Weekly Roundup

May 8, 2024

In Focus:

New HMA Report Outlines Proposed Reforms for Medicare Physician Fee Schedule

Roundup:

Arizona Restructures Medicaid Agency, Expands Leadership Roles
Arkansas Launches Four Preventative Pilot Programs for Children with Behavioral Health Conditions
Massachusetts Submits Amendment Request for MassHealth Section 1115 Demonstration
Michigan Requests Section 1115 Demonstration Extension Including SUD Pilot Program
Montana Medicaid Expansion Helps Decrease Inpatient, Emergency Service Costs
Missouri Senate to Vote on Medicaid Hospital Tax Renewal Following Filibuster
Nebraska Seeks Input on Medicaid Enterprise System Modernization
Joint Commission to Launch Rural Health Clinic Accreditation Program
Senate Finance Committee Introduces Legislation to Create Medicare Drug Shortage Prevention, Mitigation Program
Justice Department Advances Cigna’s Medicare Advantage Sale

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May 1, 2024

In Focus:

Medicaid Unwinding Check-in: Data Informed Observations to Guide Future Action

Roundup:

Alabama Legislators Hear from Arkansas, North Carolina Officials on Medicaid Expansion
Arkansas Cancels Medicaid Dental Services Procurement; Fails to Reach Agreement with Bidders
California to Adopt Health Care Spending Limit Beginning 2025
Colorado Extends Medicaid Eligibility for Beneficiaries Living with Disabilities
Connecticut House Passes Bill Aimed at Improving Elder Health Care System
Illinois Community-based Organizations to Receive More than $5 Million in Funding for Maternal, Infant Healthcare
Kansas to Implement Supplemental Waiver to Shorten IDD, Physical Disability Waiver Waitlists
Mississippi Medicaid Expansion Bill Heads to House, Senate for Vote
Oregon Medicaid Program Offers Equipment to Protect Beneficiaries Against Climate Change
CMS, NCQA Grant Two Week Extension for Insurers to Submit Star Quality Data
FTC Finalizes Rule to Prevent Digital Health Apps from Releasing Sensitive Medical Data
CVS to Acquire Medicare Advantage Broker Hella Health

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April 24, 2024

In Focus:

Five Takeaways from the CMS Medicaid Managed Care Final Rule

Roundup:

Connecticut Lawmakers Plan to Revisit Medicaid Managed Care for Enrollees
Florida Receives Eight Intents to Protest Against SMMC Awards
Georgia Governor Signs Bill to Relax Certificate-of-need Regulations, Form Health Commission
Maryland Total Cost of Care Model Improved Medicare Spending, Decreased Health Disparities in First Four Years
Massachusetts Receives Federal Approval to Provide Medicaid-funded Temporary Housing for Emergency Shelter Program
Michigan Medicaid to Offer Maternal Health Quality Payments
New York Enacted Fiscal 2025 Budget Invests in Health Equity, New Policies Promoting Access to Care
New Mexico Extends Medicaid Coverage for Seniors Receiving Long-term Care, Individuals with Disabilities
Texas Lawmakers Urge Governor to Cancel, Delay STAR, CHIP Awards
HHS Launches Investigation Examining PBMs

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April 17, 2024

In Focus:

Roundup:

Arkansas Awards CSG Government Solution IV&V Contract
Connecticut Submits Section 1115 Substance Use Disorder Demonstration Amendment
Kansas Delays KanCare, CHIP Medicaid Managed Care RFP Awards
Florida Announces Awards for Statewide Medicaid Managed Care Procurement
Mississippi Study to Test Food is Medicine Pilot Program
Nevada Proposes New Behavioral HCBS Program for Children
New York Governor Announces Fiscal 2025 State Budget Agreement with Legislature
Ohio MCOs Fund Community-based Programs Under NextGen Model
Medicare Telehealth Utilization Decreased in 2022; Does Not Limit Access to In-person Care, MedPAC Finds
CMS Proposes Transforming Episode Accountability Model to Improve Care During Surgery, Recovery for Medicare Beneficiaries
Accenture Federal Services to Acquire Cognosante
Elevance, Clayton, Dubilier & Rice Invest in Primary Care Access Partnership

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April 10, 2024

In Focus:

Roundup:

California Medicaid FFS Contracts with Heali’s Food as Medicine Platform
Colorado Settles Lawsuit Regarding Mental Health Care for Children, Agrees to Outside Examination of Program
Avesis, Elevance Health Partner with Uber to Improve Maternal Health in Georgia
Michigan Announces Medicaid Managed Care Awards
New York Governor Invests $359 Million to Expand Supportive Housing Options
North Dakota Approves Pilot Program for Paid Family Caregivers
Vermont Receives Approval for Medicaid Mobile Crisis State Plan Amendment
Virginia Governor Vetoes Prescription Drug Affordability Board Legislation
CMS Announces Final Rule to Promote Competition, Access to Care in Medicare Advantage, Part D Plans
Medicaid Supplemental, Base Payments Vary Among States, MACPAC Finds
Lawmakers Call on FTC, DOJ to Block Optum-Steward Acquisition

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April 3, 2024

In Focus:

Roundup:

Arkansas Releases Medicaid Sustainability Review Aimed at Containing Costs
Idaho Re-enrolls 22 Percent of Medicaid Beneficiaries Disenrolled During Redeterminations
Iowa Cancels Dental RFP for Iowa Dental Wellness Plan, Hawki
Molina, Cityblock Offer SDOH Resources to Dual Eligibles in Massachusetts
Mississippi Senate Passes Medicaid Expansion Bill with Work Requirements
Nebraska Governor Signs Bill to Increase Medicaid Payment Rates for Hospitals
New Mexico Open Enrollment Begins for Turquoise Care Managed Care Program
Oklahoma Launches SoonerSelect Medicaid Managed Care Program
Rhode Island Medicaid Managed Care Procurement Attracts Four Bidders
Virginia Reissues Notice of Intent to Award Medicaid Managed Care Contracts
CMS Marketplace Final Rule Adjusts Network Standards, Enrollment Period, Increases Access to Dental Care
Kaiser Permanente Acquires Geisinger Health
FTC Issues Injunction to Block Novant Health’s Acquisition of North Carolina Hospitals

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March 27, 2024

In Focus:

Roundup:

Alaska Receives Extension for Behavioral Health Reform 1115 Demonstration
California Approves Proposition 1 to Provide Funding Addressing Homelessness Crisis, Substance Misuse
Florida Governor Signs Legislative Package Aimed at Boosting Healthcare Workforce, Access
Georgia Submits Section 1115 Waiver Amendment for Personal Care Services
Maryland Submits Section 1115 Waiver Amendment for Pre-release Services
Maryland Submits AHEAD Model Application to CMS
Nebraska Legislature Passes Provider Tax Bill to Increase Medicaid Hospital Payment Rates
New York Announces RFP For Development of 13 Certified Community Behavioral Health Clinics
New York Governor Allocates $102 Million to Fund New Mental Health Care Programs
Rhode Island Senate Considers Bill to Establish a Prescription Drug Affordability Board
Rhode Island Receives CMS Approval for 1115 Waiver Amendment Permitting HCBS in Acute Hospital Settings
Vermont Submits AHEAD Model Application to CMS
Virginia Rescinds Notice of Intent to Award for Statewide Medicaid Managed Care Procurement
Biden Administration Issues Final Rule to Streamline Medicaid, CHIP Enrollment
HHS Announces Lower Coinsurance Rate for 41 Medicare Part B Drugs
CMS Signals New Guidance on Medicare Part D Coverage of Obesity Drugs
Kaiser, Town Hall Ventures Launch PACE Joint Venture
United/Optum to Acquire Steward Health Care’s Physician Network

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March 20, 2024

In Focus:

Roundup:

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March 13, 2024

In Focus:

Roundup:

Arizona Medicaid to Reimburse for Community Health Worker Organizations
Arkansas Governor Approves Committee, Strategic Plan to Support Maternal Health
Florida House Passes Bill to Establish Rural Emergency Hospitals
Georgia Senate Committee Advances Bill to Relax Certificate-of-need Regulations
Minnesota House Committee Holds Hearing on Bills to Support HRSNs Through Section 1115 Waiver
Nevada Receives Federal Approval Allowing Medicaid Funds to Cover Housing, Supportive Services
Oregon Awards $17 Million to CBOs Supporting Health Equity
Texas Announces Awards for STAR, CHIP RFP
Texas FQHCs Receive $19.3 Million to Expand Services to Underserved, Uninsured Populations in 2023
Virginia Postpones Several Caregiver Policies
Redetermination Updates: Montana, Texas
States Pause Nursing Home Staffing Penalties Amid Review of CMS Rule
CMS Permits States to Expand Medicaid Behavioral Health Professionals, Claim Federal Match Funding for Nurse Advice Lines
HHS to Investigate Cyberattack at UnitedHealth Group’s Change Healthcare
White House Pressures UnitedHealth Group to Increase Funding for Providers Affected by Cyberattack
CMS Announces Availability of Payments to Providers, Suppliers Following Cyberattacks at UnitedHealth Group’s Change Healthcare

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March 6, 2024

In Focus:

Roundup:

Colorado Receives Feedback on Behavioral Health Administrative Service Organizations; RFP Expected Spring 2024
Idaho House Committee Advances Bill to Expand Postpartum Medicaid Coverage to 12 Months
Iowa Releases Health Link Medicaid Managed Care RFP to Reprocure One Contract
Maryland Faces $236 Million Medicaid Budget Shortfall
Minnesota Requests Additional Five-year Extension of Substance Use Disorder Reform Demonstration
Mississippi Legislature Passes Bill that Would Grant Early Medicaid Coverage for Pregnant Women
Nebraska Waiver Expands HCBS to 850 Children on Developmental Disabilities Registry
Nevada Holds Workshop on Medicaid Managed Care Procurement
New York Receives Federal Approval for Section 1332 State Innovation Waiver to Expand Essential Plan Eligibility
Oregon CCOs to Offer Grant Funding to Support Community Organizations in HRSN Delivery
Pennsylvania Releases Electronic Visit Verification Module RFP
Tennessee to Release Pharmacy Benefits Administrator RFP in Fourth Quarter of 2024
Virginia Announces Awards for Statewide Medicaid Managed Care Procurement
Biden Administration Takes Steps to Prevent Corporate Overcharging of Consumers, Government Programs
Federal Regulators Launch Investigation into Private Equity Healthcare Deals
United Health Group Provides Temporary Funding, Pharmacy System During Cyber Attacks
The Ensign Group Acquires Skilled Nursing Facilities in Colorado, Kansas

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