Weekly Roundup

December 13, 2023

In Focus:

Roundup:

Medicaid Redetermination Update: Arizona, Iowa, Utah
Arkansas Assisted Living Facilities Face Financial Crisis, Possibility of Closures
California Los Angeles County Implements Free Behavioral Health Programs for K-12 Students through MCOs
Florida Senate President Proposes Initiative to Increase Healthcare Access, Workforce
Idaho Moves Forward with Magellan Health’s Behavioral Health Plan Contract
Kansas Rural Hospitals At Risk of Closing, Report Finds
Massachusetts Medicaid to Cover Doula Services By Spring 2024
Michigan Expands Medicaid Coverage to Include Community Health Worker Services
New Hampshire Releases Technical Scoring for Contract Bids on Medicaid Procurement
New Hampshire Experiences Strong Demand in Adult Medicaid Dental Program, Seeks More Providers
North Carolina Provides 12-Month Continuous Medicaid, CHIP Coverage for Children
Oregon Medicaid Committee Recommends Against SCAN Acquisition of CareOregon
West Virginia Medicaid Program Faces $114 Million Budget Deficit in Fiscal 2025
CMS Guidance Promotes Tool to Improve Medicaid Access to HCBS Direct Support Workers
Medicare Advantage Market Grows More Competitive
House Passes Bill Requiring Greater PBM Transparency, Hospital Site Neutrality Policies
Federal Government to Crack Down on Anticompetitive Health Insurer Transactions
Cigna, Humana Scrap Merger Discussions

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December 6, 2023

In Focus:

Roundup:

Arizona Medicaid Awards Long Term Care Contracts to Centene, United
Florida Legislative Research Office Projects Shortage of 18,000 Physicians by 2035
Florida Governor’s FY 2005 Budget Proposes More Funding for Florida KidCare, HCBS Waivers
Georgia Lawmakers Exploring ‘Private Option’ Model for Medicaid Expansion
Idaho Medicaid Task Force Fails to Agree on Medicaid Managed Care Restructuring
Indiana Medicaid Officials Brief Lawmakers on MLTSS Roll-out, Maternal Mortality Initiatives
Louisiana Medicaid Plan Partners with State Medical Society to Extend Value-based Payment to Independent Practitioners
New Mexico Medicaid Increases Provider Reimbursements by $409 Million
North Dakota Seeks Public Comments on Medicaid Quality Strategy Plan
Pennsylvania Announces Public Comment Period for Section 1115 Waiver Application Addressing Health-related Social Needs
Medicaid Eligibility Redetermination News: Illinois, Louisiana, Michigan, New York, Ohio, Utah
Integrated Eligibility System Updates: Florida, West Virginia
CMS Issues Medicaid Redetermination Reporting Rule With Penalties to Stop Erroneous Disenrollments
InnovAge Finalizes Acquisition of Two ConcertoCare PACE Programs

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November 29, 2023

In Focus:

Roundup:

Alabama Receives Approval for Community-Based Mobile Crisis Services SPA
Arizona Requests Section 1115 Waiver Amendment to Raise CHIP Eligibility Threshold
California Governor Signs Bill to Simplify Billing, Increase Access for Medicaid School-based Health Programs
Florida Bills Would Remove Step Therapy Requirement for Medicaid Beneficiaries with Mental Illness
Georgia Legislators Discuss Coupling Full Medicaid Expansion, Relaxation of Certificate-of-Need Requirements
Idaho Releases MMIS System Integrator Technical Advisory Services RFP
Nevada Submits Section 1332 State Innovation Waiver Application For Market Stabilization, Public Option Program
New York Essential Plan Expansion Implementation Delayed to April 2024
North Carolina Hospitals Will Receive $2.6 Billion As State Prepares to Start Medicaid Expansion
North Dakota Seeks Public Comments on Medicaid Quality Strategy Plan
Tennessee to Renew Existing TennCare Medicaid Managed Care Contracts for Now
Wisconsin Insurers Fail to Meet Federal Access Standards for Exchange Program, Report Finds
Average Time Spent on Medicaid HCBS Waiting Lists Has Decreased Since 2021
ACA Exchange Enrollment Approaches 4.6 Million Through Three Weeks of Open Enrollment
Medicare, Medicaid Improper Payment Rates Driven by Documentation Errors in Fiscal 2023, CMS Finds
CMS Launches Medicare GUIDE Model Application
CMS Issues Proposed Rule to Ensure Network Adequacy Standards For State-run Exchange Plans
Humana, Cigna In Talks to Merge By End Of Year

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November 1, 2023

In Focus:

Roundup:

Alabama Releases Modular Electronic Visit Verification RFP
California Submits Section 1115 Medicaid Waiver Amendment to Provide Rental Assistance
Florida Legislators File Bills to Study Impact of Potential Medicaid Expansion on Individuals Aged 18 to 26
FL Congressional Democrats Ask CMS to Monitor Their State’s Medicaid Eligibility Redeterminations Process.
Georgia Bidding Conference for Medicaid Managed Care Contracts Is Attended by Several Health Plans.
Georgia Democratic Leaders Call on Governor to Implement Full Medicaid Expansion
Mississippi Medicaid Managed Care Procurement Stalls Following Protests from UnitedHealthcare, Elevance
New Hampshire Providers to Receive Another Increase in Medicaid Payment Rates
Pennsylvania Bill Would Reinstate Medicaid Coverage of Most Dental Services
CMS Releases Final Rule to Increase Payments to ESRD Facilities by 2.1 Percent
Bright Health Group, Friday Health Plans Owe $1.1 Billion in Exchange Risk-Adjustment Payments

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October 18, 2023

In Focus:

Roundup:

Arizona to Release Medicaid PBM RFP ‘in the Coming Weeks’
Medicaid Eligibility Redeterminations News: Arizona, Florida, Georgia, Mississippi, North Carolina, Texas, Wyoming
Florida Launches Dental Provider Incentive Program
Minnesota Eliminates Parental Fees for Medicaid Coverage of Children With Disabilities
Nevada Governor Proposes Exchange Reinsurance in ‘Revision’ to Public Option Law
New York Medicaid Spending Exceed Expectations, Report Finds
North Carolina Receives Final Federal Approval for Medicaid Expansion
Oregon Announces 3.4 Percent Increase in 2024 Capitation Rates for Medicaid Coordinated Care Organizations
Oregon Releases RFP to Expand PACE Services
Long-term Services, Supports Spending Falls as Percentage of Total Medicaid Expenditures, CMS Reports
State Medicaid Programs Disenroll 8.8 Million Beneficiaries During First 6 Months of Redeterminations, KFF Finds
Alignment Health, Walgreens to Jointly Market Medicare Advantage Plans in 2024

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October 11, 2023

In Focus:

Roundup:

Medicaid Eligibility Redeterminations News: Alabama, Alaska, Arizona, Arkansas, Florida, Maine, Missouri, New Mexico, Oregon, Texas, Wyoming
Arizona Receives Five Bids for Medicaid Managed Long-term Care Contracts
California Enacts Law Advancing State Toward Universal Healthcare System Such As Single-payer
Idaho Medicaid Value-based Care Organizations Ask State to Stick with Current Model
Kentucky Reports Savings Following Removal of PBMs from Medicaid Program
Nevada Extends Deadline for Medicaid Managed Care RFI
New York to Launch Medicaid Social Care Networks to Address Health-related Social Needs
Dual Demos in New York, Ohio, Washington Show Mixed Results, CMS Reports
Cigna Purchases Digital Health Company Bright.md

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