HMA Weekly Roundup

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  • This week, our In Focus section reviews the Covered Outpatient Drugs final rule published by the Centers for Medicare & Medicaid Services (CMS) on January 21, 2016, addressing Medicaid drug reimbursement and changes to the Medicaid Drug Rebate Program. The Read More
    Roundup:

    Medicaid Expansion Updates in Georgia, Kansas, Louisiana, New Hampshire, Tennessee, Utah, and Wyoming

    Iowa On Track for March 1 Managed Care Transition

    New York HARP Enrollment Update

    Pennsylvania MLTSS RFP Scheduled for February Release

    CBO Lowers Exchange Enrollment Projections

    HHS Report Finds Most Medicaid Children Not Receiving All Required Dental Care

    CMS To Help Co-ops Find Investors

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated risk-based managed care in 24 states. Many state Medicaid agencies elect to post to their websites monthly enrollment figures by health plan for their Medicaid managed Read More
    Roundup:

    Nebraska considers Medicaid expansion

    Georgia requests extension of Medicaid MCO contracts

    New York Governor's budget calls for minimum MLR, drug price caps

    New Jersey MLTSS update

    White House proposes extension of 3-year federal subsidy for new expansion states

  • This week our In Focus section highlights key issues that are likely to dominate the Medicaid and health policy landscape in 2016 in states in which HMA has offices. The HMA team identified issues and milestones that will feature prominently Read More
    Roundup:

    Louisiana Governor Expands Medicaid

    Missouri Formalizes Plans for Statewide Managed Care

    North Carolina on Track for Managed Care in 2018/19

    Virginia Governor Renews Push for Medicaid Expansion

    Idaho Governor Proposes Covering 78,000 in “Coverage Gap”

    Kentucky Governor Moves to End State Exchange

    Medicaid Directors, Providers Respond to CMS Access Rule

  • This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 report. Specifically, we provide some analysis around the sharp acceleration in Medicaid managed care spending in federal fiscal year (FFY) 2015. This increase reflects the Read More
    Roundup:

    Alabama Considers Coverage Expansion

    Arkansas Rejects Medicaid Managed Care

    CMS Approves California’s $6 Billion Waiver

    Idaho Medicaid Provider Cuts Delayed

    CMS Delays Iowa Managed Care Program Implementation

    Kentucky to Develop Medicaid Expansion Waiver

    Nebraska Announces Medicaid MCO RFP Bidders

    Pennsylvania Stopgap Budget Releases Back Payments

  • This week, our In Focus section reviews Virginia’s Section 1115 demonstration waiver, which is currently posted for stakeholder review and a public comment period. The 1115 waiver seeks approval from the Centers for Medicare & Medicaid Services (CMS) to implement Read More
    Roundup:

    New York Announces FIDA Reforms

    Michigan Legislature to Vote on Health Insurer Tax

    Florida Posts MLTC Waiver Amendment for Public Comment

    Oklahoma Medicaid Approves 3 Percent Rate Reduction

    Oregon Appoints Coyner as New Medicaid Director

    Utah Medicaid Director to Step Down

    North Carolina Health Systems to Form Managed Care Entity

    Federal Budget Deal Suspends Health Insurer Fee for 2017

  • This week, our In Focus section reviews the annual Medicaid health plan ratings released in September by the National Committee for Quality Assurance (NCQA). NCQA has previously provided annual rankings and quality scores of private commercial health plans serving employers Read More
    Roundup:

    EmblemHealth Leaving New York’s MLTC Market

    Update on Coordinated Care Organizations in Oregon

    California AG Approves Daughters of Charity Deal

    FTC Rejects Hershey-Pinnacle Merger in Pennsylvania

    South Dakota Governor Proposes Medicaid Expansion

    Non-profit Hospital Financials Improved following ACA

  • This week, our In Focus section reviews the decision announced this week by the Oklahoma Health Care Authority (OHCA) on the care coordination model selected to serve the aged, blind, and disabled (ABD) Medicaid population. OHCA has selected a fully Read More
    Roundup:

    Valence Health Awarded CountyCare Medicaid Contract

    Corizon Cancels Florida Prison Health Contract

    Iowa Judge Recommends WellCare’s Contract Award be Rescinded

    Kentucky Governor Plans to Close Kynect, Shift Consumers to Federal Exchange

    Empire Announces Exit from New York FIDA Program

    Eleven Companies Respond to Pennsylvania Medicaid MCO RFP

    Washington Announces Apple Health Contract Awards

  • This week, our In Focus section reviews the draft request for proposals (RFP) for the Pennsylvania Community HealthChoices (CHC) program, which will coordinate physical health services and long term services and supports (LTSS) under a new statewide managed care program. Read More
    Roundup:

    Michigan Medicaid MCO Award Recommendations Approved

    Updates from Georgia DCH Board Meeting

    California to Begin Paying Overtime for Home Care Workers

    Connecticut Nursing Home Wages Agreement Reached

    New York Co-Op to Cease Operations at End of Month

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

    New York, CMS agree on plan to Develop I/DD Duals Demo

    South Dakota, Nebraska, Virginia Considering Expanding Medicaid

    Colorado to Vote on Universal Healthcare Proposal

    CMS Warns States on Hepatitis C Treatment Restrictions

  • This week, our In Focus section reviews the request for proposal (RFP) issued by the State of Nebraska on October 21, 2015, for the statewide rebid of their Medicaid managed care programs, integrating physical and behavioral health for nearly all Read More
    Roundup:

    California, CMS Agree on Conceptual Framework for 1115 Waiver Renewal

    Maryland Healthy Smiles Contract Awarded to Scion Dental

    CMS Approves Montana Medicaid Expansion Proposal

    Six MCOs Protest Michigan Contract Awards

    Pennsylvania Pushes Back MLTSS Procurement

    Jessee Named Texas Medicaid Director

    Wallack Named Rhode Island Medicaid Director