HMA Weekly Roundup

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  • This week, our In Focus section reviews the Hawaii QUEST Integration (QI) Medicaid Managed Care request for proposals (RFP), issued by the Hawaii Department of Human Services (DHS) on August 26, 2019. DHS intends to contract with four health plans. Read More
    Roundup:

    Arizona Releases RFI for Integrated Foster Care ASO

    California to Carve Long-Term Care into Medicaid Managed Care Statewide in 2021

    Louisiana to Seek Emergency Contracts with Current Medicaid Managed Care Plans

    Minnesota Cancels Medicaid MCO, MSHO, MSC+ RFPs

    New Jersey to Carve Long-Term Residential Services into Managed Care for DDD, MLTSS, FIDE-SNP Enrollees

    North Carolina Delays Medicaid Managed Care Rollout

    Medicare Advantage Plans Oppose Proposed Changes to CMS Audit Methodology

  • This week, our In Focus section comes from HMA Community Strategies (HMACS) Senior Associate Diana Rodin and HMA Managing Principal Sharon Silow-Carroll who authored a recent article in the Journal of Women’s Health drawing on data from the recently completed Read More
    Roundup:

    Medicaid Foster Care RFP News: Arizona, Virginia

    California Hospitals See Charity Care Expenses Fall by Half

    Delaware Received IMD Exclusion Waiver

    Florida CHIP Costs to Rise as Enrollment Increases

    Georgia Is Still Failing on Mental Health Care, Report Says

    Kansas Asks Aetna to Submit New Corrective Action Plan

    Centene, Aetna Protest Louisiana Medicaid Awards

    New Hampshire Medicaid to Expand Telehealth Coverage

    CareOregon to Become Subsidiary of Providence Health

    Portland Hospitals Urged to Contract with Centene-Trillium

    Texas Delays STAR, CHIP ImplementationWest

  • This week, our In Focus section reviews the new Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service FY 2020 proposed rules: the Physician Fee Schedule (PFS), released on July 2019, and Home Health prospective payment system, released on July Read More
    Roundup:

    Florida to Raise Medicaid Managed Care Rates 0.2 Percent

    Illinois Enacts Law to Address Medicaid Applications Backlog, Require Health Plans to Pay Providers Promptly

    Kentucky Launches Medicaid Program to Help Cover Cost of Employer-Sponsored Insurance Premiums

    Louisiana Announces Medicaid MCO Awards

    Missouri Health Care Task Force to Consider Medicaid Expansion Waiver

    New York Is Actively Pursuing DSRIP Waiver Renewal

  • This week, our In Focus section reviews the new Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service FY 2020 proposed rules. On July 29, 2019, CMS issued the Calendar Year (CY) 2020 proposed rules for the Physician Fee Schedule Read More
    Roundup:

    MCO Withdraws Florida Healthy Kids Award Protest

    Illinois Governor Vetoes Bill Aimed at Limiting His Administration's Ability to Seek Medicaid Waivers

    Kentucky AG Clears Evolent Acquisition of Passport

    Missouri Names Chief of Medicaid Transformation

    New Hampshire Medicaid Work Requirements Are Blocked

    Ohio Medicaid Enrollment Declines, Uninsured Rate Rises

    Oklahoma Lawmakers to Reconsider Medicaid Expansion

    Utah Faces Rejection of Partial Medicaid Expansion Waiver Proposal

  • This week, our In Focus section reviews the new 1332 State Relief and Empowerment Waiver resources released by the Centers for Medicare & Medicaid Services (CMS) on July 15, 2019. The new resources, intended to help states better understand regulations Read More
    Roundup:

    Florida Announces Healthy Kids Awards

    Georgia Convenes Advisory Council to Discuss Medicaid, Exchange Waivers

    Idaho Seeks Waiver to Allow Medicaid Expansion Eligibles to Remain in Exchange Plans

    Massachusetts Lawmakers Advance Drug Pricing Plan

    Study: Mortality Rates Lower in Medicaid Expansion States

    Senate Finance Committee Drafts Drug Pricing Legislation

  • This week, our In Focus section reviews the four new payment models addressing radiation oncology, kidney care, and end-stage renal disease released by the Centers for Medicare & Medicaid Services (CMS), through the Center for Medicare and Medicaid Innovation (CMMI) Read More
    Roundup:

    Arizona Releases RFP for Managed Foster Care ASO

    Indiana Implements Medicaid Work Requirements

    Iowa Medicaid Plans to Receive 8.6 Percent Rate Increase

    Minnesota Commissioner of Health Services Resigns

    New Mexico to Overhaul Developmental Disabilities Program

    New York Uses Budget Maneuver to Keep Medicaid Spending Within Global Cap

    North Carolina Begins Transition to Medicaid Managed Care

    West Virginia Delays CHIP Transition to Managed Care

  • This week, our In Focus section reviews the California fiscal 2019-20 budget. California Governor Gavin Newsom signed his first budget, and much of its related legislation on June 27, 2019. The budget appropriates $214.8 billion ($147.8 billion General Fund) in Read More
    Roundup:

    Centene Subsidiary Takes Over Health Care Services In Arizona Prisons

    California Exchange Premiums to Rise 0.8 Percent in 2020, Lowest Since 2014

    California to Pay Off $58.6 Million in Medical School Student Loans for 247 Physicians Serving Medi-Cal Patients.

    Iowa, Medicaid Plans Continue to Negotiate Fiscal 2020 Payment Rates

    Kansas Expands Medicaid Services for Brain Injuries

    Louisiana Medicaid MCO Awards Are Delayed

    New Hampshire Announces Delay of Medicaid Expansion Work Requirements

    North Carolina Could Delay Medicaid Managed Care Implementation if State Budget is Not Signed

    Oregon Announces CCO 2.0 Contract Awards

    Texas Delays STAR+PLUS Implementation

    West Virginia Releases Managed Foster Care RFP

  • 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:

    Arkansas Medicaid Work Requirements Raised Uninsured Rate, Study Finds

    Georgia to Reinstate Medicaid Benefits to 17,000 Elderly, Disabled Medicaid Members After Disenrollment Backlash

    Louisiana Receives CMS Approval for Hepatitis C Subscription Drug Model

    Maine Enrolls 26,000 Medicaid Expansion Members, Far Fewer than Expected

    New Jersey Proposes Legislation to Increase HMO Annual Assessment

  • This week, our In Focus section section highlights some of the key findings of the Spring 2019 Fiscal Survey of States, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state budget Read More
    Roundup:

    Arkansas Medicaid Corruption Probe Widens

    California Approves Plan to Allow Some Undocumented Immigrants to Enroll in Medicaid

    Expansion News: Florida, Oklahoma

    Georgia Addresses Backlash Over Elderly, Disabled Medicaid Members Slated for Disenrollment

    Kentucky Waiver to Expand Treatment for Substance Abuse

    New Hampshire Legislature Nears Agreement to Suspend Medicaid Work Requirements

    Ohio Releases RFI for Medicaid Managed Care Reprocurement

    Oregon Subcommittee Advances Plan to Cut CCO Allowable Inflation Rate to 3.3 Percent

  • This week, our In Focus section provides a high-level overview and an analysis for how health plans should consider two related and significant policy statements from the Centers for Medicare & Medicaid Services (CMS) about opportunities to further integrate care Read More
    Roundup:

    Alaska Awards Contract to Evaluate Medicaid Block Grant

    California Lawmakers Agree to Allow Undocumented Immigrants Ages 19 to 25 to Enroll in Medicaid

    Florida Governor Signs Prescription Drug Importation Bill

    Health Alliance Plan to Acquire Trusted HP-Michigan

    New Hampshire Proposal to Raise Medicaid Reimbursement Rates Faces Opposition

    Virginia Is Cited for Inadequate Oversight of Medicaid Eligibility Determinations