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- While the current federal COVID-19 Public Health Emergency (PHE) declaration could be in place through the winter months, HMA’s team of experts see many reasons to put the PHE’s Medicaid unwinding planning at the top of your list now. Read MoreRoundup:
Alabama Doubles Covered Physician Visits for Medicaid Enrollees Receiving Cancer Treatment
California Medi-Cal Procurement Protests Continue
California Releases Third-Party Monitoring RFI
Delaware Names First Director of Value-Based Healthcare Delivery
Illinois YouthCare Fails to Deliver Basic Medical Services to Foster Children, Investigation Finds
Medicaid Expansion News: Kansas, North Carolina
Elevance Files Appeal After Its Protest of Nebraska Medicaid Managed Care Awards is Denied
Maryland Declines to Pursue Higher Damages Against Medicaid Behavioral Health ASO
Ohio Delays Implementation of New Medicaid Managed Care Contracts to February 2023
Oklahoma Re-releases Medicaid Managed Care RFP
Wisconsin Releases External Quality Review, Quality Improvement Services RFP
CMS Targets Gaps in Health Equity Data, To Gradually Release Equity Scores
Sanford Health, Fairview Health Services Agree to Merge
- This week, our In Focus section reviews highlights and shares key takeaways from the 22nd annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 25, 2022, in Read MoreRoundup:
California Medi-Cal Members Can Now Fill Prescriptions at Costco
Florida Healthcare Groups File Challenge to $15 Minimum Wage Budget Provision
Hawaii Works With HMA to Develop Medicaid Social Determinants of Health Initiative
Massachusetts Home Health Care Workforce Decreases by 13 Percent from 2019 to 2022
Nebraska Says Protest of Medicaid Managed Care Contracts Will Not Delay Implementation
New Hampshire Executive Council Approves Medicaid Dental Contract
Pennsylvania Receives Federal Approval to Extend Postpartum Medicaid Coverage to 12 Months
South Dakota Voters Approve Medicaid Expansion
Virginia Projects ‘Tiny’ Increase in Fiscal 2024 State Medicaid Costs
Medicaid FFS More Likely to Cover Opioid Use Disorder Treatment than Medicaid Managed Care
Medicaid Plans Report Barriers to Telehealth Access
19 States Have Implemented Strategies to Increase Direct Care Worker Wages, Report Finds
CNSI, Kepro to Merge; Apax Partners to Exit
Walgreens’ VillageMD to Acquire Summit Health
Clover Health to Reduce Medicare ACO REACH Population by Two-Thirds in 2023
- This week, our In Focus section reviews the remaining Medicare payment and policy rules, finalized over the last several days by the Centers for Medicare & Medicaid Services (CMS), that will shape the landscape for the Medicare program in 2023 Read MoreRoundup:
Alabama Releases Medicaid Modernization Program System Integration Services RFP
Arkansas Receives Approval to Expand Community-Based Care for Certain High-Risk Individuals
District of Columbia Mayor Calls for Investigation Into Awarded Medicaid Managed Contracts
Michigan Medicaid Plan Meridian Appoints Patricia Graham as CEO
Mississippi Submits 1115 Waiver Extension Application for Aged, Blind, Disabled Individuals
New Hampshire to Award Adult Medicaid Dental Contract to Delta Dental
South Dakota Seeks Five-Year Extension of Former Foster Care Youth Medicaid 1115 Waiver
Tennessee Seeks to Extend Enhanced HCBS Supports
Vermont Releases Medicaid IV&V RFP
Wisconsin Receives Federal Approval to Use CHIP Funds For Housing Support
HHS Bolsters Medicare Behavioral, Dental, Cancer Care in Physician Fee Schedule Final Rule
HHS Focuses on Rural Health Equity in Hospital, Surgical Center Payment System Final Rule
Walgreens’ VillageMD Reportedly Explores Merger With Summit Health
- This week, our In Focus section highlights the Health Affairs article, Advancing Health Equity and Integrated Care for Rural Dual Eligibles, authored by Ellen Breslin , Samantha Di Paola , Susan McGeehan , Rebecca Kellenberg , Read MoreRoundup:
Georgia Children on Medicaid, CHIP Face Behavioral Health Access Barriers
Medicaid Dental News: Kentucky, New Hampshire, Nevada
North Carolina Says Hospitals Profited from Medicare, Despite Claims of Losses
PBM News: Ohio, Puerto Rico, Centene
OR Seeks $1.5 Billion Increase in Medicaid Funds for 2023-25 Biennial Budget
Pennsylvania Lawmakers Consider Prior Authorization Legislation
States Leverage Medicaid Managed Care to Improve Health Equity, KFF Finds
Community Medicare Advantage Plans Are Leaders in Quality, ACHP Finds
- This week, our In Focus section reviews the Mountain Health Promise request for proposals (RFP) released by the West Virginia Department of Health and Human Resources on September 30, 2022, for specialized Medicaid managed care for children and youth in Read MoreRoundup:
Arizona Receives Federal Approval of Waiver to Address Housing Needs
District of Columbia Council Approves Medicaid Managed Care Contracts Idaho Delays Behavioral Medicaid Awards to November 2022
Indiana Awards Medicaid FFS Prior Authorization, Utilization Management Contract to Kepro
Kansas, Gainwell Implement Modular Medicaid Technology Platform
Nevada Governor Tells SEIU He Will Push for Higher Payment Rates, Wages for Home Care Providers
New York Fails to Follow Up on Dual Eligible Cost Savings Opportunities, Comptroller Finds
Pennsylvania Senate Committee Passes Resolution to Study Medicaid Addiction Treatment Reimbursement Rates
HHS Offers States Certified Community Behavioral Health Clinic Planning Grants
CMS Agrees to Release Audits of 90 Medicare Advantage Plans
Acorn Health Acquires 7 Applied Behavior Analysis Centers in FL, VA For Children With Autism
Brave Health Secures $40 Million in Latest Funding Round to Expand Virtual Medicaid Behavioral Health Services
- This week, our In Focus explores a new trend to watch in Medicaid Section 1115 waiver demonstration programs. Read MoreRoundup:
California Faces Lawsuit from Health Plan Over Alleged Public Records Act Violation
Kansas to Hold Public Meetings on KanCare With Beneficiaries, Stakeholders
Massachusetts to Transition Dual Eligibles from MMP Demo to D-SNP
Mississippi Submits Amendment to Increase Reimbursement Rates for Private Duty Nurses by 15 Percent
Oklahoma Gubernatorial Candidates Clash on Medicaid Managed Care Implementation
Texas Releases STAR, CHIP Draft RFP
Utah to Transition to New MMIS in 2023
West Virginia Releases RFP for Foster Children, Youth in Medicaid Managed Care
Treasury Announces Rules Aimed at Fixing Exchange Plan ‘Family Glitch’
Walgreens Boots Alliance to Acquire Remaining 45 Percent Stake in CareCentrix
Cimarron Healthcare Capital, Tacoma Holdings Invest in Frontpoint Health
- This week, our In Focus reviews the New Mexico Medicaid managed care request for proposals (RFP), released on September 30, 2022, by the New Mexico Human Services Department (HSD). Read MoreRoundup:
Colorado Releases Medicaid, CHIP Enrollment Broker Services RFP
Louisiana to Begin Auto Assignment of Medicaid Beneficiaries into Managed Care Plans
Maine Looks to Renew NEMT Waiver, Release RFP
Minnesota Awards Medicaid Managed Care Contracts Covering Individuals Outside Twin Cities, Elderly, Disabled
Nebraska Seeks Funds to Cover Aduhelm, Reduce Waiting List for Individuals With Development Disabilities
New York Medicaid Fraud, Waste Reduction Efforts Yield Results
North Carolina Delays Implementation of Behavioral Health IDD Tailored Plans to April 2023
North Dakota Leads Country in Rate of Physicians Accepting New Medicaid Patients, Analysis Finds
Ohio Governor Looks to Expand Medicaid Eligibility for Pregnant Women to 300 Percent of Poverty
Oklahoma Implements 25 Percent Rate Increase for Developmental Disability, HCBS Providers
HCSC Names Anne Rote President of Medicaid Division
Federal Grants Topping $346 Million Awarded to Address Healthcare Staffing Shortages
Ensign Group May Soon Become Largest Nursing Home Provider in U.S.
- This week, our In Focus section looks at the current federal policy landscape and trends and the legislative outlook for the remainder of 2022 and beyond. Read MoreRoundup:
Arizona Medicaid Director to Step Down at the End of 2022
Colorado Appoints Adela Flores-Brennan as Medicaid Director
Centene Names Bill Wilson CEO of Delaware Medicaid Plan
Kansas Begins Distributing $51 Million in Bonuses for Direct Care Workers at Medicaid HCBS Providers
Massachusetts Receives Federal Approval to Extend MassHealth 1115 Waiver Through 2027
Nebraska Awards Medicaid Managed Care Contracts to 3 Health Plans
Nevada Releases Electronic Visit Verification System RFP
Oregon 1115 Waiver Renewal Is Approved by Federal Regulators
Texas Report Recommends Transitioning Medicaid-Only Services into Managed Care for Dual Eligibles
Virginia Medicaid Provider Sets Up Neighborhood Clinics to Expand Access to Preventive Health Care
OIG Calls For Increased Oversight of Medicaid Plan MLR Reporting
DentaQuest Commits $275,000 to Initiative Connecting Children to Dental Care
- This week, our In Focus section highlights an issue brief from Wakely, an HMA Company, The Basics of Evaluating PBM Contracts, published September 2022. Read MoreRoundup:
Cityblock to Serve About 10,000 MDWise Members in Indiana
Kentucky Appeals Panel Upholds 2020 Medicaid Managed Care Contracts With 5 Plans, Excluding Elevance Health
Missouri Meets Federal Requirement of 45 Days for Processing Medicaid Expansion Applications
New York PACE Could Expand Dramatically Under Bill Awaiting Governor’s Signature
Ohio Releases Medicaid Electronic Visit Verification Services RFP
AbsoluteCare Expands Into Pittsburgh Through Collaboration With Highmark Wholecare
Tennessee Is Hit With Lawsuit Over Medicaid Managed Care Procurement
Texas to Receive $165.6 Million in Settlement Over Medicaid Drug Pricing
Medicaid Eligibility Redeterminations Could Take 12 Months Following PHE, State Regulators Say
NCQA, CHCF Release Framework to Measure Health Equity in Medicaid Managed Care
UnitedHealth Group Is Cleared to Acquire Change Healthcare
Humana to Fully Acquire 20 Senior Primary Care Clinics After Buying Out Welsh, Carson’s Stake
- This week, our In Focus highlights a Health Management Associates Institute on Addiction (HMA IOA) report, Delaware Substance Use Disorder Treatment System Needs Assessment, published in June 2022. Read MoreRoundup:
Kentucky Seeks to Expand Number of PACE Providers, Counties Served
Montana Medicaid Reimbursement Rates Are 22 Percent Below Benchmarks, Study Finds
New York Proposes 1115 Waiver Amendment to Address Equity, Housing, Workforce Shortages
Oregon Medicaid Mobile Crisis Intervention Services Program Receives CMS Approval
Texas Awards STAR Health Contract to Centene/Superior HealthPlan
CareSource, Legacy Community Health Form Joint Venture to Bid on Texas STAR, CHIP RFP
CMS to Phase Out D-SNP Look-Alikes Within Medicare Advantage in 2023
Illinois Review Board to Reconsider Merger of Advocate Aurora, Atrium Health
