HMA Weekly Roundup

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  • This week our In Focus section reviews scenarios in which the federal Public Health Emergency (PHE) may expire. Read More

    Alaska Releases MMIS RFI

    California Medicaid Telehealth Visits Soar

    Georgia House Approves Minimum MLR for Medicaid Plans

    UCare to Bid on Iowa Medicaid Managed Care Contract

    Kentucky Releases PBM RFP for Fee-For-Service Medicaid

    Nebraska Medicaid Managed Care RFP Is Expected in April 2022

    North Carolina to Launch Medicaid SDOH Pilot

    Ohio Medicaid Managed Care Enrollment Begins

    Oregon Bill Passes to Address Post-PHE Coverage Losses

  • This week our In Focus section reviews the Centers for Medicare & Medicaid Services’ (CMS) Innovation Center’s newly announced model – Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH). Read More

    Arizona to Prioritize Medicaid Eligibility Redeterminations

    Arkansas Announces HCBS Workforce Stabilization Program

    California to End Child Health and Disability Prevention Program, Expand Presumptive Eligibility

    PBM News: California, Georgia, Michigan, Oregon

    Colorado Pauses Medicaid Prior Authorization Requirements

    Florida Senate Committee Advances Scaled Back Plan to Merge Medicaid Managed Care Regions

    Georgia House Passes Bill to Cover Childless Adults with HIV

    Medicaid Expansion News: Illinois, Wisconsin

    Dental News: New Hampshire, Tennessee

    New York 1199SEIU Home Care Workers to Receive Back Pay

  • This week, our In Focus section reviews the Iowa Health Link request for proposals (RFP) for Medicaid managed care organizations (MCOs) to serve the state’s traditional Medicaid program, the Children’s Health Insurance Program (CHIP) known as Healthy and Well Kids Read More

    Colorado RAE Improperly Denies Claims Due to System Issue

    District of Columbia Awards District Dual Choice Contract

    Florida House Considers Bill to Carve-in Medicaid Dental

    Iowa Releases Medicaid Managed Care RFP

    Massachusetts to Release Medicaid ACOs RFR

    Medicaid Expansion News: Missouri, North Carolina, Wyoming

    Michigan Legislature Passes PBM Transparency Bill

    Nevada Medicaid Providers Are Under-Prescribing MAT

    Oregon Focuses on Equity in Medicaid 1115 Waiver Renewal

    Rhode Island Denies Proposed Hospital Systems Merger

    Wisconsin Senate Passes Bills to Tighten Medicaid Eligibility

    CMS Ends Program to Develop Rural ACOs

  • This week, our In Focus section reviews the California Medicaid (Medi-Cal) managed care request for proposals (RFP) released by the California Department of Health Care Services (DHCS) on February 9, 2022. Read More

    Florida Lawmaker Proposes Statewide Medicaid Managed Care Procurement, Cap on Market Share

    Indiana Bill May Upend Move to Medicaid Managed LTSS

    Medicaid Expansion News: Kansas, Missouri, North Carolina, South Dakota, Wyoming

    Louisiana Awards Medicaid Managed Care Contracts

    Michigan Governor Allocates $243.3 Million to Procure Single Dental Medicaid Managed Care Plan

    Mississippi Bill that Would End Contract With Medicaid Managed Care Plan Moves to Senate

    Eligibility Redetermination News: Oregon, Utah

    West Virginia Legislators Consider Medicaid Buy-in Program

  • This week our In Focus section reviews the Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies issued by the Centers for Medicare & Read More

    Arizona to Offer HCBS Providers Incentive for EVV Use

    Arkansas PASSE Gets Investment from Trive Capital

    California Releases Medicaid Managed Care RFP

    California Medicaid Members Struggle to Fill Prescriptions

    California Plan Gets Medicaid Pact Ahead of Procurement

    Florida Senator Looks to Raise Nursing Home Employee Wages

    Kansas Bill to Extend Medicaid Plan Contracts Is Questioned

    Missouri Medicaid Recipients May Wrongly Lose Coverage

    New Mexico To Releases Medicaid Plan RFP in September 2022

    North Carolina to Join Medicaid Alternative Payment Pilot

    Texas Releases Draft of STAR+PLUS Medicaid Plan RFP

  • This week our In Focus section reviews the Delaware request for proposals (RFP) for Diamond State Health Plan (DSHP) and Diamond State Health Plan Plus (DSHP Plus), the state’s Medicaid managed care programs. Read More

    California Delays Medi-Cal Managed Care RFP By One Week

    Colorado Eyes Reform of Medicaid Behavioral Health System

    Delaware Selects Sandata Technologies for EVV Program

    Georgia Bill Would Set Minimum MLR for Medicaid Plans

    Kansas Lawmakers Look to Extend Medicaid Plan Contracts

    Massachusetts Community Behavioral Health Centers RFP

    Minnesota Governor Seeks MinnesotaCare Buy-In

    South Dakota House OKs Higher Medicaid Dental Rates

    CMS Releases 2023 Medicare, Part D Advance Notice

    Hospital Readmission Rates for Dual Eligibles Are Only Mildly Impacted by Social Determinants of Health, Study Says

    Participation in Medicare Shared Savings ACOs to Rise in 2022

  • This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state’s traditional Medicaid managed care program, and MinnesotaCare, the state’s Basic Health Program (BHP), in 80 counties outside of Read More

    Arkansas Budget Proposal Assumes Rising Medicaid Costs

    Georgia Seeks to Reinstate Medicaid Work Requirements

    Indiana Delays Release of MLTSS RFP Until May 2022

    Maryland Senators Seek Enhanced Adult Dental Coverage

    Montana Lawmakers Consider CCBHCs

    New York Expects Savings from Medicaid Plan Procurement

    Wyoming Medicaid Administrator Teri Green Retires

    Medication Assisted Treatment Use for SUD Rises, CMS Reports

    States Prepare to Restart Medicaid Redeterminations

    Exchange Plan Offerings Increase in 2021

  • This week, our In Focus section highlights the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) and Part D programs for contract year 2023 and how these changes may impact plan applications, bid submissions, Read More

    Florida Governor Snubs Federal COVID-19 Vaccine Mandate

    Georgia Budget Proposal to Fund New Insurance Exchange

    Louisiana Releases Medicaid PBM Services RFP

    Minnesota Releases Medicaid Managed Care, MinnesotaCare RFP Covering 80 Counties

    Missouri Receives 3 Bids for Medicaid Managed Care Program

    New Mexico to Extend Medicaid Postpartum Coverage

    New York Eyes Competitive Bidding for Medicaid Plans

    New York Governor Proposes Medicaid Rate Increases

    Wisconsin Releases HCBS Care Management System RFP

    Behavioral Health Group Buys Center for Behavioral Health

  • This week, our In Focus section highlights a Wakely white paper titled, CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings. Read More

    Arkansas Reaches Settlement with Empower Healthcare

    California FQHCs to Receive Less 340B Funding

    Florida Bill Would Reshape Medicaid Managed Care Regions

    Indiana Awards Medicaid Managed Care Contracts

    Expansion News: Kansas, Missouri, South Dakota, Wyoming

    Minnesota Seeks Models that Increase HCBS Provider Wages

    New York Looks to Rebuild State Healthcare Economy

    Oregon Clears Centene/Trillium to Enroll New Members

    CMS Looks to Partnerships to Address Costs, Disparities

  • This week, our In Focus highlights a new report prepared by Health Management Associates (HMA) on the potential for Medicaid Managed Care to enable states to address social determinants of health (SDOH) and health equity above and beyond what’s possible Read More

    California Receives Approval for CalAIM Demonstration

    Georgia Must Remove Medicaid Expansion Work Requirements

    Idaho Seeks Offers to Administer Behavioral Health Plan

    Iowa Delays Release of Medicaid Managed Care RFP

    Montana Must Wind Down Medicaid Expansion Premiums Above 2 Percent of Income, CMS Says

    Anthem Acquires Ohio Medicaid Contract from Paramount

    South Dakota Voters to Decide on Medicaid Expansion

    CMS Proposes Rule to Standardize Exchange Plans