HMA Weekly Roundup

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  • This week, our In Focus section reviews the policy changes included in the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and LongTerm Acute Care Hospital (LTCH) Final Rule (CMS-1735-F). Read More

    District of Columbia Council Finalizes Medicaid Managed Care Contracts

    Florida AHCA Secretary Mary Mayhew to Leave Post October 2

    Georgia Submits 1332 Waiver to Abandon ACA Health Insurance Exchanges

    Oklahoma to Transition Majority of Insure Oklahoma Members to Medicaid Expansion

    Oregon Files Notice of Noncompliance Against Medicaid CCO

  • This week, our In Focus section reviews the California request for information (RFI) regarding the Medi-Cal Managed Care Plan (MCP) contract and the upcoming Medi-Cal MCP procurement. The California Department of Health Care Services (DHCS) is seeking information to update Read More

    California Medicaid Drops Proposed LTC At Home Benefit

    Medicaid Managed Care RFP News: District of Columbia, Indiana, Louisiana, North Carolina

    Medicaid Budget News: Georgia, New Jersey, Wyoming

    Illinois to Transition Foster Kids to Medicaid Managed Care

    Kentucky Releases RFP for Single PBM

    Mississippi Advocates Renew Medicaid Expansion Push

    Nevada Releases Medicaid NEMT RFP

    Housing Supports News: New York, Utah

    Ohio Proposes Rules to Lock In Medicaid Telehealth Changes

    States Take Emergency Action on Medicaid Long-Term Care

  • This week, our In Focus section reviews Democratic Nominee Joe Biden’s healthcare plan to protect and build on the Affordable Care Act (ACA). On August 18, 2020, Biden was officially nominated as the presidential candidate. Biden vowed at the 2020 Read More

    Florida Says It Has Enough Medicaid Funding for Fiscal 2021

    Nevada to Move Forward with Proposed Medicaid Rate Cuts

    New Mexico Co-Op Plan Health Connections to Cease Operations in 2021

    Oklahoma Will Not Move Forward With Block Grant

    Oregon Approves Trillium CCO Expansion Into Portland Area

    CMS Fines Nursing Homes More Than $15 Million for Infection Control Noncompliance

  • This week, our In Focus section reviews two Medicare fee-for-service (FFS) proposed rules recently issued by the Centers for Medicare & Medicaid Services (CMS). On August 3, 2020, CMS released a proposed rule that includes updates to services furnished under Read More

    Florida Medicaid Plans to Get 1.5 Percent Rate Increase

    Kansas Governor Urges Lawmakers to Pass Expansion

    New Jersey Proposes $155 Million in Additional LTC Funding

    Ohio Medicaid Officials to Address PBM Report Omissions

    Oklahoma to Transition to Dental Managed Care in 2021

    Oregon Reviews CCO Application to Expand Into Portland

    Washington Chooses Five Cascade Care Public Option Plans

  • This week, our In Focus section examines how the federal government implemented changes to the Medicare program in response to COVID-19. As the COVID-19 pandemic began in the United States, Congress and the Administration responded with a series of legislative, Read More

    California Medi-Cal to Amend Certain Contracts to Address Racial Disparities

    Maine Budget Committee Projects Fiscal 2021 Shortfall

    Missouri Voters Approve Medicaid Expansion Ballot Measure

    Washington Announces IMC Expanded Access Awards

    Trump Administration Moves to Make Certain Medicare Telehealth and Scope of Practice Flexibilities Permanent

  • This week, our In Focus section reviews the Hawaii request for information (RFI) regarding reprocurement of the state’s QUEST Integration (QI) Medicaid managed care program, released on July 21, 2020. QI covers approximately 360, 000 individuals, including pregnant women, children, Read More

    California Seeks Section 1115 Medicaid Waiver Extension

    Florida Expects ‘Significant’ Fiscal 2020 Medicaid Budget Gap

    Georgia Lacks Proper Oversight of Medicaid Plans, Audit Says

    Iowa Medicaid Director to Step Down

    Medicaid Housing Support: Minnesota, Virginia

    New York to Leverage Exchange to Connect Individuals with Home Care Agencies

    Ohio Releases Single Pharmacy Benefit Manager RFP

    Texas Taps Cecile Young as Executive Commissioner of HHSC

    Senate COVID-19 Relief Bill Excludes More Medicaid Funding

  • This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state’s Read More

    District of Columbia Announces Medicaid Managed Care Awards

    Florida Medicaid Expansion Could Cover Nearly 700,000

    Kentucky Medicaid Plans Point to Flaw in Bidding, Awards Process

    Montana Announces Behavioral Provider Relief Grants

    Nevada Legislature Approves Cuts to Medicaid

    Oklahoma Seeks Input for Medicaid Managed Care RFP

    South Dakota Medicaid Expansion Advocates Prepare for 2022 Ballot Measures

    CMS Issues Medicare Advantage MLR Requirement Guidance

  • This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “March 2020 Medicaid and CHIP Applications, Eligibility Determination, Read More

    Georgia Delays Transition Away from Federal Exchange

    Kansas Appoints Sarah Fertig as Medicaid Director

    Michigan Plans to Cut Medicaid Rates by 3.3 Percent

    Medicaid Expansion News: Missouri, Nebraska, Oklahoma

    Nevada Considers Medicaid Reimbursement, Program Cuts

    New Jersey Extends Duration of Telehealth Access

    North Carolina Governor Signs Medicaid Managed Care Bill

    Pennsylvania Announces HealthChoices Awards

    Walmart to Sell Medicare Health Insurance in Texas

    Number of Uninsured Adults Rises by 5.4 Million, Study Shows

  • This week our In Focus section summarizes the United States Government Accountability Office (GAO) Medicaid report, State Views on Program Administration Challenges, released earlier this year. GAO conducted interviews with Medicaid officials from 50 states and the District of Columbia Read More

    Florida Governor Vetoes Disability Provider Rate Increase for Providers Serving Individuals with Disabilities

    Illinois Unit of Centene to Acquire NextLevel Members

    Kentucky Health Plans Formally Protest Medicaid Awards

    New York Medicaid Plan Sells Certain Assets to Molina

    North Carolina Medicaid Bill Awaits Governor’s Signature

    Oklahoma Voters Approve Medicaid Expansion Measure

    Virginia Governor Redirects $30 Million From Medicaid Plans

    House Votes to Increase Exchange Subsidies

  • This week, our In Focus section examines new guidance issued by the Centers for Medicare & Medicaid Services (CMS) regarding Medicare Advantage (MA) plan network adequacy requirements. On June 17, 2020, CMS released updated Medicare Advantage and 1876 Cost Plan Read More

    California Budget Adopts Cuts to Medicaid Managed Care

    Delaware to Tap Magarik to Head Health and Social Services

    Kentucky Seeks to Bring Back State-Based Health Exchange

    North Carolina House Committee Advances Medicaid Managed Care Bill

    North Dakota Seeks Input on Re-Procurement of Medicaid Expansion Managed Care Plan

    Oklahoma to Release Medicaid Managed Care RFP This Fall

    Texas Names McCreary COO of Health and Human Services

    CMS Can Force Hospitals to Reveal Prices Negotiated with Insurers, Federal Judge Rules