HMA Weekly Roundup

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  • This week, our In Focus highlights a HMA Community Strategies program evaluation of the City of Los Angeles FamilySource System (FSS). Read More
    Roundup:

    Alabama Releases RFP for Medicaid Enterprise Data Services Solution

    Arizona Releases Strategic Roadmap to Modernize Medicaid Enterprise System

    Florida Medicaid Disenrollment Could Impact Up to 1.8 Million Households

    Florida Senate Committee Approves Bill to Place Restrictions on PBMs

    Georgia Senate Committee Misses Deadline, Imperiling Mental Health Bill

    Kentucky Governor Vetoes Bill that Would Block Expanded Dental, Vision, Hearing Benefits for Medicaid Beneficiaries

    Louisiana Governor Proposes $196 Million for Medicaid Redeterminations Process

    New York Providers File Lawsuit to Delay Transition of Medicaid Pharmacy Benefits from Managed Care to FFS

    North Carolina Enacts Medicaid Expansion

    Tennessee Legislature Considers Bill to Block State from Contracting with Medicaid Plans Covering Gender-affirming Treatment in Any State

    Medicaid, CHIP Enrollment Tops 92.3 Million in December 2022

    Mosaic Dental Collective Partners with Audax Private Equity

    BCBS-NM Names Nancy Smith-Leslie as Vice President of Medicaid

  • This week our In Focus section reviews the Centers for Medicare and Medicaid Services’ (CMS) announcement of initial guidance for the new Medicare Drug Price Negotiation Program for 2026. Read More
    Roundup:

    Medicaid Expansion News: Alabama, Kansas, Mississippi, North Carolina

    Arkansas Assisted Living Providers Struggle Financially After Medicaid Reimbursement Rate Increases are Delayed

    California Expands Availability of Medi-Medi Plans for Dual Eligibles to Five More Counties

    California Seeks Federal Approval of Program Covering 6 Months of Rent for Homeless Medi-Cal Beneficiaries

    Redeterminations News: California, Illinois, Rhode Island

    Idaho House Rejects $4.7 Billion Fiscal 2024 Medicaid Budget

    Kentucky Governor Signs Legislation to Increase Medicaid Rates for Outpatient Procedures

    New York Senate Advances Proposal to Repeal Medicaid Managed Care Pharmacy Carve-out

    Most States Will Take 12-14 Months to Process Medicaid Redeterminations, KFF Survey Says

    PurposeCare Acquires Home Sweet Home

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 32 states. Read More
    Roundup:

    Alaska Submits Section 1115 Waiver Request to Extend Medicaid SUD, Behavioral Health Program

    Redeterminations News: District of Columbia, Mississippi, Washington, Wyoming

    Medicaid Expansion News: New Hampshire, North Carolina, South Dakota

    New York Has Almost $10 Billion in Surplus Federal Funding for Basic Health Option

    Oregon Medicaid CCO Purchases Hotel to Create Housing for Individuals with Behavioral Health Needs

    Pennsylvania Governor Proposes $500 Million for Mental Health Services in Schools

    Washington Pauses Apple Health Reprocurement Efforts to Focus on Medicaid Redeterminations

    Biden’s Proposed Fiscal 2024 Budget Includes Mandatory Minimum Medicaid MLR

    Help at Home Acquires Prosper Home Care

  • This week, our In Focus highlights a Wakely, an HMA Company, summary and analysis of the 2024 Medicare Advantage Advance Notice, prepared for America’s Health Insurance Plans (AHIP). Read More
    Roundup:

    Arizona House Committee Advances Bill to Reduce Medicaid Redetermination Period

    Colorado Lawmakers Introduce Bill to Authorize Medicaid Reimbursement for Community Health Services

    Redeterminations News: Delaware, Nebraska, Nevada, North Carolina, Rhode Island

    Maryland Health Information Exchange to Expand Medicaid Eligibility Redetermination Notifications

    Mississippi Releases Medicaid Utilization Management, Quality Improvement Organization IFB

    New Jersey Senate Committee Advances Bill to Increase Medicaid Reimbursement Rates for Assisted Living Facilities

    New Mexico House Passes Bill to Study Medicaid Buy-in Program

    North Carolina Senate Committee Advances Medicaid Expansion Bill

    Wisconsin Governor Proposes Tying Medicaid Expansion to Medicaid Reimbursement Rates

    West Virginia House Passes Bill to Scrap Medicaid Managed Care RFP Process, Move to Applications

    15 States Seek Section 1115 Waiver Amendments to Provide Medicaid Services to Incarcerated Individuals Prior to Release

    VillageMD Acquires CT-based Multispecialty Group Starling Physicians

    Presbyterian Healthcare Services, UnityPoint Health to Merge

  • This week, our In Focus reviews a new Health Management Associates (HMA) report, highlighting hybrid (in-person & virtual visits) as the future of child welfare service delivery. Read More
    Roundup:

    Eligibility Redeterminations: Arkansas, Alaska, Centene, Idaho, Illinois, Minnesota, Texas

    California to Award Medicaid Bonus Payments to Nursing Homes

    Illinois Releases Medicaid FFS Dental Program RFP

    Indiana Awards Medicaid MLTSS Contracts to Four Managed Care Organizations

    Iowa House, Senate Pass Separate Bills to Change Medicaid Eligibility Asset Limit

    North Carolina Further Delays Implementation of Behavioral Health IDD Tailored Plans to October 2023

    New Mexico Lawmakers Question Cancellation of Medicaid Managed Care RFP

    Oregon Names Dana Hittle as Medicaid Director

    Medicare Advantage Insurers Report Average Margins Per Enrollee Twice as High as Other Health Insurance Markets

    Elevance Agrees to Acquire BCBS-LA for $2.5 Billion

  • This week our In Focus section reviews the Centers for Medicare and Medicaid Services’ (CMS) announcement that the agency will explore three new prescription drug payment models in the Medicare and Medicaid programs: • Medicare High-Value Drug List Model Read More
    Roundup:

    Arizona to Terminate Nearly 5,300 Medicaid Providers for Non-compliance

    Medicaid Expansion News: Arkansas, Mississippi, New Mexico, North Carolina

    Florida Representative Proposes Medicaid Managed Care Pilot Program for Individuals with Developmental Disabilities

    Medicaid Dental News: Florida, Iowa, Michigan, Nebraska, Virginia,

    Iowa Recommends Maximizing Access to HCBS for Individuals with LTSS Needs

    Massachusetts to Release One Care, Senior Care Options RFR in Late 2023

    Oklahoma to Phase In Medicaid Eligibility Redeterminations by Population

    West Virginia House Committee Recommends Bill to Create Medicaid Buy-in Program

    CMS Seeks Corrective Action Plans from Hospitals Falling Short on Price Transparency Requirements

    Amazon Completes Acquisition of One Medical

  • This week our In Focus section reviews President Joseph R. Biden’s 2023 State of the Union Address (SOTU) to Congress. Read More
    Roundup:

    Alabama Legislative Committee Puts Hold on Inmate Health Contract

    Florida CHIP Enrollment Likely to Increase as Medicaid Redeterminations Begin

    Indiana House Passes Bill to Continue Medicaid Coverage of Children’s Out-of-State Hospital Care

    Michigan Governor Proposes $210 Million to Increase Wages for Direct Care Workers in Fiscal 2024 Budget

    Minnesota Lawmakers Develop Proposal for MinnesotaCare Public Option

    Missouri Representative Proposes Higher Income Limit for Ticket to Work Medicaid Program

    Montana Lawmakers Consider Bill to Allow Physician Assistants to Practice Unsupervised

    New Mexico Awards MMIS Contract to Conduent

    New York Awards $658 Million in Grants to Expand Healthcare Access

    North Carolina House Committees Advance Bill to Expand Medicaid, Increase Hospital Reimbursements

    Tennessee Governor Proposes Expanding Medicaid Eligibility Limits for Pregnant Women, Caretakers

    Virginia to Release Medicaid Managed Care RFP in June 2023

    Virginia to Release Medicaid NEMT RFP in April 2023

    West Virginia Awards Medicaid Managed Care for Foster Care Youth Contract

    CMS Approves Programs to Provide Nutritional Supports for Medicaid Enrollees

    Consonance Capital Partners Acquires Embark Behavioral Health

    Wakely Summary of 2024 MA Advance Notice

  • This week, our In Focus section reviews recently announced major policy updates from the Centers for Medicare & Medicaid Services (CMS) that affect the Medicare Advantage (MA) and Part D programs. Read More
    Roundup:

    Alaska Releases MMIS RFP California Awards $18 Million in Grants for Student Behavioral Health Center Training

    California Awards $18 Million in Grants for Student Behavioral Health Center Training

    Florida Appoints Ken Kniepmann as Assistant Deputy Secretary for Medicaid Policy and Quality

    Medicaid Expansion News: Florida, Kansas, Mississippi

    Idaho Senate Panel Recommends Focus on Prevention Through Managed Care for Medicaid Expansion Population

    Idaho Delays Award of Behavioral Health Plan Contract Pending Appeals Process

    New York Governor Prioritizes Medicaid Reimbursement Increases, Behavioral Health in Fiscal 2024 Budget

    North Carolina Seeks Waiver Amendment to Extend Medicaid Eligibility to Parents, Caretakers of Children in Foster Care

    North Carolina Announces Retirement of Medicaid Director Dave Richard

    Oklahoma to Apply for Medicaid Managed Care Waiver

    Vermont Releases Technical Assistance for Medicaid Supportive Housing Program RFP

    Federal Judge Rules Against Disenrollment of Medicaid Members Who Are Eligible for Medicare Savings Program

    CMS Officials Aim to Establish Universal Quality Measures Across Programs

    CVS Health to Acquire Oak Street Health

    Carlyle Group Looks to Acquire of Cotiviti from Veritas Capital

  • This week, our In Focus section reviews the California amendment to the Section 1115 Waiver Demonstration titled, “California Advancing and Innovating Medi-Cal (CalAIM), ” approved by the Centers for Medicare & Medicaid Services (CMS) on January 26, 2023. Read More
    Roundup:

    California Awards $119 Million to 98 Organizations to Improve Medicaid Delivery System

    California Insurer to Offer Digital Health App to Medicaid Enrollees

    Iowa House Committee Advances Medicaid Work Requirements Bill

    Indiana Reaches $66.5 Million Settlement with Former PBM

    Michigan Releases Child, Adolescent Health Center Program RFP

    Minnesota Attorney General Asks for Delay of Sanford Health, Fairview Health Services Merger

    Mississippi Senator, Representative File Medicaid Expansion Bills

    North Carolina to Move Children Covered by CHIP to Medicaid

    New Mexico Cancels Medicaid Managed Care RFP

    South Dakota Legislators Propose Medicaid Expansion Fund

    Texas Awards STAR+PLUS Medicaid Managed Care Contracts to 7 Plans

    Utah Senate Passes Legislation to Extend Medicaid Dental Coverage

    CMS Proposes Updates to Medicare Advantage Risk Adjustment Model in 2024 Advance Notice

    CMS Will Not Impose Major Penalties on Medicare Advantage Plans for Overpayments

    CMS Outlines PHE Unwinding Requirements, Phase Out of FMAP Increase

    CVS Health Invests $32.7 Million in Affordable Housing in NC, TX

  • Lee Fleisher, MD, chief medical officer and director of CMS’ Center for Clinical Standards and Quality, will deliver the morning keynote address at HMA’s March 6 conference on “Healthcare Quality: A Deep Dive on What’s Next for Providers, Payers, Read More
    Roundup:

    Arkansas Legislature Faces Potential Hurdles for Funding Medicaid Expansion

    Arizona Governor Proposes $2.7 Million to Modernize Medicaid Enterprise System

    Georgia House Speaker Does Not Plan to Take Up Medicaid Expansion

    Massachusetts Governor Appoints Kate Walsh as Secretary of Health, Human Services

    Michigan Provides Pregnancy App for Eligible Medicaid Beneficiaries

    New Mexico Medicaid Director to Step Down

    New Mexico Has Yet to Announce Medicaid Managed Care Awards

    Oklahoma Awards Medicaid Dental Contracts to 2 Plans

    Rhode Island Legislators Introduce Medicaid Housing Supports Pilot Proposal

    Wisconsin Adds Medicaid Work Requirement Advisory Referendum to April Ballot

    Wyoming Appoints Lee Grossman as State Medicaid Agent, Senior Administrator

    Exchange Plan Enrollment Rises Nearly 13 Percent to 16.3 Million in 2023

    FCC Clears Medicaid Plans to Text, Robocall Beneficiaries for Eligibility Redeterminations

    Elevance Health to Acquire BCBS of LA