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- This week, our In Focus section identifies steps that Medicare and Medicaid plans and providers can undertake to effectively return to normal operations after the end of the COVID-19 public health emergency (PHE) declaration. Read MoreRoundup:
Arkansas Seeks Federal Approval to Offer Full Medicaid Coverage to Pregnant Women
California Awards $340 Million Population Health Management Contract to Gainwell Technologies
California Medi-Cal Contract Awards Face Appeals
Iowa Awards NEMT Contract to MTM
Maryland Releases Dental Benefits Administrator RFP
Maryland Releases Medicaid NEMT Broker RFP
New Mexico Delays Medicaid Managed Care RFP Release to Third Quarter of 2022
Oklahoma Releases Medicaid Dental Managed Care RFP
Tennessee Proposes PMPM Medicaid Spending Cap to Replace Proposed Aggregate Cap
Texas Delays Releases of STAR/CHIP, STAR Kids RFPs
MedPAC Eyes Potential Standardized Benefit Options for Medicare Advantage
CMS Proposes Rule to Standardize Medicaid, CHIP Eligibility and Enrollment
CVS to Acquire Signify Health
Maximus Retains Contract to Support CMS Contact Center Operations
- This week, our In Focus section reviews preliminary 2021 Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. Read MoreRoundup:
California Awards Medi-Cal Managed Care Contracts to Three Health Plans
District of Columbia Medicaid Managed Care Contract Awards Await Mayor’s Recommendations
Florida Medicaid Providers to Pay Long-Term Care Staff $15 Per Hour
Illinois Enacts Legislation to Increase Nursing Home Pay
Iowa Awards Medicaid Managed Care Contracts to Two Health Plans
Louisiana Awards Single, Statewide PBM Contract to Magellan
Louisiana Medicaid Begins Using State Directed Payment Model for Hospitals
Mississippi Medicaid Managed Care Bidders File Protests
Nebraska Delays Medicaid Managed Care Awards to September 23
New Hampshire Releases Adult Medicaid Dental Managed Care RFP
New York Removes Barrier to Home Care M&A Activity With New Licensure Process
CMS Awards $98.9 Million to Navigators to Assist in 2023 Exchange Open Enrollment
8.8 Million Medicaid Beneficiaries Received LTSS in 2019, CMS Report Finds
Medicare Advantage Accounts for Nearly Half of All Medicare Beneficiaries, KFF Analysis Finds
Walgreens Boots Alliance Completes Acquisition of 55 Percent Stake in CareCentrix
- This week, our In Focus section highlights an HMA Issue Brief, Bolstering the Youth Behavioral Health System: Innovative State Policies to Address Access & Parity, published in August 2022. Read MoreIn Focus:Roundup:
California Releases Mobile Crisis Intervention Services RFI
California Exchange Plans Must Resubmit 2023 Rates to Reflect Impact of Inflation Reduction Act
Florida Medicaid Enrollment to Increase 5.5 Percent, Surplus to Top $1.25 Billion in Fiscal 2023
Georgia Can Reinstate Medicaid Expansion Work Requirements, Federal Judge Rules
Nebraska Awards Maxmius Contract for MMIS Provider Services Module
New York Legislators Introduce Bill to Ease Burden of Medicaid Provider Audits, Recoveries
North Carolina Healthy Opportunities Pilot Struggles to Gain Traction
Ohio Counties Win $600 Million in Damages in Opioid Lawsuit
Oregon Health Plan to Use Tech Platform to Connect Medicaid Members to Social Services
Texas Dual Eligible Demonstration Shows Cost Reductions, Study Finds
Utah Releases Medicaid Dental Managed Care RFP
U.S. Senate Panel Investigates Medicare Advantage, Part D Marketing Tactics
Sonas Home Health Care Acquires Focus Forward Skilled Care
Wakely, An HMA Company, White Paper: 2021 Supplemental Claims Impact
- This week, our In Focus section reviews the Inflation Reduction Act of 2022 (IRA), signed by President Biden on August 16, 2022. Read MoreIn Focus:Roundup:
Arizona Works on New Health Plan Contracts for ALTCS-EPD Program
Delaware Judge Denies Motion to Quash Audit of Medicaid Program
District of Columbia Accepts Bids from 2 Medicaid Managed Care Plans
Florida Medicaid Plan Capitated Rates to Fall, Driven by Lower Utilization
Illinois Announces PACE Program Awardees
Massachusetts Seeks Input on Improving Medicaid MCO/ACO Risk Adjustment Model
Minnesota Releases RFP for School-Linked SUD Services for Students
Missouri Medicaid Software Vendor Wins $23 Million in Lawsuit Against State
Nebraska Delays Medicaid Managed Care Awards to August 31
North Carolina Legislators Fail to Reach an Agreement on Medicaid Expansion
CMS Proposes Rule to Expand Medically Necessary Dental Services Covered by Medicare
Medicare Rates Expected to Rise 2.5 Percent for Inpatient Psychiatric Facilities in Fiscal 2023
Humana to Acquire Wisconsin-based MCO Inclusa
LHC Group Agrees to Acquire Three Rivers Home Health
- As the urgent needs of COVID-19 Public Health Emergency (PHE) continue to subside, state Medicaid agencies are exploring pathways and concepts to further address the historic inequities and health disparities laid bare by the pandemic. Read MoreRoundup:
California Delays Medi-Cal Managed Care Program Awards
Connecticut HUSKY Health to Cover Additional Maternity Benefits in 2023
Florida Medicaid Managed Care RFI Responses Stress Social Determinants, Providers, HCBS
Georgia Proposal to Bypass Healthcare.gov Is Again Rejected by CMS
Idaho Releases Quality Improvement Organization RFP
Mississippi Awards MississippiCAN, CHIP Medicaid Managed Care Contracts to 3 Health Plans
Missouri Commits to Trimming Medicaid Applications Backlog Under Federal Plan
Ohio Pharmacists Express Concern Over Single PBM Program
West Virginia Medicaid Must Cover Gender-Affirming Care, Federal Judge Rules
U.S. Senate Passes Legislation Allowing Medicare to Negotiate Drug Prices, Extending Enhanced Exchange Subsidies
CVS Is Reportedly Interested in Acquiring Signify Health
UnitedHealth/Optum Acquires CareMount Medical
- This week, our In Focus section reviews the request for information (RFI) on ways to strengthen the Medicare Advantage (MA) program, released by the Centers for Medicare & Medicaid Services (CMS) on July 28, 2022. Read MoreRoundup:
Alabama Releases SMI Independent Evaluator RFP
Arkansas Withdraws Previously Released PBM RFP To ‘Start from Scratch’
Georgia Receives Approval for 2 Percent Rate Increase for HCBS Waivers
Michigan Seeks Another Year to Implement SPA for Community Support Services
Mississippi Delays Medicaid Managed Care Awards to August
Missouri Submits Substance Use Disorder 1115 Waiver Application
New York Attorney General Files Antitrust Lawsuit Against CVS Over 340B Program
Ohio Releases Medicaid IV&V Services RFP
Oregon Seeks Medicaid Coverage for Individuals Up to 200 Percent of Poverty After PHE Ends
South Carolina to Convene Working Group on Emergency Mental Health
National Uninsured Rate Hits a Record Low of 8 Percent
Biden Administration May Allow Medicaid Waivers to Cover Out-of-State Abortions
Medical Transportation Management Finalizes Acquisition of Veyo
- This week, our In Focus section is the next in our series highlighting significant developments in the Medicare program. Read MoreRoundup:
California Medicaid Plans Eye State Exchange in 2024
Delaware Submits 1115 Waiver Amendment for Federal Approval
Michigan Releases RFP for EVV System for Medicaid Personal Care, Home Care
Montana Medicaid to Cover Applied Behavioral Therapy for Children With Autism
New York Proposes Rule For Medicaid Plans to Bolster Special Investigations Units
North Carolina Medicaid Expansion Negotiations Slow
CMS Releases Voluntary HCBS Quality Measure Set
Amazon to Buy 1LifeHealthcare in $3.9 Billion Deal
Vistria Group Is Investing Upwards of $200 Million in Sandstone Care
- Over the course of three weeks CMS has made a series of Medicare announcements that arguably contain the most sweeping changes to the Medicare program proposed thus far by the Biden Administration. Read MoreRoundup:
California Governor Signs Bill to Establish No-Bid Contract with Medicaid Plan
Colorado Policy Restricts Use of Behavioral Health Interns, Unlicensed Therapists
Florida Considers Denying Medicaid Coverage for Gender-Affirming Care for Transgender Youth
Georgia Receives Federal Renewal of 1915 HCBS Waiver for Five Years
Idaho Releases Medicaid Dual Programs RFI
Illinois Accepting Medicaid Applications for Individuals 42 and Up, Regardless of Immigration Status
Massachusetts Releases Request for Responses for Behavioral Health, LTSS Community Partners
New York HCBS Children’s Waiver Providers to Receive Temporary 25 Percent Rate Increase
Oregon Medicaid CCO Program ‘Helped Slow Cost Growth,’ State Says
Pennsylvania Physical HealthChoices Beneficiaries Must Choose New Plan Before August 16
Tennessee Drafts Amendment to TennCare Block Grant Waiver
Washington Seeks 5-Year Renewal of Medicaid Transformation 1115 Waiver
COVID-19 Is Associated with Increased Incidence of Future Medicaid Conditions, Costs, Wakely Study Finds
CMS Awards $49 Million in Grants to Boost Medicaid, CHIP Enrollment of Children
CMS Proposes 2.7 Percent Increase in Medicare Reimbursement Rate for Outpatient, Ambulatory Surgical Center Services
Pediatric Home Service Acquires Craig HomeCare, Cherub Medical Supply
Health Plan Joins Hospital Systems as Co-Owner of Delaware Regional Medicare ACO
- This week, our In Focus reviews the Indiana Medicaid managed long-term services and supports (MLTSS) request for proposals, released by the Indiana Department of Administration on behalf of the Family and Social Services Administration on June 30, 2022. Read MoreIn Focus:Roundup:
California Legislature Considers Bill Allowing Medi-Cal Reimbursement for Eyeglasses from Retail Labs
Delaware Awards Medicaid Managed Care Contracts to 3 Plans
Florida Governor Issues Order Increasing Audits of PBMs, Preventing Clawbacks in Future Contracts
Maine Expands Medicaid, CHIP Coverage to Individuals Under 21, Pregnant Women Regardless of Immigration Status
Massachusetts Selects 25 Community Behavioral Health Centers to Expand Treatment for Mental Health Conditions
Minnesota Releases RFP for Medicaid, MinnesotaCare Accountable Care Model
Montana Receives Approval for 1115 HEART Demonstration
Nebraska Receives Five Bids for Medicaid Managed Care Contracts
New Hampshire Releases Adult Medicaid Dental Benefit RFI
Oklahoma Proposes 25 Percent Rate Increase for Medically Fragile Medicaid Services
Pennsylvania Governor Approves Nursing Home Medicaid Reimbursement Rate Increase
South Dakota Medicaid Expansion Ballot Campaigns to Join Forces
Texas Health Plan Awards $2.1 Million in Grants to Address Social Determinants of Health
Insurers Propose Exchange Plan Premium Rate Hike of 10 Percent in 2023, Says ACASignups.net
Molina to Acquire My Choice Wisconsin
Ensign Group Acquires Skilled Nursing Facilities in Texas, Nevada, California
- This week, our In Focus section reviews the new Center for Medicare and Medicaid Innovation (CMMI) model named the Enhancing Oncology Model (EOM), released on June 27, 2022, by the Centers for Medicare & Medicaid Services (CMS). Read MoreRoundup:
This week's roundup:
In Focus: CMS Releases the Enhancing Oncology Model
In Focus: CMS Proposes Regulation for Rural Emergency Hospitals
Delaware Delays Medicaid Managed Care Contract Awards
Florida Awards Unified Operations Center Contract to Automated Health Systems
Florida Releases RFI for Children’s Medical Services Managed Care Plan
Indiana Releases MLTSS RFP
Maine Extends Dental Coverage to Medicaid Beneficiaries
Missouri Governor Signs Fiscal 2023 Budget with Funding for Medicaid Expansion
Nevada Requests 1115 Waiver to Expand Access to Behavioral Health Services
New Hampshire Governor Signs Legislation to Provide Adult Medicaid Dental Coverage
North Carolina House Committee Considers Legislation to Create Statewide Medicaid Managed Care Plan for Foster Children
Tennessee Advised by CMS to Make Changes to Medicaid Block Grant Program
Washington State Plan Aimed at Lowering Medicaid Pharmacy Payments Is Rescinded
HHS Releases New Resources to Improve Oversight of Medicaid, CHIP Managed Care Programs
CMS Releases 2021 Open Payments Data
Medicaid, CHIP Enrollment Nears 87.9 Million; Medicare Nears 64.4 million
Francisco Partners Completes Acquisition of IBM Watson Healthcare Data, Analytics Assets
