HMA Weekly Roundup

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  • This week, our In Focus section reviews the Hawaii Quest Integration (QI) Medicaid managed care request for proposals (RFP) released on December 8, 2020, and the Minnesota Families and Children Medical Assistance (MA) and MinnesotaCare programs RFP released on January Read More
    Roundup:

    Hawaii Releases Medicaid Dental TPA RFI

    Indiana Governor To Make Long-Term Care Reform a Priority

    Kentucky Awards Medicaid Managed Care PBM Contract

    Kentucky Awards Aetna Foster Care Contract

    Minnesota Releases Medicaid Managed Care RFP

    Nevada to Implement D-SNP Program in 2021

    New Jersey DHS Commissioner to Join Biden COVID-19 Team

    South Carolina Bills Propose Medicaid Expansion Referendum

    Texas Releases Medicaid Plan Procurement Timelines

    Congress Gives Medicare Physicians 2021 Pay Boost

  • This week, our In Focus section focuses on five critical policy and program trends to provide integrated care to dual-eligible individuals for Medicare and Medicaid. Both federal and state governments continue to look for ways to improve coordination and integration Read More
    Roundup:

    District of Columbia Judge Rules Medicaid Managed Care Procurement Violated Law

    Florida Medicaid Finds $89.6 Million Differential Between Prices Paid to PBMs, Prices Paid to Pharmacies

    Hawaii Medicaid Plans Sought to Limit Number of Award Winners in Current Procurement

    Louisiana to Release Medicaid Managed Care RFP in Spring

    South Carolina Medicaid Director to Step Down

    Texas Sees High Early Turn Out for Exchange Plans

    MACPAC Releases 2020 MACStats Medicaid, CHIP Data Book

  • This week, our In Focus section reviews the finalized coverage expansions for Medicare telehealth services in the Centers for Medicare & Medicaid Services (CMS) Calendar Year (CY) 2021 Physician Fee Schedule (PFS) Final Rule. Telehealth advocates will be pleased to Read More
    Roundup:

    Hawaii Releases RFP For QUEST Integration Medicaid Plans

    Missouri RFP to Carve-in Behavioral Health for Foster Kids

    Montana Receives One-Year Extension of Medicaid Expansion

    New York to Seek Medicaid Redesign Team Waiver Extension

    Ohio Taps Gainwell As Medicaid Fiscal Intermediary

    Oklahoma Medicaid Waiver Providers to Receive 20 Percent Retroactive Rate Adjustment

    Biden’s Potential Administrative Actions Could Impact Six Key Medicaid Regulations, Policies, Kaiser Reports

  • This week, our In Focus section reviews the statewide North Carolina request for applications (RFA) for Behavioral Health and Intellectual/Developmental Disability (BH IDD) Tailored Plans released by the North Carolina Department of Health and Human Services (DHHS) on November 13, Read More
    Roundup:

    Arizona to Release Procurement in August 2021 for Expanded Integrated SMI, Medicaid Managed Care Program

    Delaware Care Collaborative to Serve as Medicaid, CHIP ACO

    New Jersey Medicaid Plan to Terminate Contract with Children’s Hospital of Philadelphia

    Oregon Governor Proposes Medicaid Cuts

    Oregon CCOs Post 0.6 Percent Operating Margin

    Pennsylvania Enacts Medicaid PBM Price Transparency Law

    Texas to Drop Planned Parenthood From Medicaid Network

    CMS Releases 2021 Physician Fee Schedule

  • 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
    Roundup:

    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
    Roundup:

    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
    Roundup:

    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
    Roundup:

    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
    Roundup:

    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
    Roundup:

    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