HMA Analysis of 2020 Medicare Advantage Rate Notice and Final Call Letter

April 26, 2024April 4, 2019 by Kristin Allen

This week, our In Focus reviews the Announcement of Calendar Year (CY) 2020 Medicare Advantage Capitation Rates and Medicare Advantage (MA) and Part D Payment Policies (Rate Announcement) and Final Call Letter, issued by the Centers for Medicare & Medicaid Services (CMS) on April 1, 2019. The Rate Announcement and Call Letter includes final updates … Read More

August 16, 2023

In Focus: Arizona Releases Medicaid ALTCS-EPD Program RFPColorado Hospitals Continue to Post Operating Losses Florida Projects $600 Million Medicaid Budget Deficit for Fiscal 2024 Medicaid Eligibility Redeterminations News: Florida, Illinois, Massachusetts, Michigan, Nevada, Rhode Island, WyomingIdaho Medicaid Managed Care Task Force Holds Second Hearing Illinois Governor Signs Law Increasing Oversight of Healthcare Mergers Indiana Parents, Advocates Call on Governor to Reconsider Funding Cut for Autism Therapy Massachusetts to Raise Income Eligibility Limits for ConnectorCare Nebraska to Lift $750 Cap on Medicaid Dental Benefits New Mexico to Award Previously Announced Medicaid Plan Contracts in Defeat for Governor New York City Cannot Switch Retirees to Aetna Medicare Advantage Plan, Judge Rules North Carolina Medicaid Behavioral Health Plans Sandhills Center, Eastpointe to Merge Vermont All-Payer ACO Model Lowers Medicare Spending, Hospitalizations, Analysis Finds CMS Launches Changes to Encourage Participation in Medicare ACO REACH 4.8 Million Medicaid Beneficiaries Are Disenrolled from Medicaid Following Redeterminations, Analysis Finds 5.6 Million Medicaid Enrollees Utilize Long-term Services, Supports in 2020, KFF Finds U.S. Appeals Panel Rules False Claims Lawsuit Against Walgreens Can Proceed

August 24, 2022

In Focus: Bolstering the Youth Behavioral Health System: Innovative State Policies to Address Access & ParityCalifornia Releases Mobile Crisis Intervention Services RFI California Exchange Plans Must Resubmit 2023 Rates to Reflect Impact of Inflation Reduction Act Florida Medicaid Enrollment to Increase 5.5 Percent, Surplus to Top $1.25 Billion in Fiscal 2023 Georgia Can Reinstate Medicaid Expansion Work Requirements, Federal Judge Rules Nebraska Awards Maxmius Contract for MMIS Provider Services Module New York Legislators Introduce Bill to Ease Burden of Medicaid Provider Audits, Recoveries North Carolina Healthy Opportunities Pilot Struggles to Gain Traction Ohio Counties Win $600 Million in Damages in Opioid Lawsuit Oregon Health Plan to Use Tech Platform to Connect Medicaid Members to Social Services Texas Dual Eligible Demonstration Shows Cost Reductions, Study Finds Utah Releases Medicaid Dental Managed Care RFP U.S. Senate Panel Investigates Medicare Advantage, Part D Marketing Tactics Sonas Home Health Care Acquires Focus Forward Skilled CareWakely, An HMA Company, White Paper: 2021 Supplemental Claims Impact

July 20, 2022

In Focus: CMS Picks Up the Pace on Transforming the Medicare LandscapeCalifornia Governor Signs Bill to Establish No-Bid Contract with Medicaid Plan Colorado Policy Restricts Use of Behavioral Health Interns, Unlicensed TherapistsFlorida Considers Denying Medicaid Coverage for Gender-Affirming Care for Transgender Youth Georgia Receives Federal Renewal of 1915 HCBS Waiver for Five Years Idaho Releases Medicaid Dual Programs RFI Illinois Accepting Medicaid Applications for Individuals 42 and Up, Regardless of Immigration Status Massachusetts Releases Request for Responses for Behavioral Health, LTSS Community Partners New York HCBS Children’s Waiver Providers to Receive Temporary 25 Percent Rate Increase Oregon Medicaid CCO Program ‘Helped Slow Cost Growth,’ State Says Pennsylvania Physical HealthChoices Beneficiaries Must Choose New Plan Before August 16 Tennessee Drafts Amendment to TennCare Block Grant Waiver Washington Seeks 5-Year Renewal of Medicaid Transformation 1115 Waiver COVID-19 Is Associated with Increased Incidence of Future Medicaid Conditions, Costs, Wakely Study Finds CMS Awards $49 Million in Grants to Boost Medicaid, CHIP Enrollment of Children CMS Proposes 2.7 Percent Increase in Medicare Reimbursement Rate for Outpatient, Ambulatory Surgical Center ServicesPediatric Home Service Acquires Craig HomeCare, Cherub Medical Supply Health Plan Joins Hospital Systems as Co-Owner of Delaware Regional Medicare ACO

March 8, 2023

In Focus: Financial Impact Summary of the 2024 Medicare Advantage Advance NoticeArizona House Committee Advances Bill to Reduce Medicaid Redetermination Period Colorado Lawmakers Introduce Bill to Authorize Medicaid Reimbursement for Community Health Services Redeterminations News: Delaware, Nebraska, Nevada, North Carolina, Rhode Island Maryland Health Information Exchange to Expand Medicaid Eligibility Redetermination Notifications Mississippi Releases Medicaid Utilization Management, Quality Improvement Organization IFB New Jersey Senate Committee Advances Bill to Increase Medicaid Reimbursement Rates for Assisted Living Facilities New Mexico House Passes Bill to Study Medicaid Buy-in Program North Carolina Senate Committee Advances Medicaid Expansion Bill Wisconsin Governor Proposes Tying Medicaid Expansion to Medicaid Reimbursement Rates West Virginia House Passes Bill to Scrap Medicaid Managed Care RFP Process, Move to Applications 15 States Seek Section 1115 Waiver Amendments to Provide Medicaid Services to Incarcerated Individuals Prior to Release VillageMD Acquires CT-based Multispecialty Group Starling Physicians Presbyterian Healthcare Services, UnityPoint Health to Merge

Medicaid Managed Care Spending in 2020

August 30, 2024February 25, 2021 by Kristin Allen

This week, our In Focus section reviews preliminary 2020 Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a Freedom of Information Act request to the Centers for Medicare & Medicaid Services (CMS), HMA received a draft version of the CMS-64 report that is based on preliminary estimates of Medicaid spending … Read More

CMS Picks Up the Pace on Transforming the Medicare Landscape

August 30, 2024July 19, 2022 by Kristin Allen

Over the course of three weeks CMS has made a series of Medicare announcements that arguably contain the most sweeping changes to the Medicare program proposed thus far by the Biden Administration. With final Medicare payment rules on the horizon, CMS is poised to further the Biden Administration’s directional imprint on the Medicare program. The … Read More

HMA fosters harm reduction from street to suite

The President’s National Drug Control Strategy is the first-ever to champion harm reduction to meet people where they are and engage them in care and services. People are dying from drug overdose at an alarming rate in the U.S. For the fourth year in a row, we have lost over 100,000 people (enough to fill … Read More

Patient Protection and Affordable Care Act; 2020 Proposed Notice of Benefit and Payment Parameters

May 17, 2022March 21, 2019 by Kristin Allen

This week, our In Focus reviews the Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020. The new proposed rule does not contain as many major changes as the 2019 rule, but there are requests for comment on potentially important rulemaking starting in 2021 and guidance on important policy, such as:

Medicaid Non-Emergency Transportation Benefit: Stakeholder Perspectives on Trends and Innovations

May 17, 2022August 26, 2021 by Health Management Associates

This week, our In Focus section reviews key takeaways from the report, Medicaid Non-Emergency Transportation Benefit: Stakeholder Perspectives on Trends and Innovations, prepared by Health Management Associates (HMA) for the Medicaid and CHIP Payment and Access Commission (MACPAC).

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