HMA Weekly Roundup

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  • This week, our In Focus section reviews Texas’ biennial legislative appropriations request (LAR) for fiscal years 2020-21, submitted by the Texas Health and Human Services Commission (HHSC). The document, which totals 1, 358 pages, includes summary program data as well Read More

    Arkansas Drops 4,300 Medicaid Expansion Members for Failing to Meet Work Requirements

    Michigan Medicaid Expansion Improved Health, Finances of Low-Income Adults, Study Finds

    Pennsylvania-based Jefferson Health, Einstein Healthcare Network to Merge

    Colorado to Treat 2,000 Prisoners With Chronic Hepatitis C

    Wisconsin Transitions to Maximus for Medicaid HMO Enrollment Broker Services

    Uninsured Rate Unchanged at 8.8 Percent in 2017

  • This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for beneficiaries dually eligible for Medicare and Medicaid (duals) in nine states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Read More

    Arkansas Work Requirements Result in 4,600 Losing Coverage

    California Allows State Regulators to Veto Proposed Health Plan Mergers

    Massachusetts Releases Duals Demo 2.0 RFI

    Michigan Seeks Federal Approval for Work Requirements

    Tennessee Rereleases Pharmacy Claims Processing System RFP

    ACA Exchange Plan Premiums to Rise 3.6% in 2019

  • This week, our In Focus reviews North Carolina’s much-anticipated Prepaid Health Plan Services request for proposals (RFP), released by the Department of Health and Human Services, Division of Health Benefits on August 9, 2018, and District of Columbia’s Medicaid Managed Read More

    California Passes Bill to Cap Dialysis Reimbursements

    New Hampshire Releases Medicaid Managed Care RFP

    Mississippi Re-releases CHIP RFQ

    New York MLTC Plan GuildNet to Shut Down

    Magellan Receives Medicaid Contract in Florida

    Illinois Halts Enrollment into BCBS Dual Plan

    Phillips Appointed Texas HHSC Executive Commissioner

    Steckel Named Kentucky Medicaid Commissioner

    Oregon Health Share CEO Steps Down

    Montana to Restore Medicaid Provider Rate Cuts

    Iowa to Increase Medicaid MCO Rates

    Oklahoma Considers Provider Rate Increases

  • This week, our In Focus section highlights HMA Medicaid Market Solutions’ (MMS) efforts to support state flexibility in designing and implementing Section 1115 Demonstration Waivers promoting member engagement and personal responsibility. Over the coming weeks, HMA MMS will present a Read More

    North Carolina Releases Medicaid Managed Care RFP

    D.C. Releases RFP to Reprocure Medicaid MCO Contracts

    Arizona Releases RFI Concerning Potential Integrated Health Care Program for Foster Kids

    Arkansas Residents Sue CMS Over Work Requirements

    Ohio to Transition PBM Contracts to Transparent Pricing

    Kansas Judge Denies Temporary Injunction in Medicaid Managed Care Awards Dispute

    GAO, CMS Call for Scrutiny of Medicaid Managed Care

  • This week, our In Focus reviews a New York State Health Foundation commissioned report titled, “An Assessment of the New York Health Act: A Single-Payer Option for New York State.” The study, conducted by the RAND Corporation, analyzes a proposal Read More

    Florida Healthy Kids Releases CHIP Medical Services, Coverage ITN

    Illinois Enacts Law To Address Medicaid Eligibility Backlog For Nursing Home Residents

    North Carolina Awards Enrollment Broker Contract to Maximus

    Washington Awards Medicaid Dental Contracts

    Medicaid Expansion Makes Diabetes Medication More Affordable, Study Finds

  • This week, our In Focus reviews the New Hampshire Medicaid Care Management (MCM) Services Draft request for proposals (RFP), released by the state Department of Health and Human Services (DHHS) on July 9, 2018. The MCM program, worth $750 million Read More

    Mississippi Cancels CHIP Managed Care RFQ

    Florida Dental Plans Drop Medicaid Award Challenge

    Mississippi Medicaid Awards NEMT Contract

    Wisconsin, Maine Approved for New Reinsurance Funds

    Montana Governor Restores $45 Million in Medicaid Funding

    HHS Expands Availability of Short-Term Health Plans

    GAO Urges CMS to Increase Oversight of Medicaid Managed Care Plans, Track Over-Payments

  • This week, our In Focus reviews a case study called, “Spotlight on Health Center Payment Reform: Washington State’s FQHC Alternative Payment Methodology, ” authored and prepared for the National Association of Community Health Centers by Health Management Associates’ Principal Art Read More

    Texas Reissues STAR+PLUS RFP

    Kentucky Restores Dental, Vision Benefits to Medicaid Beneficiaries

    South Dakota Releases RFP for Medicaid, CHIP Eligibility System

    California Health Exchange Rates to Rise 8.7 Percent

    CMS to Resume Exchange Plan Risk-Adjustment Payments

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 28 states.1 Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This Read More

    Arkansas Work Requirement Takes Effect; 7,000 Beneficiaries Fall Short

    Massachusetts to Release One Care RFP in August

    Ohio to Request 3-Year Extension of Dual Demonstration

    Kansas, Rhode Island to Lift Limits on Hepatitis C Treatment

    Oklahoma Medicaid Wins Approval for Value-Based Drug Program

    New Mexico Judge Grants UnitedHealth Stay in Contract Award Dispute

    New York Launches Care Management Program for People with Developmental Disabilities

  • This week, our In Focus reviews the Mississippi Children’s Health Insurance Program (CHIP) request for qualifications (RFQ) issued by the state’s Division of Medicaid on June 8, 2018. The Mississippi CHIP program provides statewide health coverage in all 82 counties Read More

    Alabama Awards Integrated Care Network Contract

    Arizona Releases Integrated Health Care Choice Plans RFP

    Florida Awards Medicaid Prepaid Dental Program Contracts

    Kansas Medicaid Managed Care Awards Face Protest

    Kentucky Medicaid Work Requirement Struck Down By Judge

    Maine House Sustains Medicaid Expansion Funding Veto

    Nebraska Medicaid Ballot Initiative Meets Threshold

    Puerto Rico Awards Medicaid Managed Care Contracts

    Texas Cancels STAR+PLUS RFP

  • This week, our In Focus comes from Senior Consultant Rachel Patterson, who provides an overview of Chapter 3 of the Medicaid and CHIP Payment and Access Commission (MACPAC) June 2018 Report to Congress on Medicaid and CHIP, which examines the Read More

    Florida to Award Children’s Medical Services Contract to WellCare

    Florida Decision to Award Molina Contract in Region 8 to Be Challenged By Best Care Assurance

    Kansas Awards Medicaid Managed Care Contracts

    Michigan Governor Signs Medicaid Work Requirements Bill

    New Jersey Releases January 2019 Amendments to Medicaid MCO Contract

    CMS to Increase Oversight of Medicaid Managed Care Plans, States