Weekly Roundup

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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August 9, 2023

In Focus:

CMS Finalizes Mix of Reimbursement Reductions and Increases in 2024 Hospital Inpatient Final Rule

Roundup:

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August 2, 2023

In Focus:

New CMS Dementia Care Model Emphasizes Role of Caregivers

Roundup:

Alabama Seeks Medicaid Waiver to Cover Opioid, SUD Services for Individuals in IMDs
Alaska Medicaid to Cover Assisted Living Services in At-home Settings
California Receives Approval to Lift the Medicaid Asset Test in 2024
Florida Seeks Waiver to Pilot Managed Care Program for Individuals with IDD
Medicaid Eligibility Redeterminations News: Louisiana, Michigan, Minnesota, Missouri, New Hampshire
North Carolina Reaches Agreement with CMS in Hopes of Launching Medicaid Expansion by October 1
Virginia Medicaid Managed Care RFP Release Delayed to Mid to Late August
CMS Releases Final Medicare Inpatient, Long Term Care Prospective Payment System Rule
CMS Increases Medicare Reimbursement Rates for Skilled Nursing Facilities by 4 Percent in Fiscal 2024
CMS Projects 1.8 Percent Decrease in Medicare Part D Premiums in 2024
CMS Increases Medicare Hospice Rates by 3.1 Percent in Fiscal 2024
Medicaid, CHIP Enrollment Is Nearly 94.2 Million in April 2023
Medicaid Disenrollments Near 4 Million Following Redeterminations
The Ensign Group Acquires Skilled Nursing Facilities in Colorado, Washington
Help at Home Acquires IN-based My Care at Home, OH-based Berkshire Homecare

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July 26, 2023

In Focus:

CMS Plans to Improve Incentives for Medicare Providers in Accountable Care Arrangements

Roundup:

California Exchange Plan Premium Hikes Softened by State Financial Support
Medicaid Eligibility Redeterminations News: Indiana, Massachusetts, Minnesota, Montana, Washington, West Virginia, Wisconsin
Molina Healthcare Names Aaron Dunkel as President of Kansas Operations
Michigan Ends Cost Sharing in Medicaid Expansion Program
Nevada Releases Medicaid Managed Care RFI
Oklahoma Health Care Authority CEO Kevin Corbett to Resign
Medicaid Disenrollment Rates Vary Widely Among States, Report Finds
Community Health Systems to Sell Three Hospitals to Tampa General Hospital in $290 Million Deal
United’s Optum Health Names Amar Desai as CEO

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July 19, 2023

In Focus:

Medicare’s 2024 Proposed Payment Rules Offer a Mix of Opportunities and Policy Changes for Physicians and Hospitals

Roundup:

Redeterminations News: Arkansas, Connecticut, Georgia, Iowa, Kentucky, North Carolina, North Dakota, Texas, Wyoming
California Health Plan to Provide $46 Million in Grants for Housing, Other Services 
Colorado Medicaid, CHIP Are Among Payers Most Likely to Reimburse for Unnecessary Health Services, Study Finds
Florida Is Ordered to Amend Medicaid Program to Prevent Institutionalization of Children with Complex Needs
Hawaii to Seek Medicaid Services for Justice-involved Populations Prior to Release
Illinois Provides $75 Million in Funding to Address Health Disparities, Housing
Medicaid Disenrollments Top 3 Million Following Redeterminations
MTM Acquires Medical Transportation Brokerage of Arizona

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July 12, 2023

In Focus:

CMS Releases Report on Nonemergency Medical Transportation in Medicaid

Roundup:

Medicaid Eligibility Redeterminations News: Arizona, District of Columbia, Florida, Idaho, Maryland, Michigan, Mississippi, New Jersey, Tennessee, Wyoming
Florida Extends Deadline for Medicaid Managed Care ITN Responses
Georgia Launches Partial Medicaid Expansion Program With Work Requirements
Idaho Medicaid Managed Care Task Force Holds Hearing on Structure of Program Funding
New Jersey Will Allocate $5 Million to Improve Housing for Individuals with Disabilities, Acute Medical Needs
New York Releases Third-Party Liability Match, Recovery Services RFP
North Carolina Further Delays Implementation of Behavioral Health IDD Tailored Plans
Ohio Releases RFP for Medicaid Enterprise System Alternate Payment Model Logic, Reporting Tool
Pennsylvania Medicaid to Cover Care Delivered on Streets to Homeless
ACA Risk Adjustment Pool To Redistribute $15.2 Billion to Individual Plans
AmeriHealth Caritas CEO Paul Tufano to Step Down

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July 5, 2023

In Focus:

Florida Disenrolls Some Children with Complex Medical Needs During Redeterminations

Roundup:

Florida Disenrolls Some Children with Complex Medical Needs During Redeterminations
Idaho Faces Lawsuits Over Medicaid Behavioral Plan Award
Iowa Medicaid Managed Care Contracts Begin July 1
UCare Names Former Kansas Medicaid Director Jon Hamdorf Market President
Louisiana Governor Vetoes Part of Legislature’s Proposed Budget, Reinstates Health Spending Increase
Maryland Extends Pregnancy, Postpartum Medicaid Benefits to Undocumented Individuals
Massachusetts Made $85 Million in Capitation Payments on Beneficiaries Living Out of State, Audit Finds
Minnesota Releases Medicaid, MinnesotaCare IHP RFP
Minnesota Provides One Month Grace Period to Reenroll in Medicaid Following June Redeterminations
Nevada Allows Medicaid to Cover Behavioral Health Services in Schools
New Hampshire Medicaid Beneficiaries Struggle to Find Dental Care
North Carolina Governor Urges Lawmakers to Separate Medicaid Expansion from Budget
Oklahoma Disenrolls 54,000 Medicaid Enrollees During May Redeterminations
South Dakota Implements Medicaid Expansion on July 1
Washington Receives Federal Renewal of Medicaid Transformation Project Section 1115 Waiver
Washington Disenrolls 116,000 Medicaid Beneficiaries During May Redeterminations
Home Health Providers Face Proposed 2.2 Percent Medicare Rate Cut in Fiscal 2024
Molina to Acquire Bright Health Medicare Advantage Subsidiaries

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June 28, 2023

In Focus:

More than 20 Medicaid, Medicare, Marketplace Plan Executives Are Confirmed Speakers at 2023 HMA Conference

Roundup:

Medicaid Disenrollment News: Connecticut, Michigan, North Carolina, Oregon, South Carolina
California Renews Managed Care Tax, With Funds to Bolster Medicaid, Hospitals
Georgia Directs $118 Million to Medicaid Expansion in Fiscal 2024
Idaho Awards Centene/Magellan Healthcare Behavioral Health Plan Contract
Illinois Governor Creates State-based Insurance Exchange
Illinois Requests Extension for Behavioral Health Transformation Section 1115 Waiver
New Hampshire Extends Postpartum Medicaid Coverage
Washington Extends Family Planning Only Demonstration Waiver by One Year
Wisconsin to Renew Family Care, Family Care Partnership Waivers
Wisconsin Launches Independent Living Supports Pilot Program
Medicaid, CHIP Enrollment is Nearly 93.9 Million in March 2023
MACPAC Projects Medicaid Managed Care Directed Payment Spending to Be $69.3 Billion Annually
Drug Makers File Federal Lawsuit to Block Medicare From Negotiating Drug Prices
UnitedHealth Group Wins Bidding Showdown to Acquire Amedisys
CareSource to Acquire Radiant Alliance

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June 21, 2023

In Focus:

CMS Releases National Healthcare Expenditure and Enrollment Projections through 2031

Roundup:

May Medicaid Redeterminations Update: Arizona, Illinois, Indiana, Iowa, West Virginia 
California Lawmakers Introduce Bills to Modernize State Mental Health Services Act
Florida to Pilot Medicaid Managed Care for Individuals with Developmental Disabilities in 7 Counties
Idaho Releases EQRO RFP 
Illinois Pauses Enrollment in Health Benefits for Immigrant Adults Program
Indiana Names Cora Steinmetz as Medicaid Director 
Iowa Contracts With HMA to Study Service Delivery for New Health, Human Services Department 
Kentucky to Study Potential HCBS Waiver Program For Children with Severe Emotional, Intellectual Disabilities 
Montana Disenrolls 15,500 Medicaid Beneficiaries During April Redeterminations
New Mexico Awards General Dynamics Information Technology $39 Million Contract to Update Medicaid Provider Enrollment System 
Oklahoma Closed Loop Electronic Referral System for SDOH RFP Responses Are Due June 19
Tennessee Releases Medicaid, CHIP Eligibility Determination System RFI
Enhanced Medicaid Funds to States for Pausing Disenrollment Top $117 Billion, KFF Finds
Pennant Group Acquires Bluebird Home Health, Hospice, Home Care Provider

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June 14, 2023

In Focus:

To Treat Residents with OUD, Nursing Facilities Must Improve Practices and Reduce Stigma

Roundup:

Medicaid Disenrollment News: Arkansas, Georgia, Kansas, Maryland, Nebraska, New Hampshire, South Carolina
Florida Raises KidCare Income Eligibility to 300 Percent of Poverty
CareSource Files Protest Against Iowa Medicaid MCO Awards
CareSource Forms Alliance with Three Organizations to Bid on Upcoming Kansas Procurement 
New York to Form Healthcare Commission to Improve Medicaid Quality, Reduce Costs
North Carolina Enacts Law Allowing BCBS-NC, Delta Dental to Shift Assets to Holding Companies
North Dakota Names Sarah Aker Medicaid Director
Oklahoma Awards Medicaid Managed Care Contracts to Three Plans
Pennsylvania Receives 67 Responses to Community HealthChoices RFI
Texas Awards EVV System Management Services Contract to Accenture, HHAeXchange
Health Plans Must Pay for Preventive Care Under Temporary Agreement
CMS Announces New Primary Care Payment Model
Center for Autism Files for Chapter 11, Assets To Be Acquired by Founder, Former CEO
Walgreens Sells Remaining Shares of Option Care Health for $330 Million

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