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- This week our In Focus section reviews President Joseph R. Biden’s 2023 State of the Union Address (SOTU) to Congress. Read MoreRoundup:
Alabama Legislative Committee Puts Hold on Inmate Health Contract
Florida CHIP Enrollment Likely to Increase as Medicaid Redeterminations Begin
Indiana House Passes Bill to Continue Medicaid Coverage of Children’s Out-of-State Hospital Care
Michigan Governor Proposes $210 Million to Increase Wages for Direct Care Workers in Fiscal 2024 Budget
Minnesota Lawmakers Develop Proposal for MinnesotaCare Public Option
Missouri Representative Proposes Higher Income Limit for Ticket to Work Medicaid Program
Montana Lawmakers Consider Bill to Allow Physician Assistants to Practice Unsupervised
New Mexico Awards MMIS Contract to Conduent
New York Awards $658 Million in Grants to Expand Healthcare Access
North Carolina House Committees Advance Bill to Expand Medicaid, Increase Hospital Reimbursements
Tennessee Governor Proposes Expanding Medicaid Eligibility Limits for Pregnant Women, Caretakers
Virginia to Release Medicaid Managed Care RFP in June 2023
Virginia to Release Medicaid NEMT RFP in April 2023
West Virginia Awards Medicaid Managed Care for Foster Care Youth Contract
CMS Approves Programs to Provide Nutritional Supports for Medicaid Enrollees
Consonance Capital Partners Acquires Embark Behavioral Health
Wakely Summary of 2024 MA Advance Notice
- This week, our In Focus section reviews recently announced major policy updates from the Centers for Medicare & Medicaid Services (CMS) that affect the Medicare Advantage (MA) and Part D programs. Read MoreRoundup:
Alaska Releases MMIS RFP California Awards $18 Million in Grants for Student Behavioral Health Center Training
California Awards $18 Million in Grants for Student Behavioral Health Center Training
Florida Appoints Ken Kniepmann as Assistant Deputy Secretary for Medicaid Policy and Quality
Medicaid Expansion News: Florida, Kansas, Mississippi
Idaho Senate Panel Recommends Focus on Prevention Through Managed Care for Medicaid Expansion Population
Idaho Delays Award of Behavioral Health Plan Contract Pending Appeals Process
New York Governor Prioritizes Medicaid Reimbursement Increases, Behavioral Health in Fiscal 2024 Budget
North Carolina Seeks Waiver Amendment to Extend Medicaid Eligibility to Parents, Caretakers of Children in Foster Care
North Carolina Announces Retirement of Medicaid Director Dave Richard
Oklahoma to Apply for Medicaid Managed Care Waiver
Vermont Releases Technical Assistance for Medicaid Supportive Housing Program RFP
Federal Judge Rules Against Disenrollment of Medicaid Members Who Are Eligible for Medicare Savings Program
CMS Officials Aim to Establish Universal Quality Measures Across Programs
CVS Health to Acquire Oak Street Health
Carlyle Group Looks to Acquire of Cotiviti from Veritas Capital
- This week, our In Focus section reviews the California amendment to the Section 1115 Waiver Demonstration titled, “California Advancing and Innovating Medi-Cal (CalAIM), ” approved by the Centers for Medicare & Medicaid Services (CMS) on January 26, 2023. Read MoreRoundup:
California Awards $119 Million to 98 Organizations to Improve Medicaid Delivery System
California Insurer to Offer Digital Health App to Medicaid Enrollees
Iowa House Committee Advances Medicaid Work Requirements Bill
Indiana Reaches $66.5 Million Settlement with Former PBM
Michigan Releases Child, Adolescent Health Center Program RFP
Minnesota Attorney General Asks for Delay of Sanford Health, Fairview Health Services Merger
Mississippi Senator, Representative File Medicaid Expansion Bills
North Carolina to Move Children Covered by CHIP to Medicaid
New Mexico Cancels Medicaid Managed Care RFP
South Dakota Legislators Propose Medicaid Expansion Fund
Texas Awards STAR+PLUS Medicaid Managed Care Contracts to 7 Plans
Utah Senate Passes Legislation to Extend Medicaid Dental Coverage
CMS Proposes Updates to Medicare Advantage Risk Adjustment Model in 2024 Advance Notice
CMS Will Not Impose Major Penalties on Medicare Advantage Plans for Overpayments
CMS Outlines PHE Unwinding Requirements, Phase Out of FMAP Increase
CVS Health Invests $32.7 Million in Affordable Housing in NC, TX
- Lee Fleisher, MD, chief medical officer and director of CMS’ Center for Clinical Standards and Quality, will deliver the morning keynote address at HMA’s March 6 conference on “Healthcare Quality: A Deep Dive on What’s Next for Providers, Payers, Read MoreRoundup:
Arkansas Legislature Faces Potential Hurdles for Funding Medicaid Expansion
Arizona Governor Proposes $2.7 Million to Modernize Medicaid Enterprise System
Georgia House Speaker Does Not Plan to Take Up Medicaid Expansion
Massachusetts Governor Appoints Kate Walsh as Secretary of Health, Human Services
Michigan Provides Pregnancy App for Eligible Medicaid Beneficiaries
New Mexico Medicaid Director to Step Down
New Mexico Has Yet to Announce Medicaid Managed Care Awards
Oklahoma Awards Medicaid Dental Contracts to 2 Plans
Rhode Island Legislators Introduce Medicaid Housing Supports Pilot Proposal
Wisconsin Adds Medicaid Work Requirement Advisory Referendum to April Ballot
Wyoming Appoints Lee Grossman as State Medicaid Agent, Senior Administrator
Exchange Plan Enrollment Rises Nearly 13 Percent to 16.3 Million in 2023
FCC Clears Medicaid Plans to Text, Robocall Beneficiaries for Eligibility Redeterminations
Elevance Health to Acquire BCBS of LA
- In 2022, HMA convened stakeholder roundtables in three states – including New Mexico, North Dakota, and New Mexico to identify the challenges facing dually eligible individuals living in rural areas and to propose solutions to these challenges. Informed by this Read MoreIn Focus:Roundup:
Arkansas Releases RFI for Medicaid Managed Care Module of MMIS Replacement
Florida Governor Announces Proposal to Regulate PBMs
Medicaid Expansion News: Georgia, Kansas, Mississippi, North Carolina, South Dakota
Georgia Releases RFI to Audit PBMs Contracted Through Medicaid Plans
Louisiana Releases RFP for Permanent Supportive Housing Services Funded in Part by Medicaid
Michigan Doulas Push for Higher Medicaid Reimbursement Rates
Mississippi Seeks Bids for Medicaid FFS Non-emergency Transportation Services
South Carolina to Continue Several Flexibilities After COVID-19 PHE Ends
CMS Announces Medicare Accountable Care Partnerships Will Cover 13.2 Million Enrollees in 2023
Health Network One Acquires Premier Eye Care
- This week, our In Focus section reviews changes to Medicaid’s COVID-19 Public Health Emergency (PHE) unwinding. Read MoreRoundup:
Arizona Medicare Plan Receives $60 Million Investment from Chicago Pacific Founder to Launch ESRD C-SNP
California Revises List of Medicaid Managed Care Award Winners in Several Counties
Connecticut Expands Medicaid Eligibility for Children Effective January 1
Florida Appoints Jason Weida as Interim Secretary
Georgia Releases RFQC for Medicaid Managed Care Plans
Georgia Establishes State Exchange Directing Buyers to Brokers, Insurers
Idaho Legislators to Review Medicaid Expansion
Maine to Seek Renewal of Waivers for Adults in Need of Home and Community-based Services
Maryland Releases Behavioral Health ASO RFP
Maryland Implements Medicaid Comprehensive Dental Coverage
Massachusetts Selects 20 Community Partners for ACO Behavioral Health, LTSS
Nevada Receives Federal Approval for SUD Treatment Waiver
New Hampshire Legislature to Vote on Reauthorization of Medicaid Expansion Funding
New York Governor Announces $1 Billion Plan to Address Behavioral Health
North Dakota Releases Medicaid Enterprise Technical Systems Integrator RFP
Oklahoma Faces Lawsuit from Provider-led Entity Regarding Managed Care Procurement
Oregon Approves Amazon Acquisition of One Medical
Rhode Island Releases NEMT Program RFQ
Wisconsin Names Jamie Kuhn as Medicaid Director
HHS Extends Public Health Emergency Until April 11
CMS Allows States, Medicaid Plans to Spend 5 Percent of Premiums on Social Determinants of Health
CVS Health Considers Acquisition of Oak Street Health
- This week, our In Focus section reviews a rule proposed by the Centers for Medicare & Medicaid Services (CMS) on December 14, 2022, that would revise regulations governing Medicare Advantage (MA or Part C), the Medicare Prescription Drug Benefit (Part Read MoreRoundup:
California to Transition Dual Eligibles in 31 Counties to Medi-Cal Managed Care Plans in January 2023
Georgia Receives Approval for 2 State-Directed Payment Programs
Hawaii Governor Proposes Medicaid Provider Reimbursement Rate Increases
Iowa Releases Medicaid Enterprise Systems RFI
Idaho Looks to Expand Access to Crisis Services for Individuals with Developmental Disabilities
Indiana Releases Medicaid NEMT RFP
New Mexico Proposes 16 New Programs in Section 1115 Medicaid Waiver Renewal Application
New York Medicaid Pharmacy Carve-Out Could Cost $400 Million More Annually, Wakely Report Finds
Oregon Governor-Elect to Appoint James Schroeder as Interim Director of OHA
Puerto Rico to Receive $17.6 Billion in Medicaid Funding Over 5 Years Under Omnibus Spending Bill
Vermont Considers Punitive Cuts to 2023 All-Payer ACO Budget
Washington Receives Federal Approval to Offer Exchange Plans to Non-Citizens
Medicaid Eligibility Redeterminations to Begin April 2023 Under Omnibus Spending Bill
Rise Health Secures Investments from Lorient Capital, Martis Capital
- This week, our In Focus section reviews the State of Texas Access Reform (STAR), Children’s Health Insurance Program (CHIP), and Healthy Texas Women (HTW) Medicaid managed care request for proposals (RFP) released by the Texas Health and Human Services Commission Read MoreRoundup:
California to Sanction 22 Medi-Cal Plans for Poor Quality Ratings
California Governor Awards $480.5 Million in Grants for Youth Behavioral Health Infrastructure
Connecticut Governor to Appoint Andrea Barton Reeves Commissioner of Social Services
Massachusetts Medicaid Secretary To Step Down
Minnesota Judge Blocks Managed Care Plan from Expanding Board of Directors
Missouri, Mississippi, Montana, Wyoming Are Expected to Extend Medicaid Postpartum Eligibility in 2023
Nevada Releases External Quality Review Organization RFP
North Carolina Faces Lawsuit for Foster Children in Residential Psychiatric Treatment Facilities
Wyoming Requests $22 Million to Increase Nursing Home Medicaid Reimbursement Rates in 2024
CMS Rule Would Increase Availability of Standardized Exchange Plans
MedPAC Draft Recommendations Call for Medicare Payment Increases for Hospitals, Physicians in 2024
Exchange Enrollment Rises 18 Percent in First Five Weeks of Open Enrollment
SCAN Group, CareOregon to Merge as HealthRight Group
Centene Names New President, Chief Operating Officer, Other Leadership Changes
- This week, our In Focus highlights a Leavitt Partners white paper, The Impact of the 340B Program on Drug Prices Charged by Manufacturers and Covered Entities, published in November 2022. Read MoreIn Focus:Roundup:
North Carolina Appeals Ruling on Additional Community Services for Individuals with Disabilities
New Mexico Health Plan Submits Bid for New Medicaid Managed Care Contract
New York SMI Treatment Programs Face Over 1,000-Person Waiting List
Oregon Reaches $17 Million Settlement with Former PBM
Tennessee to Release Dental Benefit Management RFP in Late 2023
Texas Releases STAR & CHIP Managed Care Services RFP
Wisconsin Receives Approval to Continue Exchange Plan Reinsurance Program Through 2028
HHS Releases Medicaid, CHIP FMAP for Fiscal 2024
Defense Misses Deadline for Announcing Tricare Contract Awards
Prime Therapeutics Completes Acquisition of Magellan Rx Management from Centene
- This week, our In Focus reviews the Oklahoma Medicaid managed care SoonerSelect Program request for proposals (RFP) and the SoonerSelect Children’s Specialty Program RFP released by the Oklahoma Health Care Authority (OHCA) on November 10, 2022. Read MoreRoundup:
Arkansas Medicaid Looks to Expand Access to Behavioral, Mental Health Services
California Seeks Approval to Limit Medicaid Managed Care Choice in Metro, Urban Counties
PHE News: Delaware, New Mexico, Tennessee
Florida Medicaid Secretary Is Stepping Down
Florida Releases Medicaid Managed Care Data Books Ahead of Procurement Process
Georgia to Implement Medicaid Work Requirements After Public Health Emergency Ends
Idaho Delays Medicaid Behavioral Health Plan Contract Award
Michigan to Cover Doula Services for Medicaid Beneficiaries in 2023
Mississippi Managed Care Enrollment Falls As State Shifts Members to FFS During Pandemic
Montana Faces Lawsuit Concerning Hiring of Medicaid Director
Oklahoma Releases SoonerSelect Children’s Specialty Program RFP Covering Foster Kids
Oregon Proposes Continuous Medicaid Coverage for Beneficiaries Until Basic Health Program Launch
Medicare Advantage Plans Overbilled Government by Over $1,000 Per Patient Yearly, Audits Find
CMS Reports $70 Million in Medicare Savings Through Direct Contracting Model in 2021
Centene Sells Magellan Specialty Health to Evolent Health
