Old Weekly Roundup

September 10, 2025

In Focus:

Roundup:

Florida Seeks Input on Rural Health Transformation Program Funding
Montana Submits 1115 Demonstration for Medicaid Expansion Work Requirements
New York Proposes to End Section 1332 Waiver, Reinstate Basic Health Program by July 2026
Oregon Seeks Feedback on Providence, Compassus Home Health Joint Venture
CMS Releases Preliminary Guidance for Medicaid Managed Care State Directed Payments
CMS Pauses New Mid-Year MA Unused Supplemental Benefits Notice
SCAN Health Plan to Enter WA Medicare Advantage Market, Expand in CA and TX

View Roundup

September 3, 2025

In Focus:

Roundup:

Colorado Governor to Reverse Medicaid Rate Increases Amid Budget Deficit
Hawaii Issues Community Care Services Behavioral Health RFI
Massachusetts To Receive $12.25 Million Settlement from CVS over Medicaid Drug Pricing
New York Faces $10 Billion Deficit Increase Over Two Years as Federal Cuts Threaten Medicaid Coverage
Tennessee Medicaid Program Now Covers Obesity Management Medication
Texas Medicaid Joins Cell and Gene Therapy Access Model
CMS AHEAD Model Extended to 2035 with New Requirements for States
Cigna’s Evernorth Health Invests $3.5 Billion in Shields Health Solutions

View Roundup

August 27, 2025

In Focus:

Roundup:

Illinois Marketplace Faces Increased Premiums, Reduced Plan Participation in 2026
Louisiana Releases Medicaid Dental Benefit TPA RFI
New Mexico Approves 2026 Marketplace Rate Hikes, Adds State Premium Relief
Texas Requests Public Feedback for H.R.1 Rural Health Transformation Program Funds
Wisconsin Awards Medicaid Managed LTC Contracts
Federal Judge Blocks ACA Marketplace Rule Changes
UnitedHealth Forms Oversight Committee to Strengthen Governance

View Roundup

August 20, 2025

In Focus:

Roundup:

California Individual Marketplace Plans Propose Rate Hike of 10.3 Percent in 2026
Florida Medicaid Spending Could Exceed Fiscal 2026 Budget by $511 Million
Iowa to Implement Medicaid Work Requirements in January 2026
Louisiana Establishes Medicaid Doula Coverage Effective August 1
North Carolina Delays Medicaid Standard Plan Reprocurement by Two Years Amid $319 Million Budget Shortfall
Vermont Releases Medicaid NEMT RFP
CMS Launches Additional Verification Process to Confirm Citizenship, Immigration Status for Medicaid
Elevance, NACHC to Integrate Food as Medicine Program in Community Health Centers
CareSource Invests in Radley Health to Provide Workforce Peer Support Services for Patients with SMI

View Roundup

August 13, 2025

In Focus:

Roundup:

Arizona Joins Multi-State ArrayRx Consortium to Lower Prescription Drug Costs
Colorado HCPF Director Pledges to Mitigate Medicaid Cuts, Limit Coverage Loss Under H.R.1
Indiana Projects Medicaid Cost Surge, Adopts Cost-Saving Actions
Minnesota Releases Medicaid Provisions, Impacts from H.R. 1
North Carolina Stopgap Budget Leaves Medicaid $319M Short, Cuts Loom
Oregon Delays Medicaid Reentry Program Due to H.R.1
MACPAC Releases Issue Brief on Medicaid Financing
Ten Million Could Lose Coverage Under H.R.1 by 2034, CBO Forecasts

View Roundup

August 6, 2025

In Focus:

Roundup:

In Focus: What’s Next in Quality: CMS Conference Highlights and Stakeholder Imperatives
In Focus: Health Tech Ecosystem Leaders to Speak at HMA’s National Conference
Iowa Names Lee Grossman New Medicaid Director
Michigan Governor Urges Trump to Lengthen Transition Time for Medicaid Cuts
Oregon Announces $1.8 Million in Marketplace Coverage Enrollment Grants
Oklahoma to Submit SPA for Enhanced School-Based Medicaid Services
Urban Hospitals Leverage Rural Designation Policy as H.R.1 $50B Fund Launches
Six Additional States Receive Federal Approval for SNAP Food Choice Waivers
Increased Medicaid Spending Did Not Boost Nursing Home Staffing, OIG Finds
UnitedHealth Group Names Wayne DeVeydt CFO

View Roundup

July 30, 2025

In Focus:

Roundup:

Arkansas Law Banning PBM-Owned Pharmacies Temporarily Blocked by Federal Judge
Minnesota Suspends Medicaid Funding to Housing Providers Amid Fraud Allegations
Nevada Names Ann Jensen Medicaid Director
New Hampshire Enacts 90 Day Notice Law for Medicare Advantage Market Changes, Exits
South Dakota to Withdraw Section 1115 Medicaid Work Requirements Demonstration Proposal Following New Federal Requirements
States Sue Trump Administration Over Planned Parenthood Funding Blockade
Trump Signs Executive Order Calling for Institutionalization of Homeless Individuals With SMI
Priority Health Expands to Wisconsin with Acquisition of Group Health Cooperative of Eau Claire

View Roundup

July 23, 2025

In Focus:

Roundup:

Florida to Propose MMA Section 1115 Demonstration Home Health Aide Amendment to Close Gaps in Services for Medically Fragile Children
Maine Expands Hospital Charity Care Amid Looming Federal Medicaid Cuts
Maryland Seeks Vendor Information on Artificial Intelligence, Other Technological Solutions to Improve Medicaid, Replace Legacy MMIS
Montana Releases Draft 1115 Demonstration for Medicaid Expansion Work Requirements
Nevada Establishes PACE Effective July 1
CMS Reaffirms Statutory Limits on Medicaid Demonstrations, Workforce Initiatives
CMS Targets Duplicate Medicaid Enrollment Under New Integrity Initiatives
Marketplace Plans Seek 15 Percent Premium Hikes

View Roundup

July 16, 2025

In Focus:

Roundup:

Arizona to Hold Listening Session on Section 1115 Demonstration Renewal
Colorado Medicaid to Cover Mental Health Services Under Collaborative Care Model
Kentucky Submits New 1115 Application to Refer Expansion Enrollees to Job Services
Nebraska to Cut Medicaid Reimbursement for ABA Services
South Carolina Submits Section 1115 Demonstration Application to Expand Medicaid to Certain Caregivers with Work Requirements
Utah Seeks Federal Approval to Amend Medicaid Reform Section 1115 Demonstration
CMS Proposes Hospital Outpatient, Ambulatory Surgical Center Rate Increase of 2.4 Percent in CY 2026 Proposed Rule
Sycamore Partners to Buyout Walgreens Boots Alliance

View Roundup

July 9, 2025

In Focus:

Roundup:

Florida to Submit IDD Waiver Amendment Request
Illinois Governor Signs Laws Restricting PBMs, Prior Authorizations
Montana Prepares Section 1115 Waiver to Implement Work Requirements, Cost-Sharing
New Hampshire Governor Signs Biennial Budget Implementing Medicaid Expansion Work Requirements
Wisconsin Governor Signs Budget Preserving Some Medicaid Funding
CMS Announces $10.4 Billion in ACA Risk-Adjustment Transfers as Market Consolidates
Federal Judge Temporarily Blocks Medicaid Defunding Provision Targeting Planned Parenthood
Humana Subsidiary to Acquire FL-Based Senior Care Clinics

View Roundup