Weekly Roundup

October 2, 2024

In Focus:

Roundup:

Kentucky HCBS EVV System Go-live with Therap Pushed to January 2025
Michigan Submits Application for New Section 1115 Reentry Services Demonstration
Nevada Releases Medicaid Housing Supports, Services RFI
Oklahoma Works on SPA to Expand School-based Medicaid Services
South Carolina Coalition Pushes for Medicaid Expansion
Washington Apple Health Pregnancy Programs Increase Income Limit Beginning in November
CMS Releases Medicaid Managed Care MLR Monitoring, Reporting, Oversight Toolkit
CMS Releases NOFO for Planning Grants to Address Care Continuity for Justice-involved Individuals
States Could Improve Maternal Healthcare Access by Leveraging Medicaid Managed Care Requirements, HHS OIG Finds
Tenet Healthcare Finalizes Sale of Majority Stake in Brookwood Baptist Health to Orlando Health

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September 25, 2024

In Focus:

Roundup:

California Announces Intent to Award Medi-Cal Dental Managed Care Contracts in Los Angeles, Sacramento Counties
Maryland Renews Eight Medicaid MCO Contracts for 2025; Announces Intent to End Contract with Kaiser Permanente
Minnesota Releases Electronic Visit Verification Implementation Grant Distribution RFP
Nevada Releases Coordination Only Dual Eligible Special Needs Plan RFP
Virginia Releases Fiscal Agent Services RFP
CMS Releases Final Rule Addressing Medicaid Drug Rebate Program
Black, Latine Family Doctors More Likely to See Medicaid Patients
Hospital Readmission Penalties Remain Comparable Over Past Three Years
Cigna to Cut Medicare Advantage Plans Across Eight States in 2025

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September 18, 2024

In Focus:

Roundup:

Arizona Extends ALTCS-EPD Program Contracts for Another Year
Colorado Announces Intent to Award Regional Accountable Entity ACC Phase III Contracts
New Hampshire Receives Federal Approval for Mobile Crisis Intervention Teams
North Carolina Legislature Approves $377 Million in Medicaid Funding; $81 Million Less than Requested
Pennsylvania Lawmakers, Advocates Look to Reverse Medicaid Dental Policy
Washington Marketplace Insurance Rates to Increase Nearly 11 Percent in 2025
Hospitals File Lawsuit Against HHS Over Medicare Advantage Calculation in DSH Payments
Medicare Health Plan Ratings Drop for NCQA’s 2024 Equity Measures
Cigna Sues FTC Over PBM Drug Pricing Report

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September 11, 2024

In Focus:

Highlights from HMA Survey on State Approaches to Managing the Medicaid Pharmacy Benefit

Roundup:

Arizona Denies Appeal Over ALTCS-EPD Procurement; Will Not Rebid Contracts
Arkansas Maternal Health Committee Recommends Medicaid Doula Coverage, Prenatal Presumptive Eligibility
Florida Plan Drops Final Medicaid Managed Care Award Protest
Federal Judge Declines to Block Maryland Law Requiring 340B Participation
Massachusetts Awards One Care, Senior Care Options Program Contracts
Michigan Expands Opioid Health Home Initiative Coverage to Include SUD, Additional Region
Vermont Releases Medicaid Permanent Supportive Housing Assistance RFP
Washington Medicaid Housing Program Faces Funding Shortage
Wisconsin Medicaid to Offer Housing, Meal Support for Certain Beneficiaries in 2025
CMS Releases Medicare Administrative Contractor Consolidation RFI
Biden Administration Issues Final Rule Strengthening Mental Health Parity, Addiction Equity Act
Humana to Exit 13 Medicare Advantage Markets in 2025

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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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