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- This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 32 states. Read MoreRoundup:
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 MoreRoundup:
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 MoreRoundup:
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 MoreRoundup:
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 MoreRoundup:
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 MoreRoundup:
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 MoreRoundup:
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 MoreRoundup:
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
- In 2022, HMA convened stakeholder roundtables in three states – including New Mexico, North Dakota, and New Mexico to identify the challenges facing dually eligible individuals living in rural areas and to propose solutions to these challenges. Informed by this Read MoreIn Focus:Roundup:
Arkansas Releases RFI for Medicaid Managed Care Module of MMIS Replacement
Florida Governor Announces Proposal to Regulate PBMs
Medicaid Expansion News: Georgia, Kansas, Mississippi, North Carolina, South Dakota
Georgia Releases RFI to Audit PBMs Contracted Through Medicaid Plans
Louisiana Releases RFP for Permanent Supportive Housing Services Funded in Part by Medicaid
Michigan Doulas Push for Higher Medicaid Reimbursement Rates
Mississippi Seeks Bids for Medicaid FFS Non-emergency Transportation Services
South Carolina to Continue Several Flexibilities After COVID-19 PHE Ends
CMS Announces Medicare Accountable Care Partnerships Will Cover 13.2 Million Enrollees in 2023
Health Network One Acquires Premier Eye Care
- This week, our In Focus section reviews changes to Medicaid’s COVID-19 Public Health Emergency (PHE) unwinding. Read MoreRoundup:
Arizona Medicare Plan Receives $60 Million Investment from Chicago Pacific Founder to Launch ESRD C-SNP
California Revises List of Medicaid Managed Care Award Winners in Several Counties
Connecticut Expands Medicaid Eligibility for Children Effective January 1
Florida Appoints Jason Weida as Interim Secretary
Georgia Releases RFQC for Medicaid Managed Care Plans
Georgia Establishes State Exchange Directing Buyers to Brokers, Insurers
Idaho Legislators to Review Medicaid Expansion
Maine to Seek Renewal of Waivers for Adults in Need of Home and Community-based Services
Maryland Releases Behavioral Health ASO RFP
Maryland Implements Medicaid Comprehensive Dental Coverage
Massachusetts Selects 20 Community Partners for ACO Behavioral Health, LTSS
Nevada Receives Federal Approval for SUD Treatment Waiver
New Hampshire Legislature to Vote on Reauthorization of Medicaid Expansion Funding
New York Governor Announces $1 Billion Plan to Address Behavioral Health
North Dakota Releases Medicaid Enterprise Technical Systems Integrator RFP
Oklahoma Faces Lawsuit from Provider-led Entity Regarding Managed Care Procurement
Oregon Approves Amazon Acquisition of One Medical
Rhode Island Releases NEMT Program RFQ
Wisconsin Names Jamie Kuhn as Medicaid Director
HHS Extends Public Health Emergency Until April 11
CMS Allows States, Medicaid Plans to Spend 5 Percent of Premiums on Social Determinants of Health
CVS Health Considers Acquisition of Oak Street Health
