Blog

Oklahoma Releases Medicaid Managed Care Request for Public Feedback

This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state’s Medicaid managed care program design before finalizing a request for proposals (RFP). The RFP, which is currently in development, is scheduled to drop in the fall and has an implementation date of October 2021. Individuals, program participants, providers, trade associations, companies, and other organizations are encouraged to submit responses by August 17, 2020.

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Early Bird Registration Expires July 29 for HMA Conference, October 26-27 in Chicago

Be sure to register soon for HMA’s conference on What’s Next for Medicaid, Medicare, and Publicly Sponsored Healthcare: How Payers, Providers, and States Are Navigating a Future of Opportunity and Uncertainty, October 26-27, at the Fairmont Chicago, Millennium Park. The Early Bird registration rate of $1595 per person expires on July 29.  After that, the rate is $1795.

Read MoreEarly Bird Registration Expires July 29 for HMA Conference, October 26-27 in Chicago

Medicaid and Exchange Enrollment Update – March 2020

This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “March 2020 Medicaid and CHIP Applications, Eligibility Determination, and Enrollment Report,” published on June 22, 2020. Additionally, we review 2020 Exchange enrollment data from the “Health Insurance Exchanges 2020 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on April 2, 2020. Combined, these reports present a picture of Medicaid and Exchange enrollment in early 2020, leading up to the COVID-19 pandemic and representing 70.9 million Medicaid and CHIP enrollees and 11.4 million Exchange enrollees. Medicaid/CHIP and Exchange enrollment is expected to rise in 2020 according to a team of HMA Medicaid experts, health economists, and data analysts. A previous In Focus on HMA’s forecast model can be found here.

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GAO 50-State Medicaid Survey on Federal Policy Challenges

This week our In Focus section summarizes the United States Government Accountability Office (GAO) Medicaid report, State Views on Program Administration Challenges, released earlier this year. GAO conducted interviews with Medicaid officials from 50 states and the District of Columbia to identify challenges related to federal Medicaid policies.  

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CMS Medicare Advantage and Section 1876 Cost Plan Network Adequacy Update

This week, our In Focus section examines new guidance issued by the Centers for Medicare & Medicaid Services (CMS) regarding Medicare Advantage (MA) plan network adequacy requirements. On June 17, 2020, CMS released updated Medicare Advantage and 1876 Cost Plan Network Adequacy Guidance for Medicare Advantage (MA) health plans to use now for Contract Year 2021 network submission. 

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Inland Empire Health Plan  Releases Health Homes Program Year One Implementation Report

A new report has been released outlining Inland Empire Health Plan’s (IEHP) efforts to establish 50 care teams to support the delivery of core Health Homes Program services for IEHP’s most vulnerable members with complex health conditions.

HMA contributed to the new report and has supported implementation of IEHP’s Health Homes Program since 2018, providing consultation in the development and implementation of a clinical model of care, the design and deployment of a population health management tool, the creation and delivery of a multi-modal training program, and the provision of practice coaching to over 50 care teams.

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HMA-Developed MAT Training For Justice and Child Welfare Now Available Online

Focused on ongoing support and solutions for those living with opioid use disorder (OUD), Health Management Associates (HMA) has developed a robust web-based training program about addiction and its treatment in the criminal justice and child welfare systems, including access to, and continued use of, medications for addiction treatment (MAT).

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Impact of COVID-19 Federal Policy on Medicare Advantage

This week, our In Focus section examines the operational impacts of federal Medicare Advantage policy changes in response to the COVID-19 pandemic. On January 31, 2020, the Secretary of Health and Human Services declared a public health emergency. This was followed by a national emergency declared by President Trump on March 13, 2020. These declarations provide the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) authority to waive certain Medicare and Medicaid regulatory requirements to help health plans, providers, and other stakeholders respond to immediate needs of their members and communities. These waiver flexibilities, when combined with other legislative and regulatory changes issued by Congress and CMS have resulted in over 200 policy changes to Medicare alone. Many of these affect Medicare Advantage sponsors and have direct implications to current and future operations of plan responsibilities. We examine eight categories of requirements and flexibilities that have significant business relevance and exposure for Medicare Advantage plan sponsors:

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