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  • This week, our In Focus section reviews Kentucky’s 1115 waiver, Kentucky Helping to Engage and Achieve Long Term Health (KY HEALTH), approved by the Centers for Medicare & Medicaid Services (CMS) on January 12, 2018. The waiver was approved for five years, effective January 12, 2018, through September 30, 2023. The decision from CMS represents the first approval of a Medicaid waiver that includes a work requirement as a condition of eligibility.

    Kentucky developed the waiver in collaboration with HMA Medicaid Market Solutions (HMA MMS).

    Roundup:

    California Approves Aetna's Entry Into Medi-Cal Market

    Illinois Medicaid Sued Over Low Nursing Home Rates

    Louisiana Considers Medicaid Work Requirements

    Massachusetts Lawmakers Call for Investigation of Kindred Healthcare

    New York Budget Proposal Contemplates For-profit Conversion and MCO Profit Fees

    Pennsylvania Governor Declares Opioid Epidemic a Statewide Public Health Disaster

  • This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states. Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. Nearly all 27 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2017. This report reflects the most recent data posted.

    Roundup:

    Mississippi Obtains Approval for First Ever 10-Year Medicaid Waiver

    Arizona Submits Waiver Request for Medicaid Work Requirements, Lifetime Limit.

    California Restores Medi-Cal Coverage of Certain Dental Services

    Illinois Begins Implementing HealthChoice Medicaid Managed Care

    Iowa Considers Adding a Fourth Medicaid Managed Care Plan

    Michigan Seeks Renewal of Medicaid Expansion Waiver

    Molina Confirms Loss of New Mexico Medicaid Managed Care Contract

    South Dakota to Seek Medicaid Work Requirements

    Texas Obtains Five-Year Medicaid Waiver Renewal

  • This week, our In Focus section highlights some of the key findings of the Fiscal Survey of the States Fall 2017 report, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state budget officers in all 50 states from August through November 2017. The findings in the report focus on the key determinants of state fiscal health, highlighting data and state-by-state budget actions by area of spending. Below we summarize the major takeaway points from the report, as well as highlight key findings on Medicaid-specific and other health care budget items.

    Roundup:

    Alabama, Connecticut Issue CHIP Warnings

    D.C. to Reevaluate Medicaid Managed Care Awards

    Idaho Awards NEMT Contract to MTM

    Maryland to Expand Community Services for Individuals with Disabilities

    Mississippi Medicaid Director Resigns

    Oregon CCO FamilyCare to Close

    CMS will not Approve Medicaid Waivers Seeking Federal Designated state Health Program Funding

    House to Exclude ACA Exchange Stabilization Provisions from Spending Bill

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