HMA Weekly Roundup

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  • This week, our In Focus section reviews highlights and major findings from the study, Beyond the Numbers: Access to Reproductive Health Care for Low-Income Women in Five Communities, conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Read More

    Arkansas to Limit Health Plan Ownership of PASSEs

    Florida AHCA Secretary Addresses Medicaid Funding Priorities in Governor’s Budget Proposal

    Massachusetts Issues Social Determinants of Health RFP

    Puerto Rico Medicaid Funding Is Reduced

    Texas Faces Lawsuit Over STAR+PLUS Awards

    West Virginia Releases Medicaid Managed Care RFP

    Appleas Court Rules ACA Mandate Unconstitutional

  • This week, our In Focus section provides a high-level overview of the new Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) integration requirements in the Centers for Medicare & Medicaid Services (CMS) April 16, 2019, final rule for calendar year (CY) Read More

    Connecticut Reaches Agreement on Hospital Provider Tax

    Kentucky Legislative Committee Rejects Medicaid Managed Care Awards, Governor-Elect Pledges to Review

    North Carolina Official Says Transition to Managed Care Will Eventually Happen

    Expansion News: North Dakota, Wyoming

    Virginia Medicaid Beneficiaries Turn to ER for Dental Care

    West Virginia Medicaid Plan Cancels Proposed Merger with WVU Medicine

  • This week, our In Focus section reviews the annual Medicaid health plan ratings released in September by the National Committee for Quality Assurance (NCQA), which rated 171 Medicaid plans. For 2019-20, NCQA used a ratings methodology that scored each health Read More

    Arizona Announces Medicaid Whole Person Care Initiative

    Florida Unveils Five-Year Medicaid Housing Assistance Pilot

    Indiana Seeks Extension of HIP Medicaid Expansion

    KY Announces Medicaid Plan Awards, Likely to Face Protests

    Missouri Cuts Lead to HCBS Waiting Lists

    Oklahoma Hires HMA for Alternative to Medicaid Expansion

    Tennessee Submits Medicaid Block Grant Proposal to CMS

    Texas Releases Scoring Sheets for STAR+PLUS Awards

  • This week, our In Focus section reviews the California Advancing and Innovating Medi-Cal (CalAIM) proposal, issued by the California Department of Health Care Services (DHCS) on October 28, 2019. CalAIM would implement broad delivery system, program, and payment reform for Read More

    Colorado Issues Recommendation for Public Option

    Florida Budget Proposal Includes New IDD Funding

    Medicaid Expansion News: Idaho, Louisiana, Maine, Wyoming

    Work Requirements News: Kansas, Kentucky, Ohio, Wisconsin

    New Jersey Proposed Bill to Establish Regional Health Hub Program to Replace Medicaid ACO Demonstration

    North Carolina Suspends Medicaid Managed Care Transition

    CMS Backtracks on Guidance for Medicaid Block Grants, Per Capita Caps

  • This week, our In Focus section examines the new Medicare benefit for Opioid Use Disorder (OUD) treatment that includes counseling, as well as medicationassisted treatment (MAT) and related items and services. This benefit was established by Congress in the SUPPORT Read More

    California Awards Medicaid FFS Prescription Drug Contract to Magellan

    Indiana Releases HIP 2.0 Waiver Extensions for Public Comment

    Louisiana, Medicaid Plans Agree to One-Year Emergency Contracts

    Montana Delays Medicaid Expansion Work Requirements

    New York Submits Medicaid Redesign 1115 Waiver Amendment to Extend Medicaid to Incarcerated Individuals

    North Carolina Issues Healthy Opportunities Pilot Program RFP

    Tennessee Medicaid Releases Managed Care Re-Procurement RFI

    CMS Issues Proposed Rule to Strengthen Fiscal Accountability in Medicaid

  • This week, our In Focus section reviews the Indiana Hoosier Care Connect request for proposals (RFP), issued by the Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) on October 18, 2019. Hoosier Care Connect Read More

    Arkansas Behavioral Health Providers to Merge

    District of Columbia Is Approved for SMI/SUD Demonstration

    Medicaid Expansion News: Georgia, Idaho, Ohio

    Illinois Submits Plan to Expand Dual Demo Statewide

    Medicaid Work Requirements News: Indiana, Kentucky

    New Jersey Medicaid Sees Drop in Enrollment Among Asian, Hispanic Children

    New York May Cut $1.5 Billion From Medicaid

    Texas Medicaid Director to Step Down in May 2020

    West Virginia Awards Managed Care for Foster Children Contract to Aetna

    UnitedHealth Group to Expand Medicaid Housing Program

  • This week, our In Focus reviews the Medicare Advantage (MA) and Part D landscape files and quality performance data for the 2020 plan year from the Centers for Medicare & Medicaid Services (CMS). Data on MA and Part D offerings Read More

    California Medicaid Delivery System Proposal Includes Focus on Social Determinants, Other Policy Priorities

    Medicaid Expansion News: Kansas, Nebraska

    Massachusetts Announces Updated Timeline for One Care

    North Carolina May Further Delay Medicaid Managed Care Transition to Summer 2020

    Ohio Medicaid Plan to Drop Walgreens from Network

    Texas Announces STAR+PLUS Awards

  • This week, our In Focus section reviews highlights and shares key takeaways from the 19th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 18, 2019, in Read More

    Arizona Delays Medicaid Work Requirement Implementation

    Florida House Committee to Review Health Care Spending

    Indiana Releases Medicaid ABD RFP, Foster Care RFI

    Kansas Senate Leader Introduces Medicaid Expansion Plan

    Michigan Cancels Medicaid Behavioral Integration Pilots

    Settlement Reached in Opioid Lawsuit Filed by Ohio Counties

    Texas to Award Medicaid Dental MCO Contracts to DentaQuest, MCNA, UnitedHealth

    ACA Plan Premiums to Fall by 4 Percent in 2020

  • This week, our In Focus section reviews the Pennsylvania HealthChoices Physical Health Medicaid managed care request for applications (RFA), issued by the Pennsylvania Department of Human Services on October 15, 2019. Medicaid managed care organizations (MCOs) will serve the five Read More

    California Wholesale Drug Prices Rise 26 Percent, Study Says

    Georgia Readies Expansion, Reinsurance Waiver Proposals

    Louisiana to Resume Medicaid Auto-Disenrollment

    New York Nursing Homes Expect Reimbursement Cuts

    North Carolina Disputes ‘Conflict of Interest’ Concerns in Medicaid Managed Care Contract Awards

    Oklahoma Medicaid Expansion Advocates Gather Enough Signatures for 2020 Ballot Initiative

    Texas Submits DSRIP Draft Transition Plan to CMS

    Public Charge Rule Change Is Impacting Medicaid Enrollment

  • This week, our In Focus section reviews the Utah Medicaid Section 1115 Demonstration Waiver amendment Fallback Plan, released for public comment on September 27, 2019. The Fallback Plan would raise Utah’s Medicaid expansion income limit to 138 percent of the Read More

    Colorado Issues Draft Report on State Option Exchange Plan

    Illinois Medicaid Auto-Enrollments Favor Low-Rated Plan

    Iowa to Issue RFP for Third Medicaid Plan

    Michigan Announces Plan to Carve Out Medicaid Pharmacy Benefits from Managed Care

    Missouri House Committee Holds Medicaid Expansion Hearing

    New York Health + Hospitals Expands Program for Uninsured

    North Carolina Awards Centene Additional Medicaid Region

    Appeals Court To Hear Arguments in KY Medicaid Work Requirements Case