Weekly Roundup

October 18, 2023

In Focus:

Cut to the Point: A Summary of 2024 Star Rating Cut Point Changes

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:

Florida Releases Procurement for Statewide Medicaid Prepaid Dental Program

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:

CMS AHEAD Model Offers a Flexible Framework for State-Led Total Cost of Care Initiatives

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:

New Hampshire Releases Medicaid Managed Care RFP

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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September 6, 2023

In Focus:

Virginia Releases Cardinal Care Medicaid Managed Care RFP

Roundup:

California Medi-Cal Contracts Are Scheduled to Begin January 1
PBMs Face Lawsuit from Los Angeles County Over Opioid Crisis
Georgia Receives Approval of Waivers to Streamline Medicaid Unwinding Process
Montana Medicaid Providers Face Further Delay in Receiving Increased Rates
New York Managed Long-term Care Plan Is Closing Down
Oregon to Step Up PBM Regulation After Audit Finds Lax Oversight
Pennsylvania Senate Passes Bill to Raise Reimbursement Rate for Ambulance Services
Tennessee Awards Findhelp Contract to Connect Medicaid Beneficiaries with Social Services
Virginia Proposed Budget to Renew Individual Market Reinsurance Program
West Virginia Receives CMS Approval for Medicaid Mobile Crisis State Plan Amendment
CMS to Provide Funding to Help States Implement AHEAD Total Cost of Care Delivery System Model
Molina Acquires My Choice Wisconsin

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August 30, 2023

In Focus:

CMS Takes Next Major Step in Medicare Drug Price Negotiation Program

Roundup:

North Carolina Medicaid Expansion Will No Longer Launch on October 1
Georgia Looks to Increase Oversight of Medicaid Plans
Idaho Gears Up for Transition to Single Behavioral Health Plan Covering Inpatient, Outpatient Services Medicaid Eligibility Redeterminations News: Alaska, Illinois, Maine, Massachusetts 
Indiana Medicaid Beneficiaries Struggle to Access Dental Care
Iowa Increases Medicaid Reimbursements for Substance Abuse, Mental Health Counseling
Michigan Governor to Call for Legislation Locking in ACA Protections
Nevada Awards Magellan Contract for Complex Behavioral Care Management for Youths
North Carolina Medicaid Expansion Will No Longer Launch on October 1
Oklahoma Proposes 12 Months of Continuous Eligibility for Children on Medicaid, CHIP
CMS Takes Additional Action to Halt Wrongful Medicaid Disenrollments
Biden Administration Announces Ten Drugs for Direct Medicare Negotiation with Manufacturers
Centene to Sell Circle Health Group to PureHealth

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August 23, 2023

In Focus:

CMS Continues to Rollout New Initiatives, What to Watch for in the Fall

Roundup:

Florida Residents File Federal Lawsuit Challenging Their Disenrollment from Medicaid
Georgia Medicaid Expansion Program Sees Slow Enrollment
Hawaii Halts Medicaid Eligibility Redeterminations on Maui For Remainder of 2023
Amerigroup Iowa Names Teresa Hursey President
Louisiana Lawmakers Push to Delay Sale of BCBS Louisiana to Elevance Health
Michigan New Medicaid Managed Care Contracts Will Take Effect October 2024
CareSource, HAP Receive Approval to Form Medicaid Joint Venture
New Mexico Releases $80 Million Rural Health Care Delivery Fund RFA
Ohio Renews Contract with Medicaid EVV Company
Oregon to Implement Mandatory Annual Audits of Medicaid PBMs
Texas to Restore Medicaid Coverage of 90,000 Disenrolled Individuals
Virginia Delays Release of Medicaid Managed Care RFP to September 1
Washington Allocates Over $100 Million to Apple Health, Homes Program
CMS Warns States That Call Center Wait Times, Dropped Calls Are Impeding Medicaid Coverage Renewals
Centene to Challenge Tricare Contract Loss in Federal Claims Court

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August 16, 2023

In Focus:

Arizona Releases Medicaid ALTCS-EPD Program RFP

Roundup:

Colorado Hospitals Continue to Post Operating Losses
Florida Projects $600 Million Medicaid Budget Deficit for Fiscal 2024
Medicaid Eligibility Redeterminations News: Florida, Illinois, Massachusetts, Michigan, Nevada, Rhode Island, Wyoming
Idaho Medicaid Managed Care Task Force Holds Second Hearing
Illinois Governor Signs Law Increasing Oversight of Healthcare Mergers
Indiana Parents, Advocates Call on Governor to Reconsider Funding Cut for Autism Therapy
Massachusetts to Raise Income Eligibility Limits for ConnectorCare
Nebraska to Lift $750 Cap on Medicaid Dental Benefits
New Mexico to Award Previously Announced Medicaid Plan Contracts in Defeat for Governor
New York City Cannot Switch Retirees to Aetna Medicare Advantage Plan, Judge Rules
North Carolina Medicaid Behavioral Health Plans Sandhills Center, Eastpointe to Merge
Vermont All-Payer ACO Model Lowers Medicare Spending, Hospitalizations, Analysis Finds
CMS Launches Changes to Encourage Participation in Medicare ACO REACH
4.8 Million Medicaid Beneficiaries Are Disenrolled from Medicaid Following Redeterminations, Analysis Finds
5.6 Million Medicaid Enrollees Utilize Long-term Services, Supports in 2020, KFF Finds
U.S. Appeals Panel Rules False Claims Lawsuit Against Walgreens Can Proceed

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