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- This week our In Focus checks in on the Medicaid unwinding work and key issues HMA experts are watching as more states resume their normal policies and processes for determining eligibility. Read MoreRoundup:
Medicaid Redeterminations New: Arizona, California, Colorado, Idaho, Indiana, Iowa, Kentucky, Louisiana, Michigan, Nevada, North Carolina, North Dakota. Texas, West Virginia, Wyoming
Arkansas Submits Request for Medicaid Expansion Work Requirements
Georgia Cancels RFQC for Medicaid Managed Care Plans
Iowa Enacts Legislation Tightening Medicaid Eligibility Verification
Nevada Medicaid Drug Spending Rose 126 Percent from 2017 to 2022
New Mexico to Extend Medicaid Managed Care Contracts Additional 6 Months
New Mexico to Expand Access to Medicaid Payments for Medical, Behavioral Health Services in Schools
Pennsylvania Seeks to Implement Selective Contracting for IDD Residential, Supports Coordination Services
South Dakota Receives Federal Approval to Implement Medicaid Expansion in July
Elevance Health Names Natalie Cooper President of Amerigroup Tennessee
Texas Names Emily Zalkovsky as State Medicaid Director
Merck Seeks Injunction to Block Medicare Drug Negotiation Program
UnitedHealth/Optum Makes Unsolicited $3.26 Billion Bid for Amedisys
- This week, our In Focus section describes a new collaboration between Health Management Associates and the California Department of Health Care Services (DHCS). Read MoreRoundup:
Arizona Delays Implementation of Housing, Health Opportunities Waiver to October 2024
California Individual Mandate Generates $1.1 Billion in Fines Since 2020
Georgia Disenrolls 2,200 Medicaid Beneficiaries During April Redeterminations
Indiana Disenrolls 53,000 Medicaid Beneficiaries During First Month of Redeterminations
Kentucky Subcommittee Again Finds Deficiencies in Rules Extending Dental, Vision, Hearing Benefits to Medicaid Beneficiaries
Minnesota Enacts Legislation to Provide Comprehensive Dental Benefits to All Medicaid Beneficiaries
Missouri Uses Ex Parte Renewal Process for 47 Percent of April Medicaid Eligibility Redeterminations
Oregon to Disenroll 8,000 Medicaid Beneficiaries Following April Redeterminations
Rhode Island Releases Medicaid Managed Care RFI; New Procurement Expected Fall 2023
Wisconsin Could Disenroll Up to 300,000 Medicaid Beneficiaries During Redeterminations, Report Finds
Medicaid Disenrollments to Date Are Largely for Administrative Reasons, CMS Says
Medicaid Enrollment to Decrease by More Than 12 Million by 2025, CBO Projects
CVS/Oak Street Health to Expand Into Arkansas, Iowa, Kansas, Virginia
AHIP President, CEO to Step Down in October
Medicaid Directors to Discuss Challenges, Opportunities at HMA Conference in Chicago
- Health Management Associates has announced the preliminary lineup of speakers for its sixth annual conference, Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth. Read MoreRoundup:
California Proposes Increasing Medicaid Reimbursement Rates for Providers
Florida Disenrolls 250,000 Medicaid Beneficiaries Since Redeterminations Began
Iowa Releases Dental RFP for Iowa Dental Wellness Plan, Hawki
Iowa Expects 3,000 Individuals to Lose Medicaid Coverage by June 1
Massachusetts Considers Increasing Medicaid Reimbursement Rates for Substance Use Disorder Treatment Providers
Minnesota Legislature Passes Bill to Set Minimum Wages, Benefits for Nursing Home Staff
Nebraska Passes Certified Community Behavioral Health Clinic Act
Nevada to Transition to Medicaid Managed Care in Rural Areas
Nevada Senate Considers Bill to Reimburse Rural Hospitals at Cost for Outpatient Services
New Hampshire House Committee Subdivision Votes to Hold Medicaid Reauthorization Bill for a Year
Texas Senate Passes Bill to Extend Postpartum Medicaid Coverage
Vermont Lawmakers Approve 50 Percent Increase in Fiscal 2024 Medicaid Reimbursement Rates for Dental Services
Washington Legislature to Increase Medicaid Reimbursement Rates for Nursing Homes by 14 Percent for Two Years
CMS Releases Regulatory Requirements for State MES Modules
HCA Healthcare Acquires TX Urgent Care Centers from FastMed
- This week our In Focus section reviews the Illinois Healthcare Transformation 1115 Waiver Extension request, posted for review on May 12, 2023. Read MoreIn Focus:Roundup:
Arkansas Is Urged by Healthcare Groups to Pause Medicaid Redeterminations
Delaware Medicaid Expenses Are Projected to Increase Despite Redeterminations
Florida Releases Medicaid Prepaid Dental Program RFI, To Release RFP Summer 2023
Florida Releases D-SNP RFI, Considers Moving 300,000 Medicaid Members from D-SNPs to SMMC
Illinois to Address Social Determinants of Health in 1115 Behavioral Health Waiver Amendments
Indiana Enacts Legislation to Reform Long-term Care
North Dakota Releases Medicaid Enterprise Technical Systems Integrator RFP
Ohio Releases PACE Expansion RFP
Virginia to Release Medicaid NEMT RFP in September 2023
Virginia Disenrolls 20,000 Medicaid Beneficiaries During Redeterminations
Federal Appeals Court Temporarily Blocks Overturning of ACA Preventive Services Requirement
Wisconsin Approves Humana’s Proposed Purchase of Inclusa
Sentara to Consolidate Medicaid Plans in Virginia
- This week’s In Focus is the second in a two-part look at the Centers for Medicare & Medicaid Services’ (CMS’s) recently proposed changes to the Medicaid program. Last week we covered CMS’s proposed changes to the federal Medicaid managed care Read MoreRoundup:
Arizona Legislature Approves $3.4 Billion for Fiscal 2023 Medicaid Managed Care Payments
Arkansas Disenrolls Almost 73,000 Medicaid Beneficiaries During April Redeterminations
Georgia Community Health Commissioner to Step Down Summer 2023
Idaho Finds 29,000 Ineligible Medicaid Beneficiaries During Redeterminations Healthy Blue
Kansas Hires President Ahead of Bid on Medicaid Contract
HAP, CareSource Form Partnership to Serve Michigan Medicaid Beneficiaries
Rhode Island Senate Passes Bill to Use Medicaid Funds to Help Homeless Beneficiaries Find Housing
Virginia Plan to Cut Medicaid Payments for Preventable ER Visits Is Vacated by Federal Judge
1.7 Million Medicaid Beneficiaries Could Lose Coverage if Work Requirements are Implemented, KFF Projects
Option Health Care To Acquire Amedisys
Cano Health Looks to Sell Non-core Assets, Focus on Medicare Advantage
- This week, our In Focus section reviews CMS’s proposed changes to the federal Medicaid managed care access, finance, and quality regulation (CMS-2439-P). Read MoreRoundup:
Alabama Releases Integrated Care Network Program RFP
Arkansas Proposes Medicaid Work Requirements for Expansion Program
Florida Legislature Passes Bill to Regulate PBMs
Florida House Passes Bill to Create Pilot Program Providing Medicaid Managed Care Coverage to Individuals with IDD
Georgia Enacts Law to Create State-based Insurance Exchange
Louisiana Candidates for Governor Promise to Keep Medicaid Expansion
Mississippi Medicaid Beneficiaries Are No Longer Responsible for Copays
Nevada Expands Dental Services for Medicaid Beneficiaries with IDD
Nevada Releases Baseline Medicaid Enrollment Report Ahead of Redeterminations
New York to Gradually Redirect Medicaid Funding from Counties
Tennessee Medicaid to Cover Cost of Diapers for First Two Years
Washington Publishes Plan to Remove Barriers to Access for Health, Human Services Benefits
Medicare Advantage Enrollment Surpasses Traditional Medicare in January
Centene to Sell Apixio to New Mountain Capital
BCBS-MI, BCBS-VT to Pursue Affiliation
- This week our In Focus section reviews guidance from the Centers for Medicare & Medicaid Services (CMS), released on April 17, 2023, encouraging states to apply for the new Medicaid Reentry Section 1115 Demonstration Opportunity. Read MoreRoundup:
Arizona Requests Additional $3.3 Billion in Fiscal 2023 for Medicaid Managed Care Payments
Redeterminations News: California, Georgia, Indiana, Missouri, Nebraska, Pennsylvania
Colorado Enacts Legislation Eliminating Medicaid Co-pays for Pharmacy, Outpatient Services
Illinois Health Benefits Program for Immigrant Seniors, Adults Is Expected to Enroll 98,500
Maryland Releases Medicaid Managed Care External Quality Review RFP
Washington Requests Medicaid Coverage for Former Foster Youth, Continuous CHIP Enrollment for Children Up to Age Six
U.S. Senators Introduce Legislation to Ban PBM Spread Pricing
Kaiser Permanente to Acquire Geisinger Health
- This week, our In Focus reviews the policy changes proposed by the Centers for Medicare & Medicaid Services’ (CMS) on April 10, 2023 for the Fiscal Year (FY) 2024 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Read MoreRoundup:
Arkansas Legislature May Hold Special Session on Medicaid Spending
Florida House Passes Bill to Increase Income Threshold for KidCare Coverage
Georgia to Recommend Rate Increase for Providers Caring for Individuals with Disabilities
Illinois Receives Federal Approval for Additional Medicaid Funding in Schools
Iowa House Passes Bill to Create Medicaid Eligibility Verification System
Nevada to Review Medicaid HCBS Rate Setting Methodology
Pennsylvania Releases RFP for a Medicaid, CHIP EQRO
South Dakota to Implement Medicaid Expansion on July 1
Wisconsin Releases RFI for Eligibility Determination System
HHS Projects 6.8 Million Eligible Medicaid Beneficiaries Will Be Disenrolled During Redeterminations
Biden Administration Encourages States to Apply for Medicaid Reentry 1115 Demonstration for Individuals in Carceral Settings
Humana to Invest Another $40 Million in Affordable Housing
- This week our In Focus section reviews the Florida Statewide Medicaid Managed Care Program (SMMC) Invitation to Negotiate (ITN), released on April 11, 2023, by the Florida Agency for Health Care Administration (AHCA). Read MoreRoundup:
Alabama House Committee Holds Meeting on Medicaid Expansion
California to Seek Approval for Voluntary Medicaid Capitated Payment Model for FQHCs
California Medi-Cal To Comply With Federal Law, Continue Business with Walgreens
Delaware Struggles to Investigate Complaints Against Assisted Living, Nursing Facilities
Georgia Proposes Using Directed Payments to Make Up for Financial Losses at Rural Hospitals
Michigan to Release Medicaid Managed Care RFP in Fall 2023
New Jersey Receives Approval for Medicaid Waiver on Coordinating Behavioral Health, Covering Social Needs
New York Medicaid Audit Finds $184 Million in Uncollected Drug Rebates
Oregon Medicaid Beneficiaries Struggle to Access Mental Health Care Despite Relatively High Medicaid Rates, Study Finds
Pennsylvania Lawmakers Debate Medicaid Dental Benefits During Budget Hearing
Texas Files Federal Lawsuit Over Medicaid Provider Tax Policy Change
CMS Proposes 2.8 Percent Medicare Rate Increase for Hospitals that Meet Quality Reporting, Meaningful Use Standards
Medicaid Enrollment to Settle At Higher Than Pre-Pandemic Levels in Many States, Analysis Finds
Froedtert Health, ThedaCare to Merge
- This week, our In Focus section reviews the recently announced major policy updates from the Centers for Medicare and Medicaid Services (CMS) that affect the Medicare Advantage (MA) and Part D programs. Read MoreRoundup:
Arizona to Award $40 Million to HCBS Providers
California, Michigan Consider Legislation to Ensure Preventive Care Coverage at No Cost to Individuals
Colorado Legislature Debates Fiscal 2024 Budget Bill with $80 Million to Replace Enhanced FMAP
Connecticut House Committee Advances 2 Bills to Increase Income, Asset Limits for HUSKY C
Indiana Legislature Extends Medicaid Reimbursement Rate Hike for Out-of-state Children’s Hospitals
Iowa House Committee Holds Hearing on Bill to Create Eligibility Verification System for Medicaid
Michigan Launches Enhanced Medicaid Dental Benefits, Increased Dental Provider Reimbursement Rates
Montana House Passes Bill to Increase Medicaid Reimbursement Rates to Ambulance Providers
New York Implements Medicaid FFS Pharmacy Benefit Program
Redeterminations News: Oregon, Pennsylvania, Texas, Virginia
CMS to Increase Medicare Advantage Payments by 3.3 Percent in 2024
CMS Proposes Increasing Medicare Reimbursement Rates for Skilled Nursing Facilities by 3.7 Percent in 2024
HouseWorks Acquires Associated Home Care
UnitedHealth Group to Reduce Use of Prior Authorizations
