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- This week, our In Focus explores a new trend to watch in Medicaid Section 1115 waiver demonstration programs. Read MoreRoundup:
California Faces Lawsuit from Health Plan Over Alleged Public Records Act Violation
Kansas to Hold Public Meetings on KanCare With Beneficiaries, Stakeholders
Massachusetts to Transition Dual Eligibles from MMP Demo to D-SNP
Mississippi Submits Amendment to Increase Reimbursement Rates for Private Duty Nurses by 15 Percent
Oklahoma Gubernatorial Candidates Clash on Medicaid Managed Care Implementation
Texas Releases STAR, CHIP Draft RFP
Utah to Transition to New MMIS in 2023
West Virginia Releases RFP for Foster Children, Youth in Medicaid Managed Care
Treasury Announces Rules Aimed at Fixing Exchange Plan ‘Family Glitch’
Walgreens Boots Alliance to Acquire Remaining 45 Percent Stake in CareCentrix
Cimarron Healthcare Capital, Tacoma Holdings Invest in Frontpoint Health
- This week, our In Focus reviews the New Mexico Medicaid managed care request for proposals (RFP), released on September 30, 2022, by the New Mexico Human Services Department (HSD). Read MoreRoundup:
Colorado Releases Medicaid, CHIP Enrollment Broker Services RFP
Louisiana to Begin Auto Assignment of Medicaid Beneficiaries into Managed Care Plans
Maine Looks to Renew NEMT Waiver, Release RFP
Minnesota Awards Medicaid Managed Care Contracts Covering Individuals Outside Twin Cities, Elderly, Disabled
Nebraska Seeks Funds to Cover Aduhelm, Reduce Waiting List for Individuals With Development Disabilities
New York Medicaid Fraud, Waste Reduction Efforts Yield Results
North Carolina Delays Implementation of Behavioral Health IDD Tailored Plans to April 2023
North Dakota Leads Country in Rate of Physicians Accepting New Medicaid Patients, Analysis Finds
Ohio Governor Looks to Expand Medicaid Eligibility for Pregnant Women to 300 Percent of Poverty
Oklahoma Implements 25 Percent Rate Increase for Developmental Disability, HCBS Providers
HCSC Names Anne Rote President of Medicaid Division
Federal Grants Topping $346 Million Awarded to Address Healthcare Staffing Shortages
Ensign Group May Soon Become Largest Nursing Home Provider in U.S.
- This week, our In Focus section looks at the current federal policy landscape and trends and the legislative outlook for the remainder of 2022 and beyond. Read MoreRoundup:
Arizona Medicaid Director to Step Down at the End of 2022
Colorado Appoints Adela Flores-Brennan as Medicaid Director
Centene Names Bill Wilson CEO of Delaware Medicaid Plan
Kansas Begins Distributing $51 Million in Bonuses for Direct Care Workers at Medicaid HCBS Providers
Massachusetts Receives Federal Approval to Extend MassHealth 1115 Waiver Through 2027
Nebraska Awards Medicaid Managed Care Contracts to 3 Health Plans
Nevada Releases Electronic Visit Verification System RFP
Oregon 1115 Waiver Renewal Is Approved by Federal Regulators
Texas Report Recommends Transitioning Medicaid-Only Services into Managed Care for Dual Eligibles
Virginia Medicaid Provider Sets Up Neighborhood Clinics to Expand Access to Preventive Health Care
OIG Calls For Increased Oversight of Medicaid Plan MLR Reporting
DentaQuest Commits $275,000 to Initiative Connecting Children to Dental Care
- This week, our In Focus section highlights an issue brief from Wakely, an HMA Company, The Basics of Evaluating PBM Contracts, published September 2022. Read MoreRoundup:
Cityblock to Serve About 10,000 MDWise Members in Indiana
Kentucky Appeals Panel Upholds 2020 Medicaid Managed Care Contracts With 5 Plans, Excluding Elevance Health
Missouri Meets Federal Requirement of 45 Days for Processing Medicaid Expansion Applications
New York PACE Could Expand Dramatically Under Bill Awaiting Governor’s Signature
Ohio Releases Medicaid Electronic Visit Verification Services RFP
AbsoluteCare Expands Into Pittsburgh Through Collaboration With Highmark Wholecare
Tennessee Is Hit With Lawsuit Over Medicaid Managed Care Procurement
Texas to Receive $165.6 Million in Settlement Over Medicaid Drug Pricing
Medicaid Eligibility Redeterminations Could Take 12 Months Following PHE, State Regulators Say
NCQA, CHCF Release Framework to Measure Health Equity in Medicaid Managed Care
UnitedHealth Group Is Cleared to Acquire Change Healthcare
Humana to Fully Acquire 20 Senior Primary Care Clinics After Buying Out Welsh, Carson’s Stake
- This week, our In Focus highlights a Health Management Associates Institute on Addiction (HMA IOA) report, Delaware Substance Use Disorder Treatment System Needs Assessment, published in June 2022. Read MoreRoundup:
Kentucky Seeks to Expand Number of PACE Providers, Counties Served
Montana Medicaid Reimbursement Rates Are 22 Percent Below Benchmarks, Study Finds
New York Proposes 1115 Waiver Amendment to Address Equity, Housing, Workforce Shortages
Oregon Medicaid Mobile Crisis Intervention Services Program Receives CMS Approval
Texas Awards STAR Health Contract to Centene/Superior HealthPlan
CareSource, Legacy Community Health Form Joint Venture to Bid on Texas STAR, CHIP RFP
CMS to Phase Out D-SNP Look-Alikes Within Medicare Advantage in 2023
Illinois Review Board to Reconsider Merger of Advocate Aurora, Atrium Health
- This week, our In Focus section identifies steps that Medicare and Medicaid plans and providers can undertake to effectively return to normal operations after the end of the COVID-19 public health emergency (PHE) declaration. Read MoreRoundup:
Arkansas Seeks Federal Approval to Offer Full Medicaid Coverage to Pregnant Women
California Awards $340 Million Population Health Management Contract to Gainwell Technologies
California Medi-Cal Contract Awards Face Appeals
Iowa Awards NEMT Contract to MTM
Maryland Releases Dental Benefits Administrator RFP
Maryland Releases Medicaid NEMT Broker RFP
New Mexico Delays Medicaid Managed Care RFP Release to Third Quarter of 2022
Oklahoma Releases Medicaid Dental Managed Care RFP
Tennessee Proposes PMPM Medicaid Spending Cap to Replace Proposed Aggregate Cap
Texas Delays Releases of STAR/CHIP, STAR Kids RFPs
MedPAC Eyes Potential Standardized Benefit Options for Medicare Advantage
CMS Proposes Rule to Standardize Medicaid, CHIP Eligibility and Enrollment
CVS to Acquire Signify Health
Maximus Retains Contract to Support CMS Contact Center Operations
- This week, our In Focus section reviews preliminary 2021 Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. Read MoreRoundup:
California Awards Medi-Cal Managed Care Contracts to Three Health Plans
District of Columbia Medicaid Managed Care Contract Awards Await Mayor’s Recommendations
Florida Medicaid Providers to Pay Long-Term Care Staff $15 Per Hour
Illinois Enacts Legislation to Increase Nursing Home Pay
Iowa Awards Medicaid Managed Care Contracts to Two Health Plans
Louisiana Awards Single, Statewide PBM Contract to Magellan
Louisiana Medicaid Begins Using State Directed Payment Model for Hospitals
Mississippi Medicaid Managed Care Bidders File Protests
Nebraska Delays Medicaid Managed Care Awards to September 23
New Hampshire Releases Adult Medicaid Dental Managed Care RFP
New York Removes Barrier to Home Care M&A Activity With New Licensure Process
CMS Awards $98.9 Million to Navigators to Assist in 2023 Exchange Open Enrollment
8.8 Million Medicaid Beneficiaries Received LTSS in 2019, CMS Report Finds
Medicare Advantage Accounts for Nearly Half of All Medicare Beneficiaries, KFF Analysis Finds
Walgreens Boots Alliance Completes Acquisition of 55 Percent Stake in CareCentrix
- This week, our In Focus section highlights an HMA Issue Brief, Bolstering the Youth Behavioral Health System: Innovative State Policies to Address Access & Parity, published in August 2022. Read MoreIn Focus:Roundup:
California Releases Mobile Crisis Intervention Services RFI
California Exchange Plans Must Resubmit 2023 Rates to Reflect Impact of Inflation Reduction Act
Florida Medicaid Enrollment to Increase 5.5 Percent, Surplus to Top $1.25 Billion in Fiscal 2023
Georgia Can Reinstate Medicaid Expansion Work Requirements, Federal Judge Rules
Nebraska Awards Maxmius Contract for MMIS Provider Services Module
New York Legislators Introduce Bill to Ease Burden of Medicaid Provider Audits, Recoveries
North Carolina Healthy Opportunities Pilot Struggles to Gain Traction
Ohio Counties Win $600 Million in Damages in Opioid Lawsuit
Oregon Health Plan to Use Tech Platform to Connect Medicaid Members to Social Services
Texas Dual Eligible Demonstration Shows Cost Reductions, Study Finds
Utah Releases Medicaid Dental Managed Care RFP
U.S. Senate Panel Investigates Medicare Advantage, Part D Marketing Tactics
Sonas Home Health Care Acquires Focus Forward Skilled Care
Wakely, An HMA Company, White Paper: 2021 Supplemental Claims Impact
- This week, our In Focus section reviews the Inflation Reduction Act of 2022 (IRA), signed by President Biden on August 16, 2022. Read MoreIn Focus:Roundup:
Arizona Works on New Health Plan Contracts for ALTCS-EPD Program
Delaware Judge Denies Motion to Quash Audit of Medicaid Program
District of Columbia Accepts Bids from 2 Medicaid Managed Care Plans
Florida Medicaid Plan Capitated Rates to Fall, Driven by Lower Utilization
Illinois Announces PACE Program Awardees
Massachusetts Seeks Input on Improving Medicaid MCO/ACO Risk Adjustment Model
Minnesota Releases RFP for School-Linked SUD Services for Students
Missouri Medicaid Software Vendor Wins $23 Million in Lawsuit Against State
Nebraska Delays Medicaid Managed Care Awards to August 31
North Carolina Legislators Fail to Reach an Agreement on Medicaid Expansion
CMS Proposes Rule to Expand Medically Necessary Dental Services Covered by Medicare
Medicare Rates Expected to Rise 2.5 Percent for Inpatient Psychiatric Facilities in Fiscal 2023
Humana to Acquire Wisconsin-based MCO Inclusa
LHC Group Agrees to Acquire Three Rivers Home Health
- As the urgent needs of COVID-19 Public Health Emergency (PHE) continue to subside, state Medicaid agencies are exploring pathways and concepts to further address the historic inequities and health disparities laid bare by the pandemic. Read MoreRoundup:
California Delays Medi-Cal Managed Care Program Awards
Connecticut HUSKY Health to Cover Additional Maternity Benefits in 2023
Florida Medicaid Managed Care RFI Responses Stress Social Determinants, Providers, HCBS
Georgia Proposal to Bypass Healthcare.gov Is Again Rejected by CMS
Idaho Releases Quality Improvement Organization RFP
Mississippi Awards MississippiCAN, CHIP Medicaid Managed Care Contracts to 3 Health Plans
Missouri Commits to Trimming Medicaid Applications Backlog Under Federal Plan
Ohio Pharmacists Express Concern Over Single PBM Program
West Virginia Medicaid Must Cover Gender-Affirming Care, Federal Judge Rules
U.S. Senate Passes Legislation Allowing Medicare to Negotiate Drug Prices, Extending Enhanced Exchange Subsidies
CVS Is Reportedly Interested in Acquiring Signify Health
UnitedHealth/Optum Acquires CareMount Medical
