Old Weekly Roundup

September 4, 2024

In Focus:

How States Are Shaping Medicaid Managed Care and Marketplace Participation

Roundup:

Connecticut Medicaid Program Forecasts $210 Million Deficit in Fiscal 2025
Illinois Releases D-SNP RFP
Illinois to Release Medicaid Managed Care RFP Summer 2025
Iowa Awards Health Link Medicaid Managed Care Contract to Centene
New York Individual Marketplace Insurance Premiums to Rise in 2025
New Mexico Private Marketplace Sees Less Than 5 Percent of Disenrolled Medicaid Beneficiaries Enrolling in Private Insurance
Pennsylvania Releases CHIP RFA
Tennessee Submits Section 1115 Waiver Amendment to Expand Coverage for Working Individuals with Disabilities
CMS Issues State Guidance on Medicaid, CHIP Eligibility Renewal Timeliness Requirements
Elevance to Enter Maryland, Florida, Texas Marketplaces in 2025
The Ensign Group Acquires Skilled Nursing Facilities in CO, KS
More News Here

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August 28, 2024

In Focus:

Harnessing Opioid Abatement Funds to Prevent Overdoses and Enhance Community Care

Roundup:

Colorado Submits Section 1115 SUD Demonstration Amendment to Add HRSN Services
Georgia Board Approves Medicaid Agency’s Fiscal 2026 Budget Proposal, Increasing Spending by $347 Million
Mississippi Finalizes Medicaid Coordinated Care Contracts Following Protests
New Mexico Justice-involved Reentry Demonstration Initiative to Launch July 2025
North Carolina Child Fatality Task Force Requests Medicaid Coverage for Doula Services
Pennsylvania Awards MLTSS Contracts to Five Plans
Highmark Health to Form New I-SNP in PA
Rhode Island Receives Two Protests Over Medicaid Contract Awards
Rhode Island Releases Medicaid Enterprise System Integrator, Operational Data Store RFP
West Virginia Increases Medicaid HCBS Provider Reimbursement Rates by 15 Percent
Hospitals Increasingly Invest in Affordable Housing to Reduce Preventable Visits
Approaches to Analyzing Use, Spending in LTSS Vary, MACPAC Finds
Evolent Health Seeking Bids for Sale

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August 21, 2024

In Focus:

Improving Healthcare for Justice-Involved Populations: Key Insights on Medicaid Section 1115 Reentry Demonstrations

Roundup:

Illinois Launches PACE; Contracts with Five Organizations
Indiana Medicaid Beneficiaries to Maintain Coverage During Healthy Indiana Plan Case, Judge Rules
Michigan to Submit Dual Demonstration Renewal Request Applications by October 1
Minnesota Submits Extension Request for Section 1115 Reform 2020: Pathways to Independence Demonstration
New York Faces Another Lawsuit Over CDPAP Fiscal Intermediary RFP
North Carolina Awards Foster Care Specialty Plan Contract to Blue Cross and Blue Shield
Vermont Approves Double Digit Premium Rate Increases for Marketplace Plans
CMS Cuts Price of 10 Medicare Part D Drugs, Expects $6 Billion in Savings
CMS Announces Cell and Gene Therapy Access Model NOFO
Elevance, Clayton, Dubilier & Rice Close Deal on Primary Care Company

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August 14, 2024

In Focus:

Arizona Pauses ALTCS-EPD Procurement Following Judge’s Decision

Roundup:

Arizona Pauses ALTCS-EPD Procurement Following Judge’s Decision
Connecticut Lowers Income Eligibility Threshold For Husky A Beneficiaries Beginning in October
Florida Children’s Medical Services Procurement Expected to Drop Any Day
Idaho Awards MMIS System Integrator Advisor Contract to NTT Data
Kentucky Submits Amendment Requests for All 1915(c) HCBS Demonstrations
New Mexico Seeks Public Input on Proposed Medicaid Forward Expansion Program
New York Faces Lawsuit Over CDPAP Fiscal Intermediary Services Procurement
Oregon Announces First Round of CCBF Awards Totaling $31 Million
Highmark Begins Offering Medicaid Managed Care Coverage in West Virginia
MACPAC Releases Issue Brief Assessing Health Needs and Access to Care for CYSHCN
Rural Healthcare Group to Acquire Steward Medical Group, Health Care Network
MTM to Acquire Access2Care

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August 7, 2024

In Focus:

FY 2025 Medicare Hospital Inpatient Final Rule Will Alter Hospital Margins and Change Administrative Procedures

Roundup:

California Submits Section 1115 BH-CONNECT Demonstration Addendum to Expand Behavioral Health Community Services
ImagineCare Drops Florida Medicaid Managed Care Contract Award Protest
Louisiana to Submit Application for New Section 1115 Re-entry Demonstration
Michigan Seeks Resident Participation in Racial Health Equity Think Tank to Improve SDOH
New York Section 1115 Medicaid Redesign Team Pilot Program to Take Effect in August
Nevada Releases Section 1332 Public Option Program RFP
Oregon Lowers Insurer-proposed Rate Increases For Five Individual Marketplace Plans
Virginia Submits Extension Request for 1115 BTCSSHV Waiver Demonstration
Wisconsin Directs $258 Million in Funding Toward HCBS Minimum Fee Schedule
NCQA Updates HEDIS Quality Measures
SAMHSA Announces CCBHC Planning Grant Opportunity
Medicaid, CHIP Enrollment Drops by Nearly 1.1 Million in April 2024
Centene to Exit Medicare Advantage Market in Six States For 2025
Tenet Healthcare Sells Majority Stake in Brookwood Baptist Health to Orlando Health

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July 31, 2024

In Focus:

HMA Celebrates 59th Anniversary of Medicaid and Medicare

Roundup:

California Marketplace Health Insurance Premiums To Increase by 8 Percent in 2025
Connecticut Governor Considers Transitioning Medicaid Program to Managed Care
Florida Receives Three Protests Over Medicaid Contract Awards
Illinois to Release Medicaid Managed Care Contract Opportunities in August 2024
New Mexico Receives Federal Approval for Section 1115 Turquoise Care Demonstration Extension
North Carolina Receives Federal Approval for Patient Medical Debt Initiative
Oklahoma Plan Invests in Community Based Organizations to Improve Healthcare Access
CMS Increases Hospice Provider Medicare Reimbursement by 2.9 Percent in Fiscal 2025
Biden Administration Releases Regulatory Agenda for Remainder of Presidency
Ascension to Sell 9 Illinois Hospitals to Prime Healthcare
Centene CEO of Markets, Medicaid to Leave in December 2024
Anthem Names Joy Thomas President of Nevada Medicaid Plan

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July 24, 2024

In Focus:

Raising the Bar: Improving Health Equity through Actionable Frameworks

Roundup:

Florida Announces Revised, Additional Awards for Statewide Medicaid Managed Care Procurement
Illinois Governor Signs Bill Addressing Behavioral Workforce Shortage
Massachusetts Senate Passes Bill to Strengthen Health Care System Oversight
Pennsylvania Releases 1115 Demonstration HRSN Implementation Program Administrator RFI
Vermont Sues PBMs Over Drug Pricing
CMS Restricts ACA Broker Access to Regulate Unauthorized Plan Switches
Molina to Acquire ConnectiCare for $350 Million

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July 17, 2024

In Focus:

Leading Healthcare Experts to Speak at 2024 HMA Fall Conference

Roundup:

California Releases Grant Opportunity for Behavioral Health Infrastructure Funding
Florida Reaches Agreement to Allow Four Plans to Retain a Medicaid Managed Care Contract
Georgia Pathways to Coverage Medicaid Expansion Extension Rejected by Judge
Iowa Submits Extension Request for Section 1115 Iowa Wellness Plan Demonstration
New Hampshire to Expand Medicaid Coverage for Preventative Services, Increase Medicaid Rates
New Hampshire Receives Approval for Section 1115 SUD Treatment and Recovery Access Demonstration Extension
Oregon Ombuds Program Recommends Behavioral Health Network Adequacy in Next CCO RFP
Rhode Island Tentatively Awards Medicaid Managed Care Program Contracts to Two Plans
CMS Proposes CY 2025 Medicare Physician Fee Schedule Rule
CMS Releases Cell and Gene Therapy Access Model RFA
Pennant Group to Acquire Signature Healthcare Assets

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July 10, 2024

In Focus:

CMS Invites States to Apply for Transforming Maternal Health Model

Roundup:

California SBHIP Participants See Positive Outcomes
Florida Final Actions Against Medicaid Managed Care Plans Total $33.2 Million
Kansas Denies Aetna, CareSource Protests Over KanCare Awards
North Dakota Awards Medicaid Enterprise Systems Integrator Contract to Leidos
Oregon Releases State-Based Insurance Marketplace Solution RFP
South Carolina Governor Vetoes Study Committee to Examine Medicaid Expansion
Utah Submits Section 1115 Medicaid Demonstration Amendment Request
CMS Proposes CY 2025 Medicare Hospital OPPS/ASC Rule Addressing Health Disparities, Maternal Health
CMS Launches Making Care Primary Model Across Eight States
CMS Launches Medicare Dementia Care Model
U.S. Paid $50 Billion for Medicare Advantage Upcoding
FTC to Sue PBMs after Report Finds Affiliate Pharmacies Received 200 Times More for Common Cancer Drugs

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July 3, 2024

In Focus:

Unwinding Recent Supreme Court Rulings: Impact on Healthcare and Beyond

Roundup:

Idaho Releases Medicaid Dual, MLTSS Programs RFP
Illinois Receives Federal Approval for Section 1115 Healthcare Transformation Demonstration
Illinois Advisory Council Begins Hearings on Medicaid Financing for Sickle Cell Disease Therapies
Minnesota Rural Hospitals Form Clinically Integrated Network
New York Medicaid Seeks Approval to Provide Continuous Medicaid, CHIP Coverage for Children
Oregon Launches OHP Bridge to Expand Adult Medicaid Coverage
North Carolina Seeks Federal Approval to Help Relieve $4 Billion Medical Debt
Texas Faces Lawsuit Over Medicaid STAR, CHIP Contract Awards
Five States Receive Federal Approval to Provide Reentry Services for Incarcerated Individuals Prior to Release
CMS Proposes 1.7 Percent Cut to Medicare Home Health Provider Rates
Optum Drops Out of Bid to Purchase Steward Health Care Physician Group
Elara Caring Acquires Caregivers Home Health

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