HMA Weekly Roundup
Trends in Health Policy
This week's roundup:
- In Focus: Executive Actions and Congressional Budget Reconciliation: Trump Administration's 2025 Healthcare Overhaul
- Arkansas to Submit Section 1115 Demonstration Medicaid Work Requirement Amendment
- Florida New Statewide Medicaid Managed Care Contracts to Go into Effect February
- Minnesota Releases Report Outlining Medicaid Opportunities to Improve Care for American Indian Communities
- New York Launches Medicaid Health Equity Regional Organization Initiative Under Section 1115 Demonstration
- Vermont Governor, Regulators Approve AHEAD Model Adoption
- Trump Administration Rescinds Federal Funding Freeze
- HHS Pauses CDC Reports, Health Communications Due to Pending Review
- CMS Drops Appeal Over Federal Ruling to Recalculate UnitedHealthcare Medicare Advantage Star Rating
- More News Here
In Focus
Executive Actions and Congressional Budget Reconciliation: Trump Administration's 2025 Healthcare Overhaul
This week, our In Focus section highlights how the new Administration and Congress are poised to significantly change healthcare policies, ranging from health equity and Affordable Care Act (ACA) Marketplace subsidies to Medicaid services and prescription drug costs. Stakeholders seeking to influence these potential changes should plan to engage quickly. Today’s section covers important developments that occurred through 2 pm January 29, and healthcare stakeholders will need to remain attune to future developments impacting federal healthcare programs.
Executive Action
Over the first week of his second term, President Donald J. Trump has issued several executive orders (EOs) and presidential directives affecting healthcare stakeholders. Presidents have increasingly used EOs at the beginning of their administration to rescind policies of their predecessors and direct the federal departments and agencies to exercise their authorities in line with the president’s directives.
Though some EOs require no further action, many are just the beginning of the policymaking process, with agencies tasked with implementing the directives. This timeline can provide stakeholders with opportunities to work with to policymakers to inform how they shape the rules for compliance with these directives.
Initial EOs issued so far by President Trump include policies that:
- Rescind several of former President Biden’s Executive Orders, including:
- Executive Order 13985 of January 20, 2021, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government
- Executive Order 13988 of January 20, 2021, Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation
- Executive Order 13990 of January 20, 2021, Protecting Public Health and the Environment and Restoring Science to Tackle the Climate Crisis
- Executive Order 14009 of January 28, 2021, Strengthening Medicaid and the Affordable Care Act
- Executive Order 14070 of April 5, 2022, Continuing to Strengthen Americans’ Access to Affordable, Quality Health Coverage
- Executive Order 14075 of June 15, 2022, Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals
- Executive Order 14087, of October 19, 2022, Lowering Prescription Drug Costs for Americans
- Direct the Office of Management and Budget (OMB), the Attorney General, and Office of Personnel Management (OPM) to “coordinate the termination of all discriminatory programs,” including diversity, equity, and inclusion (DEI) programs, policies, and activities in the federal government.
- Combat “illegal private-sector diversity, equity, and inclusion (DEI) preferences, mandates, policies, programs, and activities.”
- Freeze federal rulemaking until department heads appointed or designated by the president can review and approve the rules and withdraw rules that have been sent to but not yet published in the Federal Register so they can be reviewed.
- Establish and implement the Department of Government Efficiency (DOGE) as a temporary organization within the Executive Office of the President that reports to the White House Chief of Staff. Executive agencies are directed to establish DOGE teams of at least four employees. DOGE is intended to modernize Federal technology and software to maximize governmental efficiency and productivity.
- Require OMB, OPM, and DOGE to submit a plan within 90 days to reduce the size of the federal government’s workforce through efficiency improvements and attrition.
Developments on the Federal Funding Pause
Notably, the White House OMB issued a memo (Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs) on January 27, 2025, to all agencies with instructions to temporarily pause and provide a comprehensive analysis of all activities related to obligation or disbursement of federal financial assistance programs that EOs may affect. On January 29, 2025, the administration retracted the directive for a temporary pause on federal payments, though reiterated it will continue to review federal funding.
Though it is customary for a new administration to pause communications, regulatory activity, and new funding opportunities as incoming political appointees are confirmed and policy agendas are solidified, the breadth of the federal funding pause exceeds prior orders. The first lawsuit was filed on January 28, and a federal judge for the US District Court for the District of Columbia quickly issued a temporary stay on the federal funding pause until at least February 3, 2025, while she considers arguments in the case.
The now-rescinded January 27 memo was scheduled to take effect at 5:00 pm ET on January 28, 2025, to give the Trump Administration “time to review agency programs and determine the best uses of the funding for those programs consistent with the law and the President’s priorities.” According to the memo, the pause did not apply to Medicare or Social Security payments. In a subsequent document, OMB further clarified that “mandatory programs like Medicaid and SNAP [the Supplemental Nutrition Assistance Program] will continue without pause.”
What to Watch: Executive Actions and Budget Reconciliation
The Trump Administration has indicated that federal programs and funding should be aligned with his administration’s priorities. Healthcare stakeholders should be prepared for additional scrutiny of future funding awards.
Meanwhile, congressional Republicans are preparing to quickly leverage the budget reconciliation process to pass legislation related to several priority areas, including taxes, immigration, and domestic energy production (see Spotlight on Congress: Budget Reconciliation Update). Budget reconciliation provides a rare opportunity to pass significant healthcare legislative changes on a party-line basis. House Republicans have begun to develop their menu of healthcare options, which range from changes to the ACA premium tax credit structure, expanding Health Savings Accounts, and changes in Medicaid financing and eligibility.
In a January 2025 webinar, experts from Leavitt Partners, an HMA company, Liz Wroe, Sara Singleton, and Laura Pence discussed the potential health policy priorities of the Trump Administration, the implications of reconciliation for healthcare stakeholders, and the challenges and opportunities presented while navigating this expedited process.
Navigating Change
HMA experts are working with federally funded entities to quickly analyze their federal awards and plan for the next phase of federal agency actions and oversight. HMA companies also help healthcare stakeholders seeking to inform, shape, prepare for, and implement federal policy changes. Organizations seeking to influence the outcome of these policy debates and to thrive in a dynamic legislative and regulatory environment must have the most up-to-date information, informed by partners that understand the processes and the underlying policies under consideration.
HMA experts provide additional complementary services, including analyses to predict how the Congressional Budget Office will score the costs or savings of specific policies. Especially in the reconciliation environment, the budgetary impact of particular policies can significantly influence their likelihood of passage.
Connect with Us
To learn more about the these policy changes and the impact on your organization, watch our January 2025 policy webinar and contact our featured experts: Liz Wroe, Sara Singleton, and Kevin Kirby, and Warren Brodine.
HMA Roundup
Alabama
Alabama Lawmaker Introduces 60-day Prenatal Medicaid Coverage Bill. The Alabama Reflector reported on January 27, 2025, that state Representative Marilyn Lands (D-Huntsville) has reintroduced a bill that would provide presumptive Medicaid eligibility for pregnant people for up to 60 days before formal approval of their Medicaid applications. House Bill 89 aims to expand access to prenatal care, improve maternal and infant health outcomes, and lower the maternal and infant mortality rates.
Arizona
Arizona Medicaid Fraud Targeting Indigenous People Results in Deaths, $2.5 Billion in Costs for Taxpayers. The Arizona Mirror reported on January 27, 2025, that the Arizona Health Care Cost Containment System has acknowledged Medicaid fraud in the Phoenix area targeting Indigenous people in sober living homes that failed to prevent deaths and cost taxpayers up to $2.5 billion. A review of records from the Maricopa County Office of the Medical Examiner found at least 40 deaths from drug and alcohol use related to lax oversight in the treatment programs. Under the state’s American Indian Health Program, providers are able to set their own reimbursement rates, which led to high claims beginning in 2019. Behavioral health outpatient clinics drove the most significant increases as part of a Medicaid fraud scheme, partnering with unregulated sober living homes. A class action lawsuit was filed in December by families of those who have died.
Arkansas
Arkansas to Submit Section 1115 Demonstration Medicaid Work Requirement Amendment. The Arkansas Advocate reported on January 28, 2025, that Arkansas will submit a request to amend its Arkansas Health and Opportunity for Me (ARHOME) Section 1115 demonstration to add work requirements for its Medicaid expansion population. The amendment, titled Pathway to Prosperity, would require able-bodied adults receiving Medicaid to either work, go to school, volunteer, or take care of their children at home. Additionally, it intends to remove the reporting requirement burden off the enrollee by use of data matching, and will suspend recipients who do not meet the requirements instead of disenrolling them. Arkansas will submit the request to the Centers for Medicare & Medicaid Services following a 30-day public comment period.
Connecticut
Connecticut Lawmakers Propose Medicaid Provider Rate Increases. The Connecticut Mirror reported on January 28, 2025, that Connecticut Senator Matt Lesser (D-Middletown) and Representative Jillian Gilchrest (D-West Hartford) have introduced a plan to broadly increase Medicaid provider rates. The $250 million three-year plan aims to increase rates to be at least 75 to 80 percent of current Medicare rates, beginning with a $75 million funding infusion in 2026. The proposal would also establish a process to review and update provider rates every two to three years. The rate increase would not affect major hospital systems, which are subject to a settlement agreement expiring in 2026, but would affect the rates at specialty hospitals and Connecticut Children’s Medical Center.
Comptroller Releases Healthcare Report Outlining Medicaid Reimbursement Recommendations. Westfair Business Journal reported on January 27, 2025, that Connecticut Comptroller Sean Scanlon released the state’s 2025 Healthcare Cabinet Report which outlines various legislative proposals and actions to improve healthcare for those in Medicaid. Recommendations include increasing reimbursement rates for various providers, hospitals, and other healthcare facilities. The report highlights the specific need to provide additional support to rural hospitals and federally qualified health centers, and to ensure reimbursement rates and strategies cover critical services like primary care, pediatrics, obstetrics, and behavioral healthcare. The comptroller also recommended preserving the 340B program for prescription drug prices.
Connecticut Lawmaker Proposes Medicaid Diaper Benefit. WTNH reported on January 27, 2025, that state House Human Services Committee co-chair Representative Jillian Gilchrest (D-West Hartford) has proposed legislation that would allow for Medicaid coverage of diapers for children with certain health conditions from birth to age three. The benefit aims to improve maternal and child health outcomes and save the state money by reducing use of the healthcare system for conditions such as diaper rash and urinary tract infections.
Florida
Florida New Statewide Medicaid Managed Care Contracts to Go into Effect February. The Florida Agency for Health Care Administration sent an alert reminder on January 28, 2025, that Florida’s new Statewide Medicaid Managed Care (SMMC) 3.0 contracts will go into effect on February 1, 2025. Awarded plans will now serve nine regions, consolidated from eleven regions as part of the procurement. Among other changes under the new contracts, specialty plans were not awarded separately; instead, they were awarded to a comprehensive or MMA plan. Contracts are scheduled to run through December 31, 2030.
Florida Medicaid Dental Plans to Cover Non-emergency Outpatient Dental Services in ASCs. The Florida Agency for Health Care Administration sent an alert on January 28, 2025, that Florida’s Medicaid dental plans will cover non-emergency outpatient dental services performed in ambulatory surgical centers (ASCs) and other outpatient settings under the new contracts. The state announced in June 2024 that it awarded statewide Medicaid Prepaid Dental Program contracts to incumbents Liberty Dental Plan of Florida and DentaQuest of Florida. Under the new Statewide Medicaid Managed Care contracts, dental plans are required to work with health plans to ensure continuity of care.
Idaho
Idaho Lawmakers Introduce Bill to Repeal Medicaid Expansion. The Idaho Capital Sun reported on January 24, 2025, that the state’s House Health and Welfare Committee Chairman John Vander Woude (R-Nampa) and House Assistant Majority Leader Josh Tanner (R-Eagle) have introduced a bill seeking to repeal Medicaid expansion. House Bill 58 claims that repealing the expansion could save up to $110 million per year. Some state legislators are skeptical of the savings claim, however, and Idaho’s Medicaid director previously stated that repealing expansion could cost Idaho up to $78 million per year in federal funds. The House Health and Welfare Committee approved introducing the bill, which will allow for a full committee hearing with public testimony.
Maine
Maine IDD Providers Urge Governor Mills to Include Cost of Living Adjustments in Supplemental Budget. The Maine Morning Star reported on January 25, 2025, that providers serving individuals with intellectual and developmental disabilities (IDD) are urging Maine Governor Mills to include cost of living adjustments in the supplemental budget. Providers were informed in December that anticipated cost of living adjustments for Medicaid would not be coming January 1. MaineCare, the state’s Medicaid program, currently faces a $118 million budget gap this fiscal year. Mills’ proposed budget includes $117 million to eliminate the gap.
Minnesota
Minnesota Releases Report Outlining Medicaid Opportunities to Improve Care for American Indian Communities. The Minnesota Department of Human Services (DHS) released on January 27, 2025, a report outlining pathways for the state to better support the health and wellbeing of American Indian communities through the Medicaid program. The report, titled “Pathways to Racial Equity in Medicaid: Improving the Health and Opportunity of American Indians in Minnesota,” highlights three recommendations, including investing in traditional healing services, reframing definitions of health and well-being to align with federal guidance on Indigenous knowledge, and establishing a Pathways to American Indian and Tribal Health Integration (PATH-I) Team at DHS to enhance community engagement and cultural competence. DHS will immediately begin working with American Indian communities to implement the recommended changes.
Mississippi
Mississippi House Medicaid Committee Advances Pregnancy Presumptive Eligibility Bill. Mississippi Today reported on January 22, 2025, that the Mississippi House Medicaid committee advanced a presumptive eligibility bill for pregnant women, which removes the requirement that women show proof of income. The bill, which passed both chambers last year but was not implemented due to a discrepancy between state law and federal regulations, was introduced by Committee Chairwoman Missy McGee (R-Hattiesburg).
Montana
Montana Lawmakers Consider Two Medicaid Expansion Extension Bills. Montana Public Radio reported on January 23, 2025, that Montana’s House Human Services Committee is considering two bills that could renew Medicaid expansion, which is set to expire in 2025. House Bill 245, sponsored by Rep. Ed Buttrey (R-Great Falls), would remove the expansion’s sunset provision and keep the program as-is, including work requirements. House Bill 230, sponsored by Rep. Mary Caferro (D-Helena), would remove the sunset provision, reopen 10 public assistance offices, make improvements to the state helpline, and reinstate continuous 12-month eligibility. Up to 75,000 people could lose Medicaid coverage if the expansion expires.
Montana to Update Mental Health, Developmental Disability Services Facilities. KFF Health News reported on January 27, 2025, that Montana is looking to update its behavioral health system by revamping the Montana State Hospital and updating facilities serving people with developmental disabilities. The state Department of Public Health and Human Services recommended multiple infrastructure updates to Montana Governor Greg Gianforte, including investing approximately $13.3 million in moving the Intensive Behavior Center for developmental disabilities out of Boulder, investing $19.2 million into upgrading the facilities at the Montana State Hospital, and establishing a 16-bed step-down facility for adults who have been committed to the state hospital but no longer need its intensive psychiatric facilities. The updates were developed in partnership with and approved by Montana’s Behavioral Health System for Future Generations Commission.
Nebraska
Nebraska Lawmakers Consider Assisted Living Memory Care Provider Rates Bill. The Nebraska Legislature reported on January 23, 2025, that state lawmakers are considering a bill that would establish a Medicaid reimbursement rate for assisted living memory care facilities. The bill would require the state Department of Health and Human Services to submit an amendment for its aged and disabled home and community-based services waiver to the Centers for Medicare & Medicaid Services by September 30, 2025, to include separate reimbursement rates for these providers. The current reimbursement structure has an umbrella rate for all assisted living facilities, regardless of the level of care.
New York
New York Launches Medicaid Health Equity Regional Organization Initiative Under Section 1115 Demonstration. The New York State Department of Health announced on January 24, 2025, that the state launched the Medicaid Health Equity Regional Organization Initiative, which aims to strengthen the integration of social services, including food insecurity, housing instability, and lack of transportation, with health care delivery. The state will work with the United Hospital Fund (UHF) to coordinate strategies. UHF will build off experience in the Delivery System Reform Incentive Payment program.
New York Judge Temporarily Blocks State from Removing Home Care Companies from Medicaid Program for Failure to Comply in CDPAP Consolidation. Crain’s New York Business reported on January 29, 2025, that a New York Nassau County judge has filed a temporary restraining order to block the state Department of Health from removing home care companies from the Medicaid program that failed to comply with requirements to turn over patient data as the state consolidates its Consumer Directed Personal Assistance Program (CDPAP) under a single fiscal intermediary (FI). There are approximately 600 FIs that have been ordered to turn over patient data so that Public Partnerships LLC can take over the $9 billion program on April 1, 2025. The restraining order protects approximately 50 FIs that sued the state over the consolidation while the litigation is ongoing. Governor Kathy Hochul’s office indicated the transition is still on track.
North Carolina
North Carolina Appoints Devdutta Sangvai as Medicaid Director. Q City Metro reported on January 27, 2025, that North Carolina Governor Josh Stein has named Devdutta Sangvai as secretary of the state Department of Health and Human Services. Sangvai, a doctor and former president of Duke Regional Hospital, replaces previous Medicaid director Kody Kinsley, who began his role in 2022. Sangvai was sworn into office January 12.
Oregon
Oregon Hospitals Request Additional Funding to Close Medicaid Reimbursement Gap. The Oregon Capital Chronicle reported on January 22, 2025, that the Hospital Association of Oregon is requesting additional funding to support struggling hospitals and make up for the reimbursement gap for Medicaid-covered services. According to the hospital group, the state’s Medicaid program, pays 56 cents for every dollar of care provided to Medicaid patients, according to the hospital association, which caused a $1 billion underpayment in 2023. Governor Tina Kotek’s budget proposal includes $35 million in general funding for hospital maternity reimbursement rates, a $4 million increase in medical education funding, and $25 million to pay hospitals with high numbers of uninsured or Medicaid-covered patients.
Oregon Finds Three Healthcare Entities Had Unreasonably High Spending From 2021 to 2022. The Oregon Health Authority announced on January 22, 2025, that most of Oregon’s healthcare systems, including insurance plans, hospitals, and medical groups, successfully met the Sustainable Health Care Cost Growth Target Program’s goal to limit healthcare cost growth to a 3.4 percent annual average increase per person between 2021 and 2022. However, OHA reported that three entities, including Moda Health’s Medicare Advantage plans, UnitedHealthcare’s Medicare Advantage plans, and Oregon Medical Group’s commercial plans, exceeded the target without an acceptable reason. In May, OHA will release a report on healthcare spending between 2022 and 2023. Entities that do not meet the cost targets after the May report can be placed on a performance improvement plan.
Vermont
Vermont Governor, Regulators Approve AHEAD Model Adoption. Health Payer Specialist reported on January 24, 2025, that Vermont Governor Phil Scott and the state’s Green Mountain Care Board have approved the adoption of the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. The Centers for Medicare & Medicaid Services announced Vermont as a participant in the model in July 2024. The AHEAD model aims to reduce healthcare cost growth, improve population health, and advance health equity by moving the state’s Medicare payment system to a global budget model and investing more in primary care. Vermont’s Agency of Human Services secretary must approve the model for the state to move forward with the plan, which is set to fully begin in 2027.
Virginia
Virginia Lawmakers Advance Bipartisan PBM Bill. Virginia Mercury reported on January 23, 2025, that the state Senate Education and Health Committee advanced a bipartisan bill that would eliminate pharmacy benefit managers (PBMs) operated by health plans in Medicaid and replace them with a sole, state-contracted PBM. If enacted, the legislation would also direct the Department of Medical Assistance Services to assess drug pricing, rebates, and administrative costs to give the state better oversight ability and would require the state-contracted PBM to protect pharmacy access in underserved areas. The bill aims to increase drug price transparency, support independent pharmacies, and create a more cost-effective system.
National
Trump Administration Rescinds Federal Funding Freeze. NPR reported on January 29, 2025, that the Office of Management and Budget has issued a memo rescinding its federal funding pause. The memo comes after confusion from states, including states reporting difficulty accessing the federal payment management system for Medicaid. The White House has begun restoring states’ access, as Medicaid was meant to continue without pause, though some have still reported issues with the portal. The reversal also comes after a federal judge granted an administrative stay to pause the freeze while the legality of the order was examined. Additionally, multiple states joined to sue the Trump administration over the pause, including Arizona, Illinois, Massachusetts, New York, and Oregon.
President Trump Orders Pause in Federal Award Funding. Modern Healthcare reported on January 28, 2025, that President Donald Trump has directed a pause to all federal award funding. Each federal agency must submit detailed information on programs, projects, and activities related to the pause by February 10, 2025, and pause the distribution of funds until the Office of Management and Budget (OMB) has reviewed each agency. OMB indicated that Medicare and Social Security are not affected by the pause. States have reported problems accessing the federal payment management system for Medicaid; however, the White House Press Secretary Karoline Leavitt attributed this to an “outage” and claimed payments are “still being processed and sent.” Illinois Attorney General Kwame Raoul has joined a coalition of other AGs suing the Trump administration over the pause, claiming it is unconstitutional. The lawsuit seeks a temporary restraining order against the memorandum ordering the pause.
President Trump Dismisses HHS Inspector General. Health Payer Specialist reported on January 27, 2025, that President Donald Trump has dismissed the U.S. Department of Health and Human Services (HHS) inspector general, Christi Grimm. Trump has not named his pick for Grimm’s replacement. Grimm was one of 17 inspectors general dismissed by the president.
HHS Pauses CDC Reports, Health Communications Due to Pending Review. NBC News reported on January 22, 2025, that the U.S. Department of Health and Human Services (HHS) has paused almost all external communication from federal health agencies, including reports from the Centers for Disease Control & Prevention (CDC) and the National Institutes of Health while President Trump’s administration conducts a review. Communications may be released if they are a matter of critical health and safety. Communication pauses are common when a new administration enters the White House.
OMB Nominee Russell Vought Expresses Support of Medicaid Work Requirements During Confirmation Hearing. The New York Times reported on January 22, 2025, that President Trump’s Office of Management and Budget nominee Russell T. Vought expressed his support of Medicaid work requirements during a confirmation hearing. During the last Trump administration, Vought also supported a universal Medicaid work requirement. The Congressional Budget Office estimates work requirements would cause 600,000 Medicaid beneficiaries to lose coverage.
Industry News
CMS Drops Appeal Over Federal Ruling to Recalculate UnitedHealthcare Medicare Advantage Star Rating. Modern Healthcare reported on January 24, 2025, that the Centers for Medicare & Medicaid Services (CMS) has dropped its appeal over a federal ruling ordering the agency recalculate UnitedHealthcare’s 2025 Medicare Advantage Star Rating. United sued CMS over its star rating in September 2024, claiming the agency did not follow statutory requirements when reviewing the insurer’s foreign language call center. CMS appealed the ruling in January. CMS has not disclosed the reasons why it dropped the appeal.
UnitedHealthcare Names Tim Noel as Chief Executive. Health Payer Specialist reported on January 23, 2025, that UnitedHealthcare has named Tim Noel as chief executive, taking over for Brian Thompson who was killed in December 2024. Noel has been with United since 2007 and currently serves as chief executive of the payer’s Medicare division.
Medicare Advantage Plan Prior Authorization Use Increases to Nearly 50 Million Determinations in 2023. KFF reported on January 28, 2025, that Medicare Advantage (MA) plan prior authorization use increased 7.8 percent to 49.8 million determinations in 2023, compared to the previous year. MA insurers fully or partially denied 3.2 million (6.4 percent) prior authorization requests. Of these, only 11.7 percent were appealed, with the majority of appealed denials being fully or partially overturned. KFF analyzed data submitted by Medicare Advantage insurers to the Centers for Medicare & Medicaid Services.
RFP Calendar
HMA News & Events
NEW THIS WEEK ON HMA INFORMATION SERVICES
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HMAIS Reports
- New State of The State Address Overview Report
- Updated HMA Federal Health Policy Snapshot
- Updated Arizona State Overview
Medicaid Data
Medicaid Enrollment and Financials:
- Arizona SNP Membership at 149,898, Nov-24 Data
- Colorado SNP Membership at 68,491, Nov-24 Data
- Idaho SNP Membership at 19,410, Nov-24 Data
- Indiana SNP Membership at 138,050, Nov-24 Data
- New Mexico Medicaid Managed Care Enrollment is Down 1%, Sep-24 Data
- New York Medicaid Managed Care Enrollment is Down 7%, May-24 Data
- North Carolina Medicaid Managed Care Enrollment is Up 18.2%, Aug-24 Data
- Oklahoma SNP Membership at 76,630, Nov-24 Data
- MLRs Average 89.8% at Rhode Island Medicaid MCOs, 2023 Data
- South Carolina Medicaid Managed Care Enrollment is Down 15.8%, Sep-24 Data
- South Carolina Dual Demo Enrollment is Down 19.3%, Sep-24 Data
- Wisconsin Medicaid Managed Care Enrollment is Down 10.8%, Aug-24 Data
Public Documents:
Medicaid RFPs, RFIs, and Contracts:
- Alabama Medicaid Waiver Services for IDD Waiver Programs RFP, Jan-25
- Hawaii Ombudsman Medicaid Services RFI, Jan-25
- North Carolina Cleveland County NEMT RFP, Jan-25
Medicaid Program Reports, Data, and Updates:
- Alaska Department of Health Annual Report, FY 2023
- Alaska Long-Term Forecast of Medicaid Enrollment and Spending, FY 2022-44
- Arkansas Health and Opportunity for Me (ARHOME) Waiver Documents, 2021-25
- Colorado Medicaid Dental Annual Reports, SFY 2022-24
- Connecticut Healthcare Cabinet Report, 2025
- Florida Medicaid Managed Care Encounter Data Validation Studies, 2019-24
- Georgia Governor’s Proposed Budget, FY 2026
- Minnesota Pathways to Racial Equity in Medicaid: Improving the Health and Opportunity of American Indians Report, Dec-24
- Nebraska Medicaid Annual Reports, SFY 2013-24
- Nebraska Governor’s Budget Recommendations, 2025-27
- North Carolina DHHS Strategic Plan, 2024-26
- Oregon 2021-22 Sustainable Health Care Cost Growth Target Accountability Summary, Jan-25
- Oregon Governor’s Proposed Budget, FY 2025-27
- Pennsylvania Behavioral Health External Quality Review Reports, 2023
- Tennessee Medicaid Quality Assessment and Performance Improvement Strategy Reports, 2013-24
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