HMA Weekly Roundup

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  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 29 states. Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This Read More
    Roundup:

    Alabama Releases Coordinated Health Network RFP

    Arkansas Says 3 Provider-Led Entities Will Move to Full Risk in Next Phase of PASSE Program

    Colorado, New York, Ohio Release Budget Proposals

    Kentucky Medicaid Beneficiaries Again File Lawsuit to Block Work Requirements, Premiums

    Louisiana Releases RFP for Subscription-Based Hepatitis C Drug Purchasing Agreement

    Michigan Names Gordon to Lead State Health Department

    Wisconsin Governor to Push for Medicaid Expansion Despite Legislative Opposition

    Trump Administration Is Reportedly Preparing Medicaid Block Grant Guidelines

  • This week, our In Focus section reviews a report recently submitted to the Minnesota Legislature, Accounting for Social Risk Factors in Minnesota Health Care Program Payments. The report delivers Minnesota Department of Human Services (DHS) recommendations to reduce health disparities Read More
    Roundup:

    AZ, FL, NM Name Medicaid Directors

    California Governor Orders Transition of Medicaid Pharmacy Benefit from Managed Care to FFS

    Florida Rejects Rebid of Medicaid Managed Care Contract Award for HIV/AIDS

    Virginia Medicaid Director Calls for Overhaul of Forecasting, Rate-Setting Processes

    CMS Names Chris Traylor Acting Director of Center for Medicaid and CHIP Services

  • This week, our In Focus section is led by Matt Powers, a Principal in our Chicago office, who worked with HMA colleagues to summarize the factors that non-expansion states weigh when considering whether or not to expand Medicaid under the Read More
    Roundup:

    Arkansas Drops Another 4,655 Medicaid Beneficiaries for Failing to Meet Work Requirements

    New York DOH Announces Funding for Community-Based Organizations

    Indiana Releases PBM Administrative Services RFP

    Molina Healthcare to Cut Ties with Golden Shore Medical Group Clinics

    Ohio Medicaid Director Barbara Sears To Step Down

    Oregon Names Lori Coyner Medicaid Director

    Federal Judge Rules ACA Is Unconstitutional

    December MACPAC Meeting Focuses on State Innovations in Drug Pricing, Network Adequacy, DSH Funding

  • This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “September 2018 Medicaid and CHIP Application, Eligibility Determination, Read More
    Roundup:

    Maine Judge Sets February 1 Deadline for Medicaid Expansion Enrollment

    Mississippi Awards CHIP Contracts to Molina, UnitedHealth

    New York to Sunset Duals Demo (FIDA)

    Oklahoma Seeks Federal Approval for Medicaid Work Requirements

    U.S. Health Spending Growth Slowed to 3.9 Percent in 2017, CMS Says

  • This week, our In Focus section comes to us from HMA Senior Consultant ErinMathies (Indianapolis), who reviews the premium assistance programs for the working adult population in Medicaid expansion states. Medicaid programs that pay for premiums in commercial insurance for Read More
    Roundup:

    CMS Approves Florida Request to Shorten Retroactive Medicaid Eligibility

    Massachusetts Receives CMS Approval for Flexible Services Program

    Massachusetts Approves Beth Israel-Lahey Health Merger

    New Hampshire Receives Federal Approval of Medicaid Expansion Work Requirements

    New York Provides DSRIP Update

    TennCare Director Accepts Health Care Post in Nashville

    Bipartisan Senate Bill Aims to Lower Drug Pricing

    Number of Uninsured Children Increased By 276,000 in 2017

  • This week, our In Focus section comes to us from HMA Senior Consultant Ryan Mooney (Austin), who reviewed the proposed rule on Health Reimbursement Arrangements (HRAs). On October 29, 2018, the U.S. Department of the Treasury, the Department of Labor, Read More
    Roundup:

    Judge Rejects Florida Medicaid Managed Care Contract Award for HIV/AIDS

    Kentucky Work Requirements Waiver Approved by CMS After Further Review

    Maine Judge Orders Implementation of Medicaid Expansion; LePage To Appeal

    New Mexico Judge Rejects Medicaid Contract Award Challenge By Molina

    Arkansas Delays Phase II of Medicaid Managed Care Transition Until March 2019

    Florida AHCA Secretary Justin Senior to Step Down

  • Among the biggest challenges facing clinicians today is keeping up to date with the latest medical advances, care models, and delivery system redesign efforts. The need for ongoing learning is especially true for safety net providers, where new approaches to Read More
    Roundup:

    Florida Closes ITN for Regions 3-7 of SMMC MMA PSN

    Maine Governor to Implement Medicaid Expansion Upon Taking Office

    Montana Voters Reject Tobacco Tax to Fund Medicaid Expansion

    New Jersey Creates Consumer Portal to Facilitate ACA Open Enrollment

    CMS Considers Allowing Hospitals to Use Medicaid Funds for Housing

    CMS Announces Short-Term IMD Exclusion Waivers for Serious Mental Illness

    CMS to Propose Rule Allowing States to Limit NEMT Services

  • This week, our In Focus section comes to us from Principal Elaine Peters (HMA– Florida), who reviews the recent re-procurement by the Florida Agency for Health Care Administration (AHCA) of its Statewide Medicaid Managed Care (SMMC) health and dental plans. Read More
    Roundup:

    Idaho, Nebraska, Utah Voters Approve Medicaid Expansion Ballot Measures

    New York Publishes Inpatient and Nursing Home Medicaid Rate Increase

    Texas-Based Scott and White Health Plan to Acquire FirstCare Health Plans

    California Faces Investigation Following Report of Inadequate Prison Mental Health Care

    Colorado To Tighten Limits on Opioid Prescriptions

    Midterm Election Results Are Boost for Medicaid Expansion

  • This week, our In Focus section reviews highlights and shares key takeaways from the 18th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 25, 2018, in Read More
    Roundup:

    North Carolina Receives CMS Approval for Medicaid Managed Care Transition

    Montana Voters Divided on Taxing Tobacco to Fund Medicaid Expansion

    Pennsylvania Governor Vetoes Medicaid Work Requirements Bill

    Wisconsin Receives Federal Approval for Medicaid Work Requirements

    Texas Drug Utilization Review Board Seeks to Expand Medicaid Opioid Treatment

    New York Officials Holding Statewide Forums on IDD Transition to Managed Care

    President Trump Signs Opioid Legislation

    CMS Proposes Payment Changes to Physician-Administrated, Medicare Part B Drugs

  • This week, our In Focus section comes to us from Principal Nora Leibowitz, reviewing the Centers for Medicare & Medicaid Services (CMS) guidance on Section 1332 waivers. The State Relief and Empowerment Waivers guidance, published in the Federal Register on Read More
    Roundup:

    Minnesota to Release Medicaid Managed Care RFPs in 2019

    Missouri Names State House Speaker Todd Richardson Medicaid Director

    North Carolina Receives 8 Bids for Medicaid MCO Procurement

    Pennsylvania Announces New Program to Support Housing Needs of Individuals with OUD

    Texas Releases RFI for Program Improvements to STAR Health

    Medicaid Enrollment Drops as Economy Improves, According to Report