Need to round out your collection of Weekly Roundups?
Access pdfs of this weekly newsletter’s archived issues.
- 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
- This week, our In Focus section reviews the request for information (RFI) on ways to strengthen the Medicare Advantage (MA) program, released by the Centers for Medicare & Medicaid Services (CMS) on July 28, 2022. Read MoreRoundup:
Alabama Releases SMI Independent Evaluator RFP
Arkansas Withdraws Previously Released PBM RFP To ‘Start from Scratch’
Georgia Receives Approval for 2 Percent Rate Increase for HCBS Waivers
Michigan Seeks Another Year to Implement SPA for Community Support Services
Mississippi Delays Medicaid Managed Care Awards to August
Missouri Submits Substance Use Disorder 1115 Waiver Application
New York Attorney General Files Antitrust Lawsuit Against CVS Over 340B Program
Ohio Releases Medicaid IV&V Services RFP
Oregon Seeks Medicaid Coverage for Individuals Up to 200 Percent of Poverty After PHE Ends
South Carolina to Convene Working Group on Emergency Mental Health
National Uninsured Rate Hits a Record Low of 8 Percent
Biden Administration May Allow Medicaid Waivers to Cover Out-of-State Abortions
Medical Transportation Management Finalizes Acquisition of Veyo
- This week, our In Focus section is the next in our series highlighting significant developments in the Medicare program. Read MoreRoundup:
California Medicaid Plans Eye State Exchange in 2024
Delaware Submits 1115 Waiver Amendment for Federal Approval
Michigan Releases RFP for EVV System for Medicaid Personal Care, Home Care
Montana Medicaid to Cover Applied Behavioral Therapy for Children With Autism
New York Proposes Rule For Medicaid Plans to Bolster Special Investigations Units
North Carolina Medicaid Expansion Negotiations Slow
CMS Releases Voluntary HCBS Quality Measure Set
Amazon to Buy 1LifeHealthcare in $3.9 Billion Deal
Vistria Group Is Investing Upwards of $200 Million in Sandstone Care
- Over the course of three weeks CMS has made a series of Medicare announcements that arguably contain the most sweeping changes to the Medicare program proposed thus far by the Biden Administration. Read MoreRoundup:
California Governor Signs Bill to Establish No-Bid Contract with Medicaid Plan
Colorado Policy Restricts Use of Behavioral Health Interns, Unlicensed Therapists
Florida Considers Denying Medicaid Coverage for Gender-Affirming Care for Transgender Youth
Georgia Receives Federal Renewal of 1915 HCBS Waiver for Five Years
Idaho Releases Medicaid Dual Programs RFI
Illinois Accepting Medicaid Applications for Individuals 42 and Up, Regardless of Immigration Status
Massachusetts Releases Request for Responses for Behavioral Health, LTSS Community Partners
New York HCBS Children’s Waiver Providers to Receive Temporary 25 Percent Rate Increase
Oregon Medicaid CCO Program ‘Helped Slow Cost Growth,’ State Says
Pennsylvania Physical HealthChoices Beneficiaries Must Choose New Plan Before August 16
Tennessee Drafts Amendment to TennCare Block Grant Waiver
Washington Seeks 5-Year Renewal of Medicaid Transformation 1115 Waiver
COVID-19 Is Associated with Increased Incidence of Future Medicaid Conditions, Costs, Wakely Study Finds
CMS Awards $49 Million in Grants to Boost Medicaid, CHIP Enrollment of Children
CMS Proposes 2.7 Percent Increase in Medicare Reimbursement Rate for Outpatient, Ambulatory Surgical Center Services
Pediatric Home Service Acquires Craig HomeCare, Cherub Medical Supply
Health Plan Joins Hospital Systems as Co-Owner of Delaware Regional Medicare ACO
- This week, our In Focus reviews the Indiana Medicaid managed long-term services and supports (MLTSS) request for proposals, released by the Indiana Department of Administration on behalf of the Family and Social Services Administration on June 30, 2022. Read MoreIn Focus:Roundup:
California Legislature Considers Bill Allowing Medi-Cal Reimbursement for Eyeglasses from Retail Labs
Delaware Awards Medicaid Managed Care Contracts to 3 Plans
Florida Governor Issues Order Increasing Audits of PBMs, Preventing Clawbacks in Future Contracts
Maine Expands Medicaid, CHIP Coverage to Individuals Under 21, Pregnant Women Regardless of Immigration Status
Massachusetts Selects 25 Community Behavioral Health Centers to Expand Treatment for Mental Health Conditions
Minnesota Releases RFP for Medicaid, MinnesotaCare Accountable Care Model
Montana Receives Approval for 1115 HEART Demonstration
Nebraska Receives Five Bids for Medicaid Managed Care Contracts
New Hampshire Releases Adult Medicaid Dental Benefit RFI
Oklahoma Proposes 25 Percent Rate Increase for Medically Fragile Medicaid Services
Pennsylvania Governor Approves Nursing Home Medicaid Reimbursement Rate Increase
South Dakota Medicaid Expansion Ballot Campaigns to Join Forces
Texas Health Plan Awards $2.1 Million in Grants to Address Social Determinants of Health
Insurers Propose Exchange Plan Premium Rate Hike of 10 Percent in 2023, Says ACASignups.net
Molina to Acquire My Choice Wisconsin
Ensign Group Acquires Skilled Nursing Facilities in Texas, Nevada, California
- This week, our In Focus section reviews the new Center for Medicare and Medicaid Innovation (CMMI) model named the Enhancing Oncology Model (EOM), released on June 27, 2022, by the Centers for Medicare & Medicaid Services (CMS). Read MoreRoundup:
This week's roundup:
In Focus: CMS Releases the Enhancing Oncology Model
In Focus: CMS Proposes Regulation for Rural Emergency Hospitals
Delaware Delays Medicaid Managed Care Contract Awards
Florida Awards Unified Operations Center Contract to Automated Health Systems
Florida Releases RFI for Children’s Medical Services Managed Care Plan
Indiana Releases MLTSS RFP
Maine Extends Dental Coverage to Medicaid Beneficiaries
Missouri Governor Signs Fiscal 2023 Budget with Funding for Medicaid Expansion
Nevada Requests 1115 Waiver to Expand Access to Behavioral Health Services
New Hampshire Governor Signs Legislation to Provide Adult Medicaid Dental Coverage
North Carolina House Committee Considers Legislation to Create Statewide Medicaid Managed Care Plan for Foster Children
Tennessee Advised by CMS to Make Changes to Medicaid Block Grant Program
Washington State Plan Aimed at Lowering Medicaid Pharmacy Payments Is Rescinded
HHS Releases New Resources to Improve Oversight of Medicaid, CHIP Managed Care Programs
CMS Releases 2021 Open Payments Data
Medicaid, CHIP Enrollment Nears 87.9 Million; Medicare Nears 64.4 million
Francisco Partners Completes Acquisition of IBM Watson Healthcare Data, Analytics Assets
- Be sure to register for HMA’s 2022 Conference by Monday, July 11, to get the special early bird rate of $1, 695 per person. After July 11, the rate is $1, 895. Read MoreRoundup:
California Extends Medicaid Coverage to Undocumented Residents
Colorado Receives Federal Approval to Establish Standardized Exchange Plan Option
Hawaii to Restore Medicaid Dental Benefits to Adults in 2023
Indiana Awards MMIS Maintenance, Operations Contract to Gainwell Technologies
Louisiana Enacts Bill Prohibiting Medicaid Plans from Conducting Provider Prepayment Reviews
Massachusetts Is Granted Temporary Extension of Existing 1115 Medicaid Waiver
Nebraska is Seeking Not-for-profit Organizations to Provide Housing Stability Services
North Carolina Legislative Budget Agreement Does Not Contain Provisions for Medicaid Expansion
Oregon Low-Income, Undocumented Residents To Gain Health Insurance July 1
Pennsylvania Governor Proposes Fiscal 2023 Nursing Home Rate Increase
Vermont is Granted 1115 Waiver Extension Through 2027
Virginia Enacts 30 Percent Increase in Medicaid Dental Reimbursement Rates
HHS Releases RFI to Strengthen Primary Care System
CMS to Launch New Risk-Based Payment Model for Medicare Cancer Care
Evolent Health to Acquire IPG from TPG Growth
- This week, our In Focus section highlights a presentation from HMA and Wakely, an HMA company, titled “Staying Ahead of the Star Rating Curve – A Case Study, ” which was given at the 12th Medicare Stars, HEDIS, Quality Assurance, Read MoreRoundup:
California Lawmakers Pass Spending Proposal to Increase Medi-Cal Reimbursement Rate for Doula Coverage
Montana Medicaid Director Has ‘Not Had Conversations’ Regarding a Potential Transition to Managed Care
North Carolina Foster Care Carve-Out Bill Faces Obstacles
Ohio Medicaid Plan to Offer Members Access to Walgreens Health Corner
CMS Approves 12-Month Postpartum Medicaid Coverage in District of Columbia, Maine, Minnesota, New Mexico
Pharmaceutical Company to Pay $233 Million in Medicaid Fraud Settlement
- On June 3, 2022, the Centers for Medicare & Medicaid Services (CMS) notified states that they will have an additional year, until March 31, 2025, to use funding from the American Rescue Plan Act (ARPA) to strengthen their Medicaid Read MoreRoundup:
Delaware Delays Medicaid Managed Care Contract Awards to July
Florida Names Bidders In Modular MMIS Procurement
Louisiana Names Additional Medicaid Managed Care Contract Winner
Maryland Releases Draft Medicaid 1115 Waiver Amendment to Cover Ambulance, Dental
North Carolina Senate Committee Considers Carve-Out of Foster Care from Managed Care
North Carolina Senate Passes Medicaid Expansion Bill
Texas Health Plan Did Not Meet Fraud, Abuse Detection Requirements, State Report Says
West Virginia Submits SUD Continuum of Care 1115 Waiver Renewal for Federal Approval
MACPAC Recommends New System for Monitoring Medicaid Access
AMA Looks to Block Expansion of Non-Physician Scope of Practice
Medicaid Managed Care Enrollment Approaches 68 Million in 2020, CMS Reports
Sverica Capital Management Invests in SG Homecare
- This week, our In Focus highlights a white paper from Wakely, an HMA Company, exploring the potential design elements and expected effects of a public option or a low-cost plan being newly introduced in the Affordable Care Act (ACA) individual Read MoreRoundup:
Alaska Releases Behavioral Health Information Management System RFI
Delaware Releases Proposed 1115 Waiver Amendment
Florida Can Recoup Medicaid Payments in Personal Injury Case, Supreme Court Rules
Florida to Begin Medicaid Managed Care Procurement as Early as October 2022
Florida Delays Award Announcements for Modular MMIS Vendors
Georgia Releases Medicaid Managed Care RFI
Illinois Increases Medicaid Funding for Nursing Homes by $700 Million
Missouri Is Still Processing Medicaid Expansion Applications Slower than Federal Law Allows
North Carolina Senate Gives Initial Approval to Medicaid Expansion Bill
Oregon Medicaid CCO Completes Corrective Action Plan
South Dakota Voters Deal Blow to Opponents of Medicaid Expansion
Tennessee Issues RFI for Roadmap to Improve Oversight, Planning of D-SNPs
FTC to Begin Inquiry Into PBM Practices
Health Plans to Issue $1 Billion in MLR Rebates in 2022, KFF Projects
Medical Transportation Management to Acquire Veyo
UnitedHealth’s Optum Acquires Healthcare Associates of Texas
