Weekly Roundup

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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September 23, 2020

In Focus:

CMS Eyes Medicaid Alternative Payment Models (APM) Expansion to Control Growth in Spending

Roundup:

Delaware Approves Four ACOs to Serve Medicaid Population in 2021
New York Finds $700 Million in Improper Medicaid Payments
Vermont ACO Pilot Program Failed to Meet Enrollment, Spending Targets
House Passes Federal Funding Bill to Relax Repayment Terms for COVID-19 Medicare Loans
CMS Announces Additional $165 Million MFP Funding for 33 States
Justice Ginsburg’s Death Could Jeopardize the ACA
CMS Innovation Agency Announces Roll Out of Risk-Based Model for Dual Eligibles

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September 16, 2020

In Focus:

Missouri Pharmacy and Clinical Services Management Solution RFI; Kentucky Pharmacy Benefit Manager RFP

Roundup:

California to Release Medi-Cal Managed Care RFP in Late 2021
Nevada Medicaid Enrollment Increases by 87,000
North Carolina Voters Support Medicaid Expansion, Poll Finds
North Dakota to Release Medicaid Expansion Managed Care RFP in October
CMS Releases Medicaid, CHIP Data Files in Continued Effort to Promote Transparency
CMS Withdraws Medicaid Fiscal Accountability Rule
CMS Issues Guidance on Value-Based Care Arrangements in Medicaid

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September 9, 2020

In Focus:

CMS Finalizes Policy to Use Hospital Negotiated Charge Data to Set Payment Rates

Roundup:

District of Columbia Council Finalizes Medicaid Managed Care Contracts
Florida AHCA Secretary Mary Mayhew to Leave Post October 2
Georgia Submits 1332 Waiver to Abandon ACA Health Insurance Exchanges
Oklahoma to Transition Majority of Insure Oklahoma Members to Medicaid Expansion
Oregon Files Notice of Noncompliance Against Medicaid CCO

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