HMA Weekly Roundup

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  • 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

    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

    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

    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

    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

  • This week, our In Focus section covers the report, Medicaid Expansion in Missouri – Economic Implications for Missouri and Interviews Reflecting Arkansas, Indiana, and Ohio Experiences, prepared by HMA Medicaid Market Solutions (MMS) Managing Director Matt Powers and Managing Principal Read More

    DC Medicaid Managed Care RFP Deadline Is Extended to February 14

    Georgia Proposal to Drop ACA Exchange Is Delayed by Trump Administration

    Illinois Medicaid Director to Step Down

    Senate Committee Advances Bill to Limit Number of Medicaid Plans, Eliminate Role of PBMs

    Texas HHSC Commissioner to Step Down

    Medicaid Expansion updates in Missouri, Tennessee, Wyoming

    Proposed HHS Funding Cuts to Impact Medicaid, Medicare

    States Criticize Proposed Medicaid Fiscal Accountability Rule

  • This week, our In Focus section comes from HMA Medicaid Market Solutions (MMS) Managing Director Matt Powers and Senior Consultant Desmond Banks. On January 30, 2020, the Centers for Medicare & Medicaid Services (CMS) convened an event titled, Transforming Medicaid: Read More

    California Health Plan Tax Is Blocked

    California Taps Brad Gilbert for Health Care Services Post

    Florida Bill Would Require ‘Essential’ Providers to Contract with Medicaid Plans or Lose Supplemental Payments

    Idaho Releases Behavioral Health Plan RFI

    Montana Hopes to Invest in Community-Based Mental Health

    Oklahoma Governor Announces Medicaid Plan, Including Alternative Expansion, Managed Care, Block Grants

    Pennsylvania Partners with Medicaid Plans on Jobs, Training

    Tennessee Governor Hopes to Extend Medicaid Postpartum Coverage to Full Year

    Texas Further Delays STAR, CHIP Medicaid Plan Awards

  • This week, our In Focus section reviews value-based payment (VBP) opportunities for long-term care providers. HMA Principal Dana McHugh authored the article, “Life Plan Communities and Value-Based Payments: Aligning Incentives So Everyone Benefits”, for LeadingAge national magazine, discussing how life Read More

    Hawaii Announces Medicaid QUEST Integration Awards

    Louisiana Health Department, Medicaid Plans Appeal Decision to Throw Out Contracts

    Nevada Intends to Issue Medicaid Managed Care RFP in January 2021

    New Jersey Temporarily Freezes Enrollment in UnitedHealth Medicaid Plan

    WellCare Withdraws Protest Against Texas STAR+PLUS Awards

    Medicaid Expansion Updates in Kansas, Missouri, Oklahoma, Wyoming

    Supreme Court Allows Trump Administration to Enforce Public Charge Rule

  • This week, our In Focus section reviews two Medicaid managed care requests for proposals (RFPs) released on January 10, 2020. The District of Columbia Department of Health Care Finance (DHCF) issued an RFP for the DC Healthy Families Program (DCHFP); Read More

    Medicaid Director Changes: California, Minnesota, Tennessee

    Illinois Again Delays Transition to Managed Foster Kids

    Kansas Governor to Prioritize Medicaid Expansion

    Louisiana to Rebid Medicaid Managed Care Contracts

    New York Medicaid Redesign Team to Tackle Budget Shortfall

    Ohio Issues Plan to Address Medicaid Applications Backlog

    Pennsylvania-based Hospital May Buy Health Partners Plans

    Texas Wins Approval of Medicaid Waiver for Women’s Health

    CMS to Again Issue Guidance on Medicaid Block Grants

  • This week, our In Focus section reviews the Texas STAR Kids Medicaid Managed Care in the Dallas Service Area (SA) request for proposals (RFP) released by the Texas Health and Human Services Commission (HHSC) on December 13, 2019. The RFP Read More

    Arkansas PBM Case To Be Heard by U.S. Supreme Court

    District of Columbia Releases Medicaid Managed Care RFP

    Medicaid Expansion News: Florida, Kansas

    Kentucky Releases Medicaid Managed Care RFP

    Montana Awards Contract for Medicaid Medical Review

    North Carolina Hasn’t Yet Set Medicaid Managed Care Transition Date, Official Says

    Oklahoma Files Lawsuit Against Three Opioid Distributors

    Rhode Island Issues Rite Smiles Medicaid Managed Dental LOI

    Texas Delays Dallas Area STAR Kids RFP Implementation Date

  • This week, our In Focus section reviews the West Virginia Mountain Health Trust request for proposals (RFP) released by the West Virginia Department of Administration (DOA) for the Department for Health and Human Resources (DHHR) on December 17, 2019. Mountain Read More

    District of Columbia Releases Medicaid Quality Strategy

    Expansion News: Georgia, Iowa, Kansas, Michigan, Mississippi, Nebraska, Utah, Wyoming

    Kentucky to Rebid Medicaid Managed Care Contracts

    Louisiana Awaits Approval of Emergency Medicaid Contracts

    Massachusetts Announces One Care Dual Demo Awards

    New York to Cut Medicaid Provider Reimbursements 1 Percent

    Pharmacy News: New York, Ohio, Pennsylvania

    Transportation News: Oregon, Texas

    Rhode Island Issues Medicaid Dual Eligible Strategy RFI

    WellCare Protests Texas STAR+PLUS Awards