HMA Weekly Roundup

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  • This week, our In Focus section looks at a new Medicare model, Direct Contracting, introduced by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. The new model will build on and continue testing potential reforms to the Medicare Read More

    California Legislative Analyst Projects 14.2 Percent Increase in Fiscal 2022 Medicaid Spending

    California Delays Implementation of Medi-Cal Rx

    Illinois Unveils Medicaid Transformation Proposal

    Kentucky Submits Waiver to Treat SUD in Prisons

    Kentucky Judge Orders Mediation of Medicaid Managed Care Procurement Dispute

    Missouri to Release Medicaid Managed Care RFP By July 2021

    North Carolina Releases RFA for Behavioral, IDD Plans

    CMS Releases Final Rule Revising Several Provisions of Medicaid and CHIP Managed Care Regulations

    State Tax Revenues Fall $28 Billion, Report Finds

  • In this week’s In Focus section, Health Management Associates (HMA) Managing Director MMS Matt Powers, Senior Consultant Kaitlyn Feiock, and Regional Vice President Kathleen Nolan look at the future of the Patient Protection and Affordable Care Act (ACA). Read More

    Hawaii Releases Community Care Services Program RFP

    New Jersey to Submit Section 1115 Waiver Renewal

    New York Lawmakers Seek To Delay Medicaid Drug Carve-out

    North Carolina Launches Medicaid Managed Care Enrollment Website

    Neighborhood Health Plan of Rhode Island Signs Three-Year Duals Demo Contract Extension

    Tennessee Receives Federal Waiver Approval for Katie Beckett Program for Children with Disabilities

    CMS Issues Final Rule on Medicaid Managed Care Changes

  • This week our In Focus section highlights a paper by Health Management Associates (HMA) Principal Sarah Barth, JD and Research Assistant Sarina Coates-Golden entitled, Reimbursement for Evidence-Based Health Promotion Programs in the Community – Strategies and Approaches to Medicaid and Read More

    Arizona Is Approved to Increase Hospital Reimbursements

    Georgia Receives Federal Approval to Exit ACA Exchanges

    Kentucky to Comply With Court Order to Grant Medicaid Managed Care Contract to Anthem

    Nebraska Names Kevin Bagley as Medicaid Director

    Ohio Releases OhioRISE Managed Behavioral Plan RFA

    Texas Republican Lawmakers Consider Medicaid Expansion

    CMS Issues Final Rule on Health Plan Price Transparency

    Telehealth Flexibilities to Be Permanent for Medicare Home Health Providers

  • This week, our In Focus section reviews the statewide Oklahoma Medicaid managed care request for proposals (RFP) released by the Oklahoma Health Care Authority on October 15, 2020, and the North Dakota Medicaid expansion managed care RFP released by the Read More

    California Releases RFI for Dental ASO

    Florida Procurement for Canada Drug Importation Program Fails to Attract Any Bidders

    Georgia Eyes Privatization of Prison Healthcare Services

    Hawaii Tentatively Schedules QUEST Integration RFP Release for December 2020, Community Care Services RFP for November

    Indiana Receives 10-Year Extension for HIP Alternative Medicaid Expansion Program

    Kentucky Health Plan Appeals Order to Grant Medicaid Managed Care Contract to Anthem

    Verma Says CMMI Record on Value-Based Payments ‘Is Deeply Concerning,’ Calls for Change

  • This week, our In Focus section shares highlights and key takeaways from the 20th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 14, 2020, in two Read More

    Florida Taps Shevaun Harris for Acting Lead of AHCA

    Georgia Receives Approval For Limited Medicaid Expansion

    Illinois Integrated Health Homes Program Is Delayed

    Nebraska Wins Federal Approval of Two-Tiered Medicaid Expansion Waiver

    North Dakota Releases RFP for Medicaid Expansion MCOs

    Oklahoma Releases Medicaid Managed Care, Dental RFPs

    Ohio MCO to Bid on Oklahoma Medicaid Managed Care RFP

    Virginia Budget Agreement Includes Funding for Adult Medicaid Dental Coverage

    ACA Exchange Premiums to Decrease 2 Percent in 2021

  • This week, our In Focus section reviews UnitedHealth Group’s The Path Forward to a Next-Generation Health System, an outline of policy recommendations to achieve a high-quality, affordable health care system. The paper focuses on four goals: 1) achieve universal coverage; Read More

    Illinois to Offer Health Coverage to Elderly Undocumented Immigrants

    Kentucky Is Temporarily Blocked from Moving Ahead with Medicaid Managed Care Contract

    Oklahoma Proposal to Transition Medicaid to Managed Care Faces Bipartisan Opposition

    Texas Is Hit with Federal Order to Fix Early Childhood Intervention Program

    Rate of Uninsured Children Rises, Report Shows

    More Medicare Advantage Plans to Cover Home-Based Support Services in 2021

  • This week, our In Focus section reviews the Ohio Medicaid Managed Care request for applications (RFA) released by the Ohio Department of Medicaid (ODM) on September 30, 2020. The RFA follows the release of two requests for information (RFIs) in Read More

    D.C. Implements New Medicaid Managed Care Contracts

    Kansas Awards Conduent Contract to Handle Medicaid Applications

    Kentucky to Relaunch State Exchange for 2022 Coverage

    North Carolina Awards EVV Contract to Sandata

    Trump Ends COVID-19 Relief Talks Until After Election

    Medicaid, CHIP Enrollment Reaches 75 Million Through June

    Senate Passes Legislation to Relax Medicare Provider Relief Loans, Delay Medicaid DSH Cuts

  • This week, our In Focus section reviews two recent Medicare developments from the Centers for Medicare & Medicaid Services (CMS). On September 24, 2020, CMS released the Medicare Advantage (MA) and Part D landscape files for the 2021 plan year. Read More

    Delaware Medicaid to Add Dental Coverage for Adults

    Nebraska Medicaid Expansion Begins October 1

    North Carolina PLE Petitions to Reverse Medicaid Managed Care Procurement Ruling

    Ohio Releases Medicaid Managed Care RFA

    Ohio Announces Creation of Medicaid Managed Care Program for Children with Behavioral Health Needs

    Texas Seeks Input On Procuring MCOs for Healthy Texas Women Program

    House Democrats Unveil COVID-19 Bill That Includes $50 Billion for Healthcare Providers

    Trump Administration Approves Drug Importation Program

    CMS Warns of Significant Decrease in Utilization of Health Services Among Children Enrolled in Medicaid, CHIP

  • On September 15, 2020, the Centers for Medicare & Medicaid Services (CMS) released State Medicaid Director (SMD) letter #20-004 regarding value-based care (VBC) opportunities in Medicaid. In the letter, CMS lays out a road map for state Medicaid agencies Read More

    Delaware Approves Four ACOs to Serve Medicaid Population in 2021

    New York Finds $700 Million in Improper Medicaid Payments

    Vermont ACO Pilot Program Failed to Meet Enrollment, Spending Targets

    House Passes Federal Funding Bill to Relax Repayment Terms for COVID-19 Medicare Loans

    CMS Announces Additional $165 Million MFP Funding for 33 States

    Justice Ginsburg’s Death Could Jeopardize the ACA

    CMS Innovation Agency Announces Roll Out of Risk-Based Model for Dual Eligibles

  • This week, our In Focus sections reviews the Missouri HealthNet Pharmacy and Clinical Services Management Solution request for information (RFI) and the Kentucky Medicaid Managed Care Organization (MCO) Pharmacy Benefit Manager request for proposals (RFP). Read More

    California to Release Medi-Cal Managed Care RFP in Late 2021

    Nevada Medicaid Enrollment Increases by 87,000

    North Carolina Voters Support Medicaid Expansion, Poll Finds

    North Dakota to Release Medicaid Expansion Managed Care RFP in October

    CMS Releases Medicaid, CHIP Data Files in Continued Effort to Promote Transparency

    CMS Withdraws Medicaid Fiscal Accountability Rule

    CMS Issues Guidance on Value-Based Care Arrangements in Medicaid