Old Weekly Roundup

November 13, 2024

In Focus:

Roundup:

Michigan to Rebid Contracts for Coordinated Health HIDE SNP
New York Selects 24 Home Care Subcontractors to Administer CDPAP Services
South Carolina Names Eunice Medina Medicaid Director
South Dakota Releases Medicaid Dental ASO RFP
Tennessee Submits Amendment Request for 1115 TennCare III Demonstration
Vermont OneCare ACO to Shut Down in 2025
Virginia to Submit 1115 Building and Transforming Coverage, Services, and Supports for a Healthier Virginia Demonstration Amendment in December
ACO REACH Model Generates $695 Million in Net Savings in 2023
DOJ, AGs Sue to Prevent UnitedHealth Group’s Acquisition of Amedisys
Cigna Will Not Pursue Merger with Humana

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November 6, 2024

In Focus:

Roundup:

California Voters Approve Ballot Measure to Redirect MCO Tax Revenue to Medicaid Program.
Florida Names Brian Meyer Medicaid Director
Minnesota to Release RFP for Prepaid Medical Assistance Program/MinnesotaCare in 2026, Special Needs BasicCare Program in 2027
New York Submits 1115 Medicaid Redesign Team Demonstration Amendment for MBI-WPD, CPT Program
Ohio Releases Next Generation MyCare Program Awards
Oklahoma to Submit Medicaid SPA for Community Health Services
South Dakota Voters Approve Medicaid Expansion Work Requirements Consideration
Texas to Delay Medicaid STAR, CHIP Contracts Until Summer 2025
CMS Issues 2025 Outpatient Hospital Final Rule
CMS Finalizes CY2025 Medicare Physician Fee Schedule, Home Health and ESRD Payment Updates
Wakely Releases Analysis of Acuity Changes During Medicaid Unwinding
Elevance Sues CMS Over 2025 Medicare Advantage Star Ratings
Pharmaceutical Companies Seek to Reopen Lawsuits Over Medicare Drug Price Negotiation Program

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October 30, 2024

In Focus:

Roundup:

Illinois D-SNP Procurement Attracts Six Bidders
Michigan Releases In Lieu of Services Program Policy Guide for Medicaid Plans
Nevada Releases Draft Section 1115 Reentry Services Demonstration
Wisconsin Receives Federal Approval for BadgerCare Reform Demonstration Extension
CMS Announces Additional State Participants in AHEAD Model
Medicare Shared Savings ACOs Saved $2.1 Billion in 2023
Orlando Health Finalizes Acquisition of FL-based Steward Health Hospitals

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October 23, 2024

In Focus:

Roundup:

Colorado Individual Marketplace Premiums to Increase 5.6 Percent in 2025
Maryland PDAB to Set Upper Payment Limit on High-cost Prescription Drugs
Nevada Releases Medicaid Managed Care RFP
Oregon Announces 3.1 Percent Increase in 2025 Capitation Rates for Medicaid CCOs
States are Implementing Policies to Address Managed Care, Provider Rates, Health Disparities, KFF Medicaid Directors Survey Finds
Nearly 1.5 Million Part D Enrollees Reach the IRA Out-of-Pocket Drug Limit by June 2024
Medicare Advantage Plans Sue CMS Over 2025 Star Ratings
CVS Health Names David Joyner as CEO
Elevance to Acquire CareBridge
CareSource Partners with Nomi Health to Improve Healthcare Access for Medicaid Members Across Three States

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October 16, 2024

In Focus:

Roundup:

Louisiana Submits Section 1115 Reentry Demonstration Application
Massachusetts to Submit Section 1115 MassHealth Demonstration Amendment to Support One Care Transition to FIDE-SNP
Mississippi Medicaid Executive Director Drew Snyder Resigns, Cindy Bradshaw Appointed Replacement
Rhode Island to Reevaluate Medicaid Contract Awards
Four States Receive Federal Approval to Allow Medicaid Coverage for Traditional Health Care Practices
Average Medicare Advantage Star Ratings Decrease for 2025
CMS to Modernize Coverage Transition Process between Medicaid/CHIP, Federal Marketplace

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October 9, 2024

In Focus:

Roundup:

Colorado Announces Behavioral Health ASO Awards
Kansas Judge Denies Aetna’s Petition for Judicial Review Over KanCare Awards
Michigan Announces Award Recommendations for MI Coordinated Health HIDE SNP
New York School-based Providers to Transition Medicaid Payments to Managed Care in April 2025
Texas Pauses Medicaid STAR, CHIP Contract Awards
CMS Releases Medicare $2 Drug List Model RFI
CMS Releases Final Guidance for Second Cycle of Medicare Drug Price Negotiations
CMS Issues Revised IPPS Policy to Reduce Low Wage Hospitals Payments in Fiscal 2025
UnitedHealthcare Sues CMS Over Medicare Advantage Star Rating
MTM Completes Acquisition of Access2Care
Elevance Acquires Kroger’s Specialty Pharmacy Business

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October 2, 2024

In Focus:

Roundup:

Kentucky HCBS EVV System Go-live with Therap Pushed to January 2025
Michigan Submits Application for New Section 1115 Reentry Services Demonstration
Nevada Releases Medicaid Housing Supports, Services RFI
Oklahoma Works on SPA to Expand School-based Medicaid Services
South Carolina Coalition Pushes for Medicaid Expansion
Washington Apple Health Pregnancy Programs Increase Income Limit Beginning in November
CMS Releases Medicaid Managed Care MLR Monitoring, Reporting, Oversight Toolkit
CMS Releases NOFO for Planning Grants to Address Care Continuity for Justice-involved Individuals
States Could Improve Maternal Healthcare Access by Leveraging Medicaid Managed Care Requirements, HHS OIG Finds
Tenet Healthcare Finalizes Sale of Majority Stake in Brookwood Baptist Health to Orlando Health

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September 25, 2024

In Focus:

Roundup:

California Announces Intent to Award Medi-Cal Dental Managed Care Contracts in Los Angeles, Sacramento Counties
Maryland Renews Eight Medicaid MCO Contracts for 2025; Announces Intent to End Contract with Kaiser Permanente
Minnesota Releases Electronic Visit Verification Implementation Grant Distribution RFP
Nevada Releases Coordination Only Dual Eligible Special Needs Plan RFP
Virginia Releases Fiscal Agent Services RFP
CMS Releases Final Rule Addressing Medicaid Drug Rebate Program
Black, Latine Family Doctors More Likely to See Medicaid Patients
Hospital Readmission Penalties Remain Comparable Over Past Three Years
Cigna to Cut Medicare Advantage Plans Across Eight States in 2025

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September 18, 2024

In Focus:

Roundup:

Arizona Extends ALTCS-EPD Program Contracts for Another Year
Colorado Announces Intent to Award Regional Accountable Entity ACC Phase III Contracts
New Hampshire Receives Federal Approval for Mobile Crisis Intervention Teams
North Carolina Legislature Approves $377 Million in Medicaid Funding; $81 Million Less than Requested
Pennsylvania Lawmakers, Advocates Look to Reverse Medicaid Dental Policy
Washington Marketplace Insurance Rates to Increase Nearly 11 Percent in 2025
Hospitals File Lawsuit Against HHS Over Medicare Advantage Calculation in DSH Payments
Medicare Health Plan Ratings Drop for NCQA’s 2024 Equity Measures
Cigna Sues FTC Over PBM Drug Pricing Report

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September 11, 2024

In Focus:

Highlights from HMA Survey on State Approaches to Managing the Medicaid Pharmacy Benefit

Roundup:

Arizona Denies Appeal Over ALTCS-EPD Procurement; Will Not Rebid Contracts
Arkansas Maternal Health Committee Recommends Medicaid Doula Coverage, Prenatal Presumptive Eligibility
Florida Plan Drops Final Medicaid Managed Care Award Protest
Federal Judge Declines to Block Maryland Law Requiring 340B Participation
Massachusetts Awards One Care, Senior Care Options Program Contracts
Michigan Expands Opioid Health Home Initiative Coverage to Include SUD, Additional Region
Vermont Releases Medicaid Permanent Supportive Housing Assistance RFP
Washington Medicaid Housing Program Faces Funding Shortage
Wisconsin Medicaid to Offer Housing, Meal Support for Certain Beneficiaries in 2025
CMS Releases Medicare Administrative Contractor Consolidation RFI
Biden Administration Issues Final Rule Strengthening Mental Health Parity, Addiction Equity Act
Humana to Exit 13 Medicare Advantage Markets in 2025

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