Blog

COVID-19 Policy Flexibilities Affecting Children and Youth with Special Health Care Needs

This week, our In Focus section reviews a new report from Health Management Associates, COVID-19 Policy Flexibilities Affecting Children and Youth with Special Health Care Needs: What to Keep, Modify, or Discard?. In response to the COVID-19 pandemic, the federal government and states rapidly established new, temporary regulations and flexibilities, while providers deployed innovative technologies to connect with their patients. The report examines how COVID-19 and the responses by federal and state governments, health systems, and providers affect health care for children and youth with special health care needs (CYSHCN).

Read More

Tennessee Releases Medicaid Managed Care RFP

This week our In Focus reviews the Tennessee Medicaid managed care request for proposals (RFP) released on June 11, 2021, by the State of Tennessee, Division of TennCare. Tennessee will select three plans to provide physical services, behavioral services, and Managed Long-Term Services and Supports (MLTSS), including nursing facility services and home and community-based services (HCBS), to beneficiaries enrolled in TennCare (Medicaid), CoverKids (Children’s Health Insurance Program), and Dual Eligible Special Needs Plans (D-SNP). Current incumbents serve over 1.5 million beneficiaries, with contracts worth $12 billion annually.

Read More

Indiana Releases Medicaid Managed Care RFP

This week, our In Focus section reviews the Indiana Medicaid managed care request for proposals (RFP) for health plans serving beneficiaries enrolled in Hoosier Healthwise and Healthy Indiana Plan (HIP) programs. Contracts will be worth over $6 billion annually.  The RFP was released on June 7, 2021, by the Indiana Department of Administration on behalf of the Family and Social Services Administration Office of Medicaid Policy and Planning.

Read More

Long-Term Care and Care Facilities Post-COVID-19 Pandemic

While disrupting all aspects of life around the world, the COVID-19 pandemic has had an enormous impact on the long-term care delivery system in this country with long-term care facilities being disproportionately impacted by the pandemic. Nursing homes and senior living communities were in the difficult position of needing to keep patients safe while continuing to provide care and mitigate the risks of infection for both patients and staff.

Read More

California Releases Draft Medi-Cal Managed Care RFP

This week, our In Focus section reviews the draft Medi-Cal Managed Care Plans (MCPs) request for proposals (RFP) released on June 1, 2021, by the California Department of Health Care Services (DHCS). California will procure MCPs for the Two-Plan Model, Geographic Managed Care (GMC), Regional Model, Imperial Model, and San Benito Model. This RFP excludes County Operated Health Systems (COHS) Plans and Local Initiative Plans. Of the total 13.5 million Medi-Cal beneficiaries, there are nearly 11.6 million in Medicaid managed care, of which approximately 3.5 million will be served under this RFP. A final RFP release date is still “to be determined” but expected in late 2021. Feedback on the draft RFP is due July 1, as well as voluntary non-binding letters of intent. A pre-proposal web conference will be held on June 10.

Read More

Which Medicare Changes Should Continue Beyond the COVID-19 Pandemic? Four Questions for Policymakers

In an issue brief prepared for The Commonwealth Fund and The SCAN Foundation, HMA consultant Jennifer Podulka and Vice President Jonathan Blum, analyze the temporary COVID-19-related changes to Medicare regulations, described the benefits and risks of the changes, and offered a framework to support policymakers’ decisions on the future of these temporary policies.

Read More

California Proposed May Revision Budget Adds Medi-Cal Expansions

This week, our In Focus section reviews California’s May Revision to the Governor’s Budget, which proposes a $267.8 billion budget (with $196.8 billion General Fund) for fiscal year 2021-22. The revised budget includes $24.4 billion in reserves, the largest in history. The May Revision builds on the California Advancing and Innovating Medi-Cal (CalAIM) proposal and introduces several Medi-Cal initiatives and benefits for fiscal year 2021-22.

Read More

CMS Inpatient Hospital Proposed Rule to Repeal Market-based MS-DRG Weight Methodology

This week, our In Focus section reviews the key provisions of the Centers for Medicare & Medicaid (CMS) Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (CMS-1752-P), which includes Medicare payment updates and policy changes for the upcoming FY, with a comment deadline of June 28, 2021. This year’s proposed rule includes several proposals the hospital industry should carefully consider. In particular, the Biden Administration has proposed to:

Read More