Weekly Roundup

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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June 7, 2023

In Focus:

Takeaways from the Early Medicaid Unwinding Actions

Roundup:

Medicaid Redeterminations New: Arizona, California, Colorado, Idaho, Indiana, Iowa, Kentucky, Louisiana, Michigan, Nevada, North Carolina, North Dakota. Texas, West Virginia, Wyoming
Arkansas Submits Request for Medicaid Expansion Work Requirements
Georgia Cancels RFQC for Medicaid Managed Care Plans
Iowa Enacts Legislation Tightening Medicaid Eligibility Verification
Nevada Medicaid Drug Spending Rose 126 Percent from 2017 to 2022
New Mexico to Extend Medicaid Managed Care Contracts Additional 6 Months
New Mexico to Expand Access to Medicaid Payments for Medical, Behavioral Health Services in Schools
Pennsylvania Seeks to Implement Selective Contracting for IDD Residential, Supports Coordination Services
South Dakota Receives Federal Approval to Implement Medicaid Expansion in July
Elevance Health Names Natalie Cooper President of Amerigroup Tennessee
Texas Names Emily Zalkovsky as State Medicaid Director
Merck Seeks Injunction to Block Medicare Drug Negotiation Program
UnitedHealth/Optum Makes Unsolicited $3.26 Billion Bid for Amedisys

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May 31, 2023

In Focus:

Health Management Associates Selected as CalAIM Technical Assistance Vendor

Roundup:

Arizona Delays Implementation of Housing, Health Opportunities Waiver to October 2024
California Individual Mandate Generates $1.1 Billion in Fines Since 2020
Georgia Disenrolls 2,200 Medicaid Beneficiaries During April Redeterminations
Indiana Disenrolls 53,000 Medicaid Beneficiaries During First Month of Redeterminations
Kentucky Subcommittee Again Finds Deficiencies in Rules Extending Dental, Vision, Hearing Benefits to Medicaid Beneficiaries
Minnesota Enacts Legislation to Provide Comprehensive Dental Benefits to All Medicaid Beneficiaries
Missouri Uses Ex Parte Renewal Process for 47 Percent of April Medicaid Eligibility Redeterminations
Oregon to Disenroll 8,000 Medicaid Beneficiaries Following April Redeterminations
Rhode Island Releases Medicaid Managed Care RFI; New Procurement Expected Fall 2023
Wisconsin Could Disenroll Up to 300,000 Medicaid Beneficiaries During Redeterminations, Report Finds
Medicaid Disenrollments to Date Are Largely for Administrative Reasons, CMS Says
Medicaid Enrollment to Decrease by More Than 12 Million by 2025, CBO Projects
CVS/Oak Street Health to Expand Into Arkansas, Iowa, Kansas, Virginia
AHIP President, CEO to Step Down in October
Medicaid Directors to Discuss Challenges, Opportunities at HMA Conference in Chicago

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May 24, 2023

In Focus:

Roundup:

California Proposes Increasing Medicaid Reimbursement Rates for Providers
Florida Disenrolls 250,000 Medicaid Beneficiaries Since Redeterminations Began
Iowa Releases Dental RFP for Iowa Dental Wellness Plan, Hawki
Iowa Expects 3,000 Individuals to Lose Medicaid Coverage by June 1
Massachusetts Considers Increasing Medicaid Reimbursement Rates for Substance Use Disorder Treatment Providers
Minnesota Legislature Passes Bill to Set Minimum Wages, Benefits for Nursing Home Staff
Nebraska Passes Certified Community Behavioral Health Clinic Act
Nevada to Transition to Medicaid Managed Care in Rural Areas
Nevada Senate Considers Bill to Reimburse Rural Hospitals at Cost for Outpatient Services
New Hampshire House Committee Subdivision Votes to Hold Medicaid Reauthorization Bill for a Year
Texas Senate Passes Bill to Extend Postpartum Medicaid Coverage
Vermont Lawmakers Approve 50 Percent Increase in Fiscal 2024 Medicaid Reimbursement Rates for Dental Services
Washington Legislature to Increase Medicaid Reimbursement Rates for Nursing Homes by 14 Percent For Two Years
CMS Releases Regulatory Requirements for State MES Modules
HCA Healthcare Acquires TX Urgent Care Centers from FastMed

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May 17, 2023

In Focus:

Illinois Requests Section 1115 Waiver Extension to Respond to HRSNs and Eliminate Inequities

Roundup:

Arkansas Is Urged by Healthcare Groups to Pause Medicaid Redeterminations
Delaware Medicaid Expenses Are Projected to Increase Despite Redeterminations
Florida Releases Medicaid Prepaid Dental Program RFI, To Release RFP Summer 2023
Florida Releases D-SNP RFI, Considers Moving 300,000 Medicaid Members from D-SNPs to SMMC
Illinois to Address Social Determinants of Health in 1115 Behavioral Health Waiver Amendments
Indiana Enacts Legislation to Reform Long-term Care
North Dakota Releases Medicaid Enterprise Technical Systems Integrator RFP
Ohio Releases PACE Expansion RFP
Virginia to Release Medicaid NEMT RFP in September 2023
Virginia Disenrolls 20,000 Medicaid Beneficiaries During Redeterminations
Federal Appeals Court Temporarily Blocks Overturning of ACA Preventive Services Requirement
Wisconsin Approves Humana’s Proposed Purchase of Inclusa
Sentara to Consolidate Medicaid Plans in Virginia

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May 10, 2023

In Focus:

How Will CMS’s Proposed Rule Shift Standards for Medicaid Enrollee Access to Services?

Roundup:

Arizona Legislature Approves $3.4 Billion for Fiscal 2023 Medicaid Managed Care Payments
Arkansas Disenrolls Almost 73,000 Medicaid Beneficiaries During April Redeterminations
Georgia Community Health Commissioner to Step Down Summer 2023
Idaho Finds 29,000 Ineligible Medicaid Beneficiaries During Redeterminations Healthy Blue
Kansas Hires President Ahead of Bid on Medicaid Contract
HAP, CareSource Form Partnership to Serve Michigan Medicaid Beneficiaries
Rhode Island Senate Passes Bill to Use Medicaid Funds to Help Homeless Beneficiaries Find Housing
Virginia Plan to Cut Medicaid Payments for Preventable ER Visits Is Vacated by Federal Judge
1.7 Million Medicaid Beneficiaries Could Lose Coverage if Work Requirements are Implemented, KFF Projects
Option Health Care To Acquire Amedisys
Cano Health Looks to Sell Non-core Assets, Focus on Medicare Advantage

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May 3, 2023

In Focus:

What You Need to Know about CMS’s Proposed Changes to Medicaid Managed Care Rules

Roundup:

Alabama Releases Integrated Care Network Program RFP
Arkansas Proposes Medicaid Work Requirements for Expansion Program
Florida Legislature Passes Bill to Regulate PBMs
Florida House Passes Bill to Create Pilot Program Providing Medicaid Managed Care Coverage to Individuals with IDD
Georgia Enacts Law to Create State-based Insurance Exchange
Louisiana Candidates for Governor Promise to Keep Medicaid Expansion
Mississippi Medicaid Beneficiaries Are No Longer Responsible for Copays
Nevada Expands Dental Services for Medicaid Beneficiaries with IDD
Nevada Releases Baseline Medicaid Enrollment Report Ahead of Redeterminations
New York to Gradually Redirect Medicaid Funding from Counties
Tennessee Medicaid to Cover Cost of Diapers for First Two Years
Washington Publishes Plan to Remove Barriers to Access for Health, Human Services Benefits
Medicare Advantage Enrollment Surpasses Traditional Medicare in January
Centene to Sell Apixio to New Mountain Capital
BCBS-MI, BCBS-VT to Pursue Affiliation

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April 26, 2023

In Focus:

Roundup:

Arizona Requests Additional $3.3 Billion in Fiscal 2023 for Medicaid Managed Care Payments
Redeterminations News: California, Georgia, Indiana, Missouri, Nebraska, Pennsylvania
Colorado Enacts Legislation Eliminating Medicaid Co-pays for Pharmacy, Outpatient Services
Illinois Health Benefits Program for Immigrant Seniors, Adults Is Expected to Enroll 98,500
Maryland Releases Medicaid Managed Care External Quality Review RFP
Washington Requests Medicaid Coverage for Former Foster Youth, Continuous CHIP Enrollment for Children Up to Age Six
U.S. Senators Introduce Legislation to Ban PBM Spread Pricing
Kaiser Permanente to Acquire Geisinger Health

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April 19, 2023

In Focus:

CMS’s 2024 Hospital Inpatient Regulation Proposes to Increase Payments to Hospitals, Support Safety Net Hospitals, and Modify the NTAP Program

Roundup:

Arkansas Legislature May Hold Special Session on Medicaid Spending
Florida House Passes Bill to Increase Income Threshold for KidCare Coverage
Georgia to Recommend Rate Increase for Providers Caring for Individuals with Disabilities
Illinois Receives Federal Approval for Additional Medicaid Funding in Schools
Iowa House Passes Bill to Create Medicaid Eligibility Verification System
Nevada to Review Medicaid HCBS Rate Setting Methodology
South Dakota to Implement Medicaid Expansion on July 1
Wisconsin Releases RFI for Eligibility Determination System
HHS Projects 6.8 Million Eligible Medicaid Beneficiaries Will Be Disenrolled During Redeterminations
Biden Administration Encourages States to Apply for Medicaid Reentry 1115 Demonstration for Individuals in Carceral Settings
Humana to Invest Another $40 Million in Affordable Housing

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