permanent

    Medicaid Expansion News: Florida, Mississippi, South Dakota

    Kentucky Senate Panel Clears Bills to Reduce Number of Medicaid Plans, Eliminate Copays

    Missouri to Contract With 3 Medicaid Managed Care Plans

    Puerto Rico Needs Risk-Based Oversight of Medicaid Procurement Process, GAO Says

    Tennessee Lawmakers Introduce Medicaid Buy-in Bill

    House Proposal Would Raise ACA Subsidies for Two Years

  • In a report to the Medicaid and CHIP Payment and Access Commission (MACPAC), HMA consultants Sarah Barth, Sharon Lewis and former research assistant Taylor Simmons, provided insight and review of Medicaid services for people with intellectual or developmental disabilities (ID/DD). Read More
    Roundup:

    Arizona Awards Medicaid Housing Contract

    Drug Importation News: Colorado, Florida

    Medicaid Expansion News: Georgia, Kansas, Missouri

    Kentucky Releases RFP for Medicaid Fee-for-Service PBM

    DentaQuest Medicaid, CHIP Lives Top 840,000 in Lousiana

    New Jersey Medicaid Covers Doulas, Raises Midwives Rates

    New York Retroactively Cuts Medicaid Managed Care Rates

    Oklahoma Announces Medicaid Managed Care Awards

    Texas Schedules STAR+PLUS Pre-Solicitation Meetings

    Wisconsin Medicaid to Cover SUD Treatment

  • This week, our In Focus section reviews a new model – Geographic Direct Contracting – introduced by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. The model will test whether a geographic-based approach to care delivery and value-based Read More
    Roundup:

    Alabama Seeks Medicaid Quality Improvement Organization

    Florida Receives Medicaid Managed Care Waiver Extension

    Kentucky Seeks External Quality Review Organization

    Missouri Lawmakers Consider Extending Provider Tax to Fund Medicaid Expansion

    New Jersey Lifts UnitedHealth Medicaid Enrollment Freeze

    New Mexico Medicaid Enrollment to Hit 931,000 By June 2021

    Oklahoma to Move Forward with Medicaid Managed Care

    Medicaid, CHIP Enrollment to Rise 5-10 Million by 2022

    Medicare ACO Membership Falls in 2021

  • Health Management Associates (HMA) announced on January 14, 2021, the creation of the HMA Institute on Addiction (IOA), a division dedicated to supporting the national effort to build an evidence-based, patient-centered, and sustainable addiction treatment ecosystem. HMA is home to Read More
    Roundup:

    Kentucky Medicaid Directed Payments Initiative Is Approved

    North Carolina Readies for Medicaid Managed Care Launch

    Ohio Delays Implementation of Medicaid Work Requirements

    Pennsylvania Receives Health Care Reform Recommendations

    Texas Uncompensated Care Waiver Extension Is Approved

    CMS Reports 4.6 Million Medicaid Beneficiaries Were Treated for Substance Use Disorder in 2018

    CMS Releases Preliminary State Medicaid Expenditure Data

    CMS Rule Change Lets Physicians Prescribe Buprenorphine for Opioid Use Disorder Without Waiver

    CMS Announces 2022 Medicare Advantage, Part D Rates

  • This week’s In Focus highlights a recent HMA publication examining the drivers and barriers to Medicare Advantage plan adoption of newly available supplemental benefits intended to address unmet health and social needs. Unlike Traditional Medicare, Medicare Advantage plans, which provide Read More
    Roundup:

    Arizona Approves UnitedHealth Group Acquisition of Certain Solstice Health Plans Operations

    Colorado Releases Report on Medicaid Prescription Drugs

    Medicaid Expansion News: Georgia, Oklahoma, Texas, Virginia

    Minnesota Releases Medicaid Plan Procurement Timeline

    Oklahoma Medicaid RFP Bidders to Include CareSource

    South Carolina Governor Taps Thomas Clark Phillip Jr. as Acting Medicaid Director

    Tennessee Medicaid Block Grant Receives CMS Approval

    CMS Withdraws Medicaid Fiscal Accountability Rule

  • This week, our In Focus section reviews the Hawaii Quest Integration (QI) Medicaid managed care request for proposals (RFP) released on December 8, 2020, and the Minnesota Families and Children Medical Assistance (MA) and MinnesotaCare programs RFP released on January Read More
    Roundup:

    Hawaii Releases Medicaid Dental TPA RFI

    Indiana Governor To Make Long-Term Care Reform a Priority

    Kentucky Awards Medicaid Managed Care PBM Contract

    Kentucky Awards Aetna Foster Care Contract

    Minnesota Releases Medicaid Managed Care RFP

    Nevada to Implement D-SNP Program in 2021

    New Jersey DHS Commissioner to Join Biden COVID-19 Team

    South Carolina Bills Propose Medicaid Expansion Referendum

    Texas Releases Medicaid Plan Procurement Timelines

    Congress Gives Medicare Physicians 2021 Pay Boost

  • This week, our In Focus section focuses on five critical policy and program trends to provide integrated care to dual-eligible individuals for Medicare and Medicaid. Both federal and state governments continue to look for ways to improve coordination and integration Read More
    Roundup:

    District of Columbia Judge Rules Medicaid Managed Care Procurement Violated Law

    Florida Medicaid Finds $89.6 Million Differential Between Prices Paid to PBMs, Prices Paid to Pharmacies

    Hawaii Medicaid Plans Sought to Limit Number of Award Winners in Current Procurement

    Louisiana to Release Medicaid Managed Care RFP in Spring

    South Carolina Medicaid Director to Step Down

    Texas Sees High Early Turn Out for Exchange Plans

    MACPAC Releases 2020 MACStats Medicaid, CHIP Data Book

  • This week, our In Focus section reviews the finalized coverage expansions for Medicare telehealth services in the Centers for Medicare & Medicaid Services (CMS) Calendar Year (CY) 2021 Physician Fee Schedule (PFS) Final Rule. Telehealth advocates will be pleased to Read More
    Roundup:

    Hawaii Releases RFP For QUEST Integration Medicaid Plans

    Missouri RFP to Carve-in Behavioral Health for Foster Kids

    Montana Receives One-Year Extension of Medicaid Expansion

    New York to Seek Medicaid Redesign Team Waiver Extension

    Ohio Taps Gainwell As Medicaid Fiscal Intermediary

    Oklahoma Medicaid Waiver Providers to Receive 20 Percent Retroactive Rate Adjustment

    Biden’s Potential Administrative Actions Could Impact Six Key Medicaid Regulations, Policies, Kaiser Reports

  • This week, our In Focus section reviews the statewide North Carolina request for applications (RFA) for Behavioral Health and Intellectual/Developmental Disability (BH IDD) Tailored Plans released by the North Carolina Department of Health and Human Services (DHHS) on November 13, Read More
    Roundup:

    Arizona to Release Procurement in August 2021 for Expanded Integrated SMI, Medicaid Managed Care Program

    Delaware Care Collaborative to Serve as Medicaid, CHIP ACO

    New Jersey Medicaid Plan to Terminate Contract with Children’s Hospital of Philadelphia

    Oregon Governor Proposes Medicaid Cuts

    Oregon CCOs Post 0.6 Percent Operating Margin

    Pennsylvania Enacts Medicaid PBM Price Transparency Law

    Texas to Drop Planned Parenthood From Medicaid Network

    CMS Releases 2021 Physician Fee Schedule