Weekly Roundup

April 26, 2023

In Focus:

Biden Administration Encourages States to Apply for Medicaid Reentry 1115 Demonstration for Individuals in Carceral Settings

Roundup:

Arizona Requests Additional $3.3 Billion in Fiscal 2023 for Medicaid Managed Care Payments
Redeterminations News: California, Georgia, Indiana, Missouri, Nebraska, Pennsylvania
Colorado Enacts Legislation Eliminating Medicaid Co-pays for Pharmacy, Outpatient Services
Illinois Health Benefits Program for Immigrant Seniors, Adults Is Expected to Enroll 98,500
Maryland Releases Medicaid Managed Care External Quality Review RFP
Washington Requests Medicaid Coverage for Former Foster Youth, Continuous CHIP Enrollment for Children Up to Age Six
U.S. Senators Introduce Legislation to Ban PBM Spread Pricing
Kaiser Permanente to Acquire Geisinger Health

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April 19, 2023

In Focus:

CMS’s 2024 Hospital Inpatient Regulation Proposes to Increase Payments to Hospitals, Support Safety Net Hospitals, and Modify the NTAP Program

Roundup:

Arkansas Legislature May Hold Special Session on Medicaid Spending
Florida House Passes Bill to Increase Income Threshold for KidCare Coverage
Georgia to Recommend Rate Increase for Providers Caring for Individuals with Disabilities
Illinois Receives Federal Approval for Additional Medicaid Funding in Schools
Iowa House Passes Bill to Create Medicaid Eligibility Verification System
Nevada to Review Medicaid HCBS Rate Setting Methodology
South Dakota to Implement Medicaid Expansion on July 1
Wisconsin Releases RFI for Eligibility Determination System
HHS Projects 6.8 Million Eligible Medicaid Beneficiaries Will Be Disenrolled During Redeterminations
Biden Administration Encourages States to Apply for Medicaid Reentry 1115 Demonstration for Individuals in Carceral Settings
Humana to Invest Another $40 Million in Affordable Housing

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April 12, 2023

In Focus:

Florida Releases Medicaid Managed Care ITN

Roundup:

Alabama House Committee Holds Meeting on Medicaid Expansion
Arizona Must Improve Health Care for Individuals in Carceral Settings, Judge Rules
California to Seek Approval for Voluntary Medicaid Capitated Payment Model for FQHCs
California Medi-Cal To Comply With Federal Law, Continue Business with Walgreens
Delaware Struggles to Investigate Complaints Against Assisted Living, Nursing Facilities
Georgia Proposes Using Directed Payments to Make Up for Financial Losses at Rural Hospitals
Michigan to Release Medicaid Managed Care RFP in Fall 2023
New Jersey Receives Approval for Medicaid Waiver on Coordinating Behavioral Health, Covering Social Needs
New York Medicaid Audit Finds $184 Million in Uncollected Drug Rebates
Oregon Medicaid Beneficiaries Struggle to Access Mental Health Care Despite Relatively High Medicaid Rates, Study Finds
Pennsylvania Lawmakers Debate Medicaid Dental Benefits During Budget Hearing
Texas Files Federal Lawsuit Over Medicaid Provider Tax Policy Change
CMS Proposes 2.8 Percent Medicare Rate Increase for Hospitals that Meet Quality Reporting, Meaningful Use Standards
Medicaid Enrollment to Settle At Higher Than Pre-Pandemic Levels in Many States, Analysis Finds
Froedtert Health, ThedaCare to Merge

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April 5, 2023

In Focus:

Medicare Advantage Capitation Rates and Part C and Part D Payment Policies

Roundup:

Arizona to Award $40 Million to HCBS Providers
California, Michigan Consider Legislation to Ensure Preventive Care Coverage at No Cost to Individuals
Colorado Legislature Debates Fiscal 2024 Budget Bill with $80 Million to Replace Enhanced FMAP
Connecticut House Committee Advances 2 Bills to Increase Income, Asset Limits for HUSKY C
Indiana Legislature Extends Medicaid Reimbursement Rate Hike for Out-of-state Children’s Hospitals
Iowa House Committee Holds Hearing on Bill to Create Eligibility Verification System for Medicaid
Michigan Launches Enhanced Medicaid Dental Benefits, Increased Dental Provider Reimbursement Rates
Montana House Passes Bill to Increase Medicaid Reimbursement Rates to Ambulance Providers
New York Implements Medicaid FFS Pharmacy Benefit Program
Redeterminations News: Oregon, Pennsylvania, Texas, Virginia
CMS to Increase Medicare Advantage Payments by 3.3 Percent in 2024
CMS Proposes Increasing Medicare Reimbursement Rates for Skilled Nursing Facilities by 3.7 Percent in 2024
HouseWorks Acquires Associated Home Care
UnitedHealth Group to Reduce Use of Prior Authorizations

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March 29, 2023

In Focus:

HMA Community Strategies Conducts Evaluation for the City of Los Angeles FamilySource System

Roundup:

Alabama Releases RFP for Medicaid Enterprise Data Services Solution
Arizona Releases Strategic Roadmap to Modernize Medicaid Enterprise System
Florida Medicaid Disenrollment Could Impact Up to 1.8 Million Households
Florida Senate Committee Approves Bill to Place Restrictions on PBMs
Georgia Senate Committee Misses Deadline, Imperiling Mental Health Bill
Kentucky Governor Vetoes Bill that Would Block Expanded Dental, Vision, Hearing Benefits for Medicaid Beneficiaries
Louisiana Governor Proposes $196 Million for Medicaid Redeterminations Process
New York Providers File Lawsuit to Delay Transition of Medicaid Pharmacy Benefits from Managed Care to FFS
North Carolina Enacts Medicaid Expansion
Tennessee Legislature Considers Bill to Block State from Contracting with Medicaid Plans Covering Gender-affirming Treatment in Any State
Medicaid, CHIP Enrollment Tops 92.3 Million in December 2022
Mosaic Dental Collective Partners with Audax Private Equity
BCBS-NM Names Nancy Smith-Leslie as Vice President of Medicaid

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March 22, 2023

In Focus:

Medicare Drug Negotiation Guidance: What You Need to Know

Roundup:

Medicaid Expansion News: Alabama, Kansas, Mississippi, North Carolina
Arkansas Assisted Living Providers Struggle Financially After Medicaid Reimbursement Rate Increases are Delayed
California Expands Availability of Medi-Medi Plans for Dual Eligibles to Five More Counties
California Seeks Federal Approval of Program Covering 6 Months of Rent for Homeless Medi-Cal Beneficiaries
Redeterminations News: California, Illinois, Rhode Island
Idaho House Rejects $4.7 Billion Fiscal 2024 Medicaid Budget
Kentucky Governor Signs Legislation to Increase Medicaid Rates for Outpatient Procedures
New York Senate Advances Proposal to Repeal Medicaid Managed Care Pharmacy Carve-out
Most States Will Take 12-14 Months to Process Medicaid Redeterminations, KFF Survey Says
PurposeCare Acquires Home Sweet Home

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March 15, 2023

In Focus:

Medicaid Managed Care Enrollment Update – Q4 2022

Roundup:

Alaska Submits Section 1115 Waiver Request to Extend Medicaid SUD, Behavioral Health Program
Redeterminations News: District of Columbia, Mississippi, Washington, Wyoming
Medicaid Expansion News: New Hampshire, North Carolina, South Dakota
New York Has Almost $10 Billion in Surplus Federal Funding for Basic Health Option
Oregon Medicaid CCO Purchases Hotel to Create Housing for Individuals with Behavioral Health Needs
Pennsylvania Governor Proposes $500 Million for Mental Health Services in Schools
Washington Pauses Apple Health Reprocurement Efforts to Focus on Medicaid Redeterminations
Biden’s Proposed Fiscal 2024 Budget Includes Mandatory Minimum Medicaid MLR
Help at Home Acquires Prosper Home Care

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March 8, 2023

In Focus:

Financial Impact Summary of the 2024 Medicare Advantage Advance Notice

Roundup:

Arizona House Committee Advances Bill to Reduce Medicaid Redetermination Period
Colorado Lawmakers Introduce Bill to Authorize Medicaid Reimbursement for Community Health Services
Redeterminations News: Delaware, Nebraska, Nevada, North Carolina, Rhode Island
Maryland Health Information Exchange to Expand Medicaid Eligibility Redetermination Notifications
Mississippi Releases Medicaid Utilization Management, Quality Improvement Organization IFB
New Jersey Senate Committee Advances Bill to Increase Medicaid Reimbursement Rates for Assisted Living Facilities
New Mexico House Passes Bill to Study Medicaid Buy-in Program
North Carolina Senate Committee Advances Medicaid Expansion Bill
Wisconsin Governor Proposes Tying Medicaid Expansion to Medicaid Reimbursement Rates
West Virginia House Passes Bill to Scrap Medicaid Managed Care RFP Process, Move to Applications
15 States Seek Section 1115 Waiver Amendments to Provide Medicaid Services to Incarcerated Individuals Prior to Release
VillageMD Acquires CT-based Multispecialty Group Starling Physicians
Presbyterian Healthcare Services, UnityPoint Health to Merge

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March 1, 2023

In Focus:

Evaluating the Delivery of Virtual Child Welfare Services

Roundup:

Eligibility Redeterminations: Arkansas, Alaska, Centene, Idaho, Illinois, Minnesota, Texas
California to Award Medicaid Bonus Payments to Nursing Homes 
Illinois Releases Medicaid FFS Dental Program RFP
Indiana Awards Medicaid MLTSS Contracts to Four Managed Care Organizations
Iowa House, Senate Pass Separate Bills to Change Medicaid Eligibility Asset Limit
North Carolina Further Delays Implementation of Behavioral Health IDD Tailored Plans to October 2023
New Mexico Lawmakers Question Cancellation of Medicaid Managed Care RFP
Oregon Names Dana Hittle as Medicaid Director
Medicare Advantage Insurers Report Average Margins Per Enrollee Twice as High as Other Health Insurance Markets
Elevance Agrees to Acquire BCBS-LA for $2.5 Billion

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