Weekly Roundup

November 29, 2023

In Focus:

Roundup:

Alabama Receives Approval for Community-Based Mobile Crisis Services SPA
Arizona Requests Section 1115 Waiver Amendment to Raise CHIP Eligibility Threshold
California Governor Signs Bill to Simplify Billing, Increase Access for Medicaid School-based Health Programs
Florida Bills Would Remove Step Therapy Requirement for Medicaid Beneficiaries with Mental Illness
Georgia Legislators Discuss Coupling Full Medicaid Expansion, Relaxation of Certificate-of-Need Requirements
Idaho Releases MMIS System Integrator Technical Advisory Services RFP
Nevada Submits Section 1332 State Innovation Waiver Application For Market Stabilization, Public Option Program
New York Essential Plan Expansion Implementation Delayed to April 2024
North Carolina Hospitals Will Receive $2.6 Billion As State Prepares to Start Medicaid Expansion
North Dakota Seeks Public Comments on Medicaid Quality Strategy Plan
Tennessee to Renew Existing TennCare Medicaid Managed Care Contracts for Now
Wisconsin Insurers Fail to Meet Federal Access Standards for Exchange Program, Report Finds
Average Time Spent on Medicaid HCBS Waiting Lists Has Decreased Since 2021
ACA Exchange Enrollment Approaches 4.6 Million Through Three Weeks of Open Enrollment
Medicare, Medicaid Improper Payment Rates Driven by Documentation Errors in Fiscal 2023, CMS Finds
CMS Launches Medicare GUIDE Model Application
CMS Issues Proposed Rule to Ensure Network Adequacy Standards For State-run Exchange Plans
Humana, Cigna In Talks to Merge By End Of Year

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November 1, 2023

In Focus:

Roundup:

Alabama Releases Modular Electronic Visit Verification RFP
California Submits Section 1115 Medicaid Waiver Amendment to Provide Rental Assistance
Florida Legislators File Bills to Study Impact of Potential Medicaid Expansion on Individuals Aged 18 to 26
FL Congressional Democrats Ask CMS to Monitor Their State’s Medicaid Eligibility Redeterminations Process.
Georgia Bidding Conference for Medicaid Managed Care Contracts Is Attended by Several Health Plans.
Georgia Democratic Leaders Call on Governor to Implement Full Medicaid Expansion
Mississippi Medicaid Managed Care Procurement Stalls Following Protests from UnitedHealthcare, Elevance
New Hampshire Providers to Receive Another Increase in Medicaid Payment Rates
Pennsylvania Bill Would Reinstate Medicaid Coverage of Most Dental Services
CMS Releases Final Rule to Increase Payments to ESRD Facilities by 2.1 Percent
Bright Health Group, Friday Health Plans Owe $1.1 Billion in Exchange Risk-Adjustment Payments

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October 18, 2023

In Focus:

Roundup:

Arizona to Release Medicaid PBM RFP ‘in the Coming Weeks’
Medicaid Eligibility Redeterminations News: Arizona, Florida, Georgia, Mississippi, North Carolina, Texas, Wyoming
Florida Launches Dental Provider Incentive Program
Minnesota Eliminates Parental Fees for Medicaid Coverage of Children With Disabilities
Nevada Governor Proposes Exchange Reinsurance in ‘Revision’ to Public Option Law
New York Medicaid Spending Exceed Expectations, Report Finds
North Carolina Receives Final Federal Approval for Medicaid Expansion
Oregon Announces 3.4 Percent Increase in 2024 Capitation Rates for Medicaid Coordinated Care Organizations
Oregon Releases RFP to Expand PACE Services
Long-term Services, Supports Spending Falls as Percentage of Total Medicaid Expenditures, CMS Reports
State Medicaid Programs Disenroll 8.8 Million Beneficiaries During First 6 Months of Redeterminations, KFF Finds
Alignment Health, Walgreens to Jointly Market Medicare Advantage Plans in 2024

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October 11, 2023

In Focus:

Roundup:

Medicaid Eligibility Redeterminations News: Alabama, Alaska, Arizona, Arkansas, Florida, Maine, Missouri, New Mexico, Oregon, Texas, Wyoming
Arizona Receives Five Bids for Medicaid Managed Long-term Care Contracts
California Enacts Law Advancing State Toward Universal Healthcare System Such As Single-payer
Idaho Medicaid Value-based Care Organizations Ask State to Stick with Current Model
Kentucky Reports Savings Following Removal of PBMs from Medicaid Program
Nevada Extends Deadline for Medicaid Managed Care RFI
New York to Launch Medicaid Social Care Networks to Address Health-related Social Needs
Dual Demos in New York, Ohio, Washington Show Mixed Results, CMS Reports
Cigna Purchases Digital Health Company Bright.md

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September 20, 2023

In Focus:

Roundup:

Help at Home to Cease Operations in Alabama
Arkansas Working Group Makes Recommendations Aimed at Improving Foster Care System
Florida Delays Bidding for Medicaid Managed Care Contract
AmeriHealth Caritas Names Melody Bonomo as Florida Market President
Nebraska Launches Program to Enroll Inmates Nearing Release in Medicaid
Nevada Medicaid Plan Aims to Improve Maternal Health-related HEDIS Scores
New Mexico Seeks Public Comments on Section 1115 Waiver Renewal Application Addendum
North Dakota Seeks Public Comments on IDD HCBS Waiver Renewal Application
Medicaid Eligibility Redeterminations News: Florida, Kansas, Louisiana, Mississippi, Nevada, North Carolina, Texas, Virginia
Utah Considers Carve Out of Medicaid ACO Pharmacy Benefits to Fee-for-Service
Vermont Releases HCBS Business Supports RFP
NCQA Includes Equity Measure in 2023 Health Plan Quality Ratings
CVS Health/Aetna Promotes Mark Santos to Head of Medicaid

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September 13, 2023

In Focus:

Roundup:

Redeterminations News: Arizona, Arkansas, Idaho, West Virginia
California Medicaid Director Jacey Cooper Is Leaving to Join CMS
District of Columbia Receives Approval for Community-Based Mobile Crisis Services SPA
Florida Renews Medicaid Utilization Management Contract with Acentra Health
Hawaii Receives $4 Million Project LAUNCH Federal Grant to Improve Children’s Behavioral Health
Michigan Expects Medicaid Community Health Worker Benefit to Impact 50,000 Residents If Approved
BCBS-NC Names Angela Boykin CEO of Medicaid Plan
Oregon to Seek Federal Approval for Basic Health Plan
Pennsylvania to Review Rates for Providers Serving Individuals with Intellectual Disabilities, Autism
CMS to Lower Cost of 34 Prescription Drugs Beginning October 1
Walmart May Buy Majority Stake in ChenMed

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