HMA Weekly Roundup

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  • This week, our In Focus section reviews the Biden Administration’s proposed rule revising eligibility standards for premium subsidies for families, released on April 5, 20221. Read More

    Florida Governor Signs Medicaid Managed Care, Nursing Home Legislation

    Illinois Lawmakers Approve Medicaid Bill Expanding Certain Benefits, Coverage

    Louisiana Awards NEMT Contract

    Louisiana Legislature Passes Bill to Provide Medicaid Dental Coverage to Adults

    Massachusetts Releases Medicaid ACO RFR

    New York Files 1115 Waiver Amendment to Address Health Equity

    New York Medicaid Director Brett Friedman Steps Down

    Oregon Governor Establishes Taskforce to Develop Medicaid Bridge Plan

    Rhode Island Names Kristin Pono Sousa Medicaid Director

    HHS Extends Public Health Emergency for 90 Days to July 15

    Genuine Health Group Acquires Accountable Care Medical Group

  • This week, our In Focus section reviews the Texas STAR+PLUS managed care services request for proposals (RFP) released on March 31, 2022, by the Texas Health and Human Services Commission (HHSC). Read More

    Florida Reaches $484 Million Settlement with Pharmacy Chain Over Opioid Claims

    Georgia Enacts Bill to Implement 85 Percent Minimum MLR Requirement for Medicaid Plans

    BCBS-Illinois Appoints Stephen Harris as President

    Kansas Senate Approves Bill to Extend KanCare Contracts Through 2024

    Minnesota DHS Recommends Actions to Improve Racial Equity, Health Outcomes in Medicaid

    New Mexico HCBS Providers to Receive Temporary 15 Percent Reimbursement Rate Increase

    Oklahoma Names Traylor Rains State Medicaid Director

    Rhode Island Medicaid Managed Care Bid Is Rejected After Missing Submission Deadline

    Biden Proposes Fix to Exchange ‘Family Glitch’ Impacting 5 Million Individuals

    CMS Finalizes 8.5 Percent Rate Increase for Medicare Advantage, Part D Plans

    Intermountain Healthcare, SCL Health Complete Merger

    UnitedHealth/Optum to Acquire Majority Stake in Kelsey-Seybold Clinic

    Federal Judge Dismisses Anthem’s Claims in PBM Lawsuit Against Cigna

  • This week, our In Focus section reviews President Biden’s budget proposal for federal fiscal year 2023, released on March 28, 2022. Read More

    Arkansas Eligibles Face Barriers Enrolling in Medicaid, Report Finds

    Connecticut Medicaid Enrollment Increases by 120,000 During Pandemic

    Florida Medicaid Plan Has New Enrollment Suspended by State

    Kansas Governor Urges Legislature to Remove Budget Bill Provision to Extend KanCare Contracts

    Michigan Home-Based Care Providers Struggle After Reimbursement Rate Cut

    New Hampshire Hospitals Can Proceed with Lawsuit Over Vermont Over Medicaid Rates

    North Carolina Launches Initiative to Provide Integrated Care for Children On Medicaid, CHIP

    Pennsylvania to Release MMIS RFP in September 2022

    South Carolina Receives CMS Approval of Temporary HCBS Rate Increases

    Health Plan Invests More Than $85 Million to Help Develop Affordable Housing in Texas

    Medicaid Spending Will Exceed $1 Trillion in 2028, CMS Projects

  • This week our In Focus section reviews the issue brief and policymaker playbook that explore the outlook for temporary COVID-19-related changes to the Medicare and Medicaid programs, prepared in partnership with Manatt Health for The SCAN Foundation. Read More

    California Extends Medi-Cal Assisted Living Waiver Program

    Colorado, Novartis Begin Medicaid Value-Based Drug Pacts

    Illinois to Fund Effort on Social Determinants of Health

    Iowa to Release Medicaid Enterprise Provider Solutions RFI

    NEMT News: Michigan, Utah

    Nevada Releases RFP for Medicaid Dental Benefits Plan

    Medicaid Plans Can Play Important Role in Redeterminations

    CMS Says Medicaid, Exchange Enrollment Is at All-Time High

  • This week our In Focus section highlights HMA’s insights on how stakeholders can prepare for the unwinding of Medicaid’s Public Health Emergency Continuous Eligibility policy. Read More

    Florida Legislature Passes Bill Reducing Number of Medicaid Managed Care Regions

    Georgia House Passes Bill to Carve-Out Medicaid Pharmacy Benefits

    Iowa Releases Non-Emergency Medical Transportation RFP

    New Jersey Seeks Approval of Adult Continuous Eligibility, Maternal Care Programs in Medicaid 1115 Waiver Extension

    New York Legislature Rejects Competitive Bidding for Medicaid Managed Care

    CMS Must Issue Decision on TX Waiver Programs

    Congress Extends Medicare Telehealth Coverage in Newly Approved Budget

  • 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