Weekly Roundup

December 16, 2020

In Focus:

2020 In Review: Top Medicare-Medicaid Integration Trends and Policies

Roundup:

District of Columbia Judge Rules Medicaid Managed Care Procurement Violated Law
Florida Medicaid Finds $89.6 Million Differential Between Prices Paid to PBMs, Prices Paid to Pharmacies
Hawaii Medicaid Plans Sought to Limit Number of Award Winners in Current Procurement
Louisiana to Release Medicaid Managed Care RFP in Spring
South Carolina Medicaid Director to Step Down
Texas Sees High Early Turn Out for Exchange Plans
MACPAC Releases 2020 MACStats Medicaid, CHIP Data Book

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December 9, 2020

In Focus:

CMS Finalizes Meaningful Expansions of Medicare Telehealth Service Coverage Through 2021

Roundup:

Hawaii Releases RFP For Quest Integration Medicaid Plans
Missouri RFP To Carve-In Behavioral Health for Foster Kids
Montana Receives One-Year Extension of Medicaid Expansion
New York To Seek Medicaid Redesign Team Waiver Extension
Ohio Taps Gainwell As Medicaid Fiscal Intermediary
Oklahoma Medicaid Waiver Providers to Receive 20 Percent Retroactive Rate Adjustment
Biden’s Potential Administrative Actions Could Impact

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December 2, 2020

In Focus:

North Carolina Releases RFA For Behavioral Health, Intellectual/ Developmental Disability Tailored Plans

Roundup:

Arizona To Release Procurement in August 2021 For Expanded Integrated SMI, Medicaid Managed Care Program
Delaware Care Collaborative to Serve as Medicaid, Chip ACO
New Jersey Medicaid Plan to Terminate Contract with Children’s Hospital of Philadelphia
Oregon Governor Proposes Medicaid Cuts
Oregon CCOs Post 0.6 Percent Operating Margin
Pennsylvania Enacts Medicaid PBM Price Transparency Law
Texas To Drop Planned Parenthood from Medicaid Network
CMS Releases 2021 Physician Fee Schedule

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November 18, 2020

In Focus:

CMS Introduces New Medicare Direct Contracting Model Opportunity

Roundup:

California Legislative Analyst Projects 14.2 Percent Increase in Fiscal 2022 Medicaid Spending
California Delays Implementation of Medi-Cal Rx
Illinois Unveils Medicaid Transformation Proposal
Kentucky Submits Waiver to Treat SUD in Prisons
Kentucky Judge Orders Mediation of Medicaid Managed Care Procurement Dispute
Missouri to Release Medicaid Managed Care RFP By July 2021
North Carolina Releases RFA for Behavioral, IDD Plans
CMS Releases Final Rule Revising Several Provisions of Medicaid and CHIP Managed Care Regulations
State Tax Revenues Fall $28 Billion, Report Finds

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November 11, 2020

In Focus:

A Short-Term Path to Avoid ACA Uncertainty as the Pandemic Continues

Roundup:

Hawaii Releases Community Care Services Program RFP
New Jersey to Submit Section 1115 Waiver Renewal
New York Lawmakers Seek To Delay Medicaid Drug Carve-out
North Carolina Launches Medicaid Managed Care Enrollment Website
Neighborhood Health Plan of Rhode Island Signs Three-Year Duals Demo Contract Extension
Tennessee Receives Federal Waiver Approval for Katie Beckett Program for Children with Disabilities
CMS Issues Final Rule on Medicaid Managed Care Changes

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November 4, 2020

In Focus:

HMA Colleagues Author Evidence-Based Health Promotion Programs Paper

Roundup:

Arizona Is Approved to Increase Hospital Reimbursements
Georgia Receives Federal Approval to Exit ACA Exchanges
Kentucky to Comply With Court Order to Grant Medicaid Managed Care Contract to Anthem
Nebraska Names Kevin Bagley as Medicaid Director
Ohio Releases OhioRISE Managed Behavioral Plan RFA
Texas Republican Lawmakers Consider Medicaid Expansion
CMS Issues Final Rule on Health Plan Price Transparency
Telehealth Flexibilities to Be Permanent for Medicare Home Health Providers

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October 28, 2020

In Focus:

Oklahoma, North Dakota Release Medicaid Managed Care RFPs

Roundup:

California Releases RFI for Dental ASO
Florida Procurement for Canada Drug Importation Program Fails to Attract Any Bidders
Georgia Eyes Privatization of Prison Healthcare Services
Hawaii Tentatively Schedules QUEST Integration RFP Release for December 2020, Community Care Services RFP for November
Indiana Receives 10-Year Extension for HIP Alternative Medicaid Expansion Program
Kentucky Health Plan Appeals Order to Grant Medicaid Managed Care Contract to Anthem
Verma Says CMMI Record on Value-Based Payments ‘Is Deeply Concerning,’ Calls for Change

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October 14, 2020

In Focus:

HMA Summary of UnitedHealth Group’s ‘The Path Forward’

Roundup:

Illinois to Offer Health Coverage to Elderly Undocumented Immigrants
Kentucky Is Temporarily Blocked from Moving Ahead with Medicaid Managed Care Contract
Oklahoma Proposal to Transition Medicaid to Managed Care Faces Bipartisan Opposition
Texas Is Hit with Federal Order to Fix Early Childhood Intervention Program
Rate of Uninsured Children Rises, Report Shows
More Medicare Advantage Plans to Cover Home-Based Support Services in 2021

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October 7, 2020

In Focus:

Ohio Releases Medicaid Managed Care RFA

Roundup:

D.C. Implements New Medicaid Managed Care Contracts
Kansas Awards Conduent Contract to Handle Medicaid Applications
Kentucky to Relaunch State Exchange for 2022 Coverage
North Carolina Awards EVV Contract to Sandata
Trump Ends COVID-19 Relief Talks Until After Election
Medicaid, CHIP Enrollment Reaches 75 Million Through June
Senate Passes Legislation to Relax Medicare Provider Relief Loans, Delay Medicaid DSH Cuts

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September 30, 2020

In Focus:

HMA Analysis of 2021 Medicare Advantage Landscape and Mandatory Medicare Radiation Oncology and ESRD Treatment Choices Innovation Models

Roundup:

Delaware Medicaid to Add Dental Coverage for Adults
Nebraska Medicaid Expansion Begins October 1
North Carolina PLE Petitions to Reverse Medicaid Managed Care Procurement Ruling
Ohio Releases Medicaid Managed Care RFA
Ohio Announces Creation of Medicaid Managed Care Program for Children with Behavioral Health Needs
Texas Seeks Input On Procuring MCOs for Healthy Texas Women Program
House Democrats Unveil COVID-19 Bill That Includes $50 Billion for Healthcare Providers
Trump Administration Approves Drug Importation Program
CMS Warns of Significant Decrease in Utilization of Health Services Among Children Enrolled in Medicaid, CHIP

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