Weekly Roundup

April 6, 2022

In Focus:

Texas Releases STAR+PLUS RFP

Roundup:

Florida Reaches $484 Million Settlement with Pharmacy Chain Over Opioid Claims
Georgia Enacts Bill to Implement 85 Percent Minimum MLR Requirement for Medicaid Plans
BCBS-Illinois Appoints Stephen Harris as President
Kansas Senate Approves Bill to Extend KanCare Contracts Through 2024
Minnesota DHS Recommends Actions to Improve Racial Equity, Health Outcomes in Medicaid
New Mexico HCBS Providers to Receive Temporary 15 Percent Reimbursement Rate Increase
Oklahoma Names Traylor Rains State Medicaid Director
Rhode Island Medicaid Managed Care Bid Is Rejected After Missing Submission Deadline
Biden Proposes Fix to Exchange ‘Family Glitch’ Impacting 5 Million Individuals
CMS Finalizes 8.5 Percent Rate Increase for Medicare Advantage, Part D Plans
Intermountain Healthcare, SCL Health Complete Merger
UnitedHealth/Optum to Acquire Majority Stake in Kelsey-Seybold Clinic
Federal Judge Dismisses Anthem’s Claims in PBM Lawsuit Against Cigna

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March 30, 2022

In Focus:

President’s Budget Recommends Significant Investments in Unity Agenda Issues

Roundup:

Arkansas Eligibles Face Barriers Enrolling in Medicaid, Report Finds
Connecticut Medicaid Enrollment Increases by 120,000 During Pandemic
Florida Medicaid Plan Has New Enrollment Suspended by State
Kansas Governor Urges Legislature to Remove Budget Bill Provision to Extend KanCare Contracts
Michigan Home-Based Care Providers Struggle After Reimbursement Rate Cut
New Hampshire Hospitals Can Proceed with Lawsuit Over Vermont Over Medicaid Rates
North Carolina Launches Initiative to Provide Integrated Care for Children On Medicaid, CHIP
Pennsylvania to Release MMIS RFP in September 2022
South Carolina Receives CMS Approval of Temporary HCBS Rate Increases
Health Plan Invests More Than $85 Million to Help Develop Affordable Housing in Texas
Medicaid Spending Will Exceed $1 Trillion in 2028, CMS Projects

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March 23, 2022

In Focus:

Learning from COVID-19-Related Flexibilities: Moving Toward More Person-Centered Medicare and Medicaid Programs

Roundup:

California Extends Medi-Cal Assisted Living Waiver Program
Colorado, Novartis Begin Medicaid Value-Based Drug Pacts
Illinois to Fund Effort on Social Determinants of Health
Iowa to Release Medicaid Enterprise Provider Solutions RFI
NEMT News: Michigan, Utah
Nevada Releases RFP for Medicaid Dental Benefits Plan
Medicaid Plans Can Play Important Role in Redeterminations
CMS Says Medicaid, Exchange Enrollment Is at All-Time High

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March 16, 2022

In Focus:

How Stakeholders Can Prepare for Unwinding of Medicaid Public Health Emergency Continuous Eligibility

Roundup:

Florida Legislature Passes Bill Reducing Number of Medicaid Managed Care Regions
Georgia House Passes Bill to Carve-Out Medicaid Pharmacy Benefits
Iowa Releases Non-Emergency Medical Transportation RFP
New Jersey Seeks Approval of Adult Continuous Eligibility, Maternal Care Programs in Medicaid 1115 Waiver Extension
New York Legislature Rejects Competitive Bidding for Medicaid Managed Care
CMS Must Issue Decision on TX Waiver Programs
Congress Extends Medicare Telehealth Coverage in Newly Approved Budget

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March 9, 2022

In Focus:

HMA Experts Lay Out Scenarios for Transitioning from COVID-19 Public Health Emergency

Roundup:

Alaska Releases MMIS RFI
California Medicaid Telehealth Visits Soar
Georgia House Approves Minimum MLR for Medicaid Plans
UCare to Bid on Iowa Medicaid Managed Care Contract
Kentucky Releases PBM RFP for Fee-For-Service Medicaid
Nebraska Medicaid Managed Care RFP Is Expected in April 2022
North Carolina to Launch Medicaid SDOH Pilot
Ohio Medicaid Managed Care Enrollment Begins
Oregon Bill Passes to Address Post-PHE Coverage Losses

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March 2, 2022

In Focus:

CMS Will Accept Applications for New Medicare ACO REACH Model

Roundup:

Arizona to Prioritize Medicaid Eligibility Redeterminations
Arkansas Announces HCBS Workforce Stabilization Program
California to End Child Health and Disability Prevention Program, Expand Presumptive Eligibility
PBM News: California, Georgia, Michigan, Oregon
Colorado Pauses Medicaid Prior Authorization Requirements
Florida Senate Committee Advances Scaled Back Plan to Merge Medicaid Managed Care Regions
Georgia House Passes Bill to Cover Childless Adults with HIV
Medicaid Expansion News: Illinois, Wisconsin
Dental News: New Hampshire, Tennessee
New York 1199SEIU Home Care Workers to Receive Back Pay

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February 23, 2022

In Focus:

Iowa Releases Medicaid Managed Care RFP

Roundup:

Colorado RAE Improperly Denies Claims Due to System Issue
District of Columbia Awards District Dual Choice Contract
Florida House Considers Bill to Carve-in Medicaid Dental
Iowa Releases Medicaid Managed Care RFP
Massachusetts to Release Medicaid ACOs RFR
Medicaid Expansion News: Missouri, North Carolina, Wyoming
Michigan Legislature Passes PBM Transparency Bill
Nevada Medicaid Providers Are Under-Prescribing MAT
Oregon Focuses on Equity in Medicaid 1115 Waiver Renewal
Rhode Island Denies Proposed Hospital Systems Merger
Wisconsin Senate Passes Bills to Tighten Medicaid Eligibility
CMS Ends Program to Develop Rural ACOs

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February 16, 2022

In Focus:

California Releases Medi-Cal Managed Care RFP for Two-Plan, GMC, and Regional Models

Roundup:

Florida Lawmaker Proposes Statewide Medicaid Managed Care Procurement, Cap on Market Share
Indiana Bill May Upend Move to Medicaid Managed LTSS
Medicaid Expansion News: Kansas, Missouri, North Carolina, South Dakota, Wyoming
Louisiana Awards Medicaid Managed Care Contracts
Michigan Governor Allocates $243.3 Million to Procure Single Dental Medicaid Managed Care Plan
Mississippi Bill that Would End Contract With Medicaid Managed Care Plan Moves to Senate
Eligibility Redetermination News: Oregon, Utah
West Virginia Legislators Consider Medicaid Buy-in Program

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February 9, 2022

In Focus:

CMS Payment Notice Signals Shift in COVID-19 Policies For Medicare Advantage and Part D Programs

Roundup:

Arizona to Offer HCBS Providers Incentive for EVV Use
Arkansas PASSE Gets Investment from Trive Capital
California Releases Medicaid Managed Care RFP
California Medicaid Members Struggle to Fill Prescriptions
California Plan Gets Medicaid Pact Ahead of Procurement
Florida Senator Looks to Raise Nursing Home Employee Wages
Kansas Bill to Extend Medicaid Plan Contracts Is Questioned
Missouri Medicaid Recipients May Wrongly Lose Coverage
New Mexico To Releases Medicaid Plan RFP in September 2022
North Carolina to Join Medicaid Alternative Payment Pilot
Texas Releases Draft of STAR+PLUS Medicaid Plan RFP

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February 2, 2022

In Focus:

Delaware Releases Medicaid Managed Care RFP

Roundup:

California Delays Medi-Cal Managed Care RFP By One Week
Colorado Eyes Reform of Medicaid Behavioral Health System
Delaware Selects Sandata Technologies for EVV Program
Georgia Bill Would Set Minimum MLR for Medicaid Plans
Kansas Lawmakers Look to Extend Medicaid Plan Contracts
Massachusetts Community Behavioral Health Centers RFP
Minnesota Governor Seeks MinnesotaCare Buy-In
South Dakota House OKs Higher Medicaid Dental Rates
CMS Releases 2023 Medicare, Part D Advance Notice
Hospital Readmission Rates for Dual Eligibles Are Only Mildly Impacted by Social Determinants of Health, Study Says
Participation in Medicare Shared Savings ACOs to Rise in 2022

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