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PCMH 2017 Readiness Assessment Tool

PCMH 2017 Readiness Assessment Tool:  Measure Readiness for NCQA PCMH 2017 Concepts HMA has developed a PCMH 2017 Readiness Assessment Tool, which can be used as a self-assessment tool by a primary care practice, or by their HMA consultant, to assess their current progress toward meeting NCQA PCMH 2017 concepts. This tool allows for a simple … Read More

March 30, 2022

In Focus: President’s Budget Recommends Significant Investments in Unity Agenda Issues HMA Conference: Drew Altman of KFF to Deliver Keynote Address on Politics and the ‘New Normal’ for U.S. Healthcare at HMA Conference in Chicago, October 10-11Arkansas Eligibles Face Barriers Enrolling in Medicaid, Report FindsConnecticut Medicaid Enrollment Increases by 120,000 During PandemicFlorida Medicaid Plan Has New Enrollment Suspended by StateKansas Governor Urges Legislature to Remove Budget Bill Provision to Extend KanCare ContractsMichigan Home-Based Care Providers Struggle After Reimbursement Rate CutNew Hampshire Hospitals Can Proceed with Lawsuit Over Vermont Over Medicaid RatesNorth Carolina Launches Initiative to Provide Integrated Care for Children On Medicaid, CHIPPennsylvania to Release MMIS RFP in September 2022South Carolina Receives CMS Approval of Temporary HCBS Rate IncreasesHealth Plan Invests More Than $85 Million to Help Develop Affordable Housing in TexasMedicaid Spending Will Exceed $1 Trillion in 2028, CMS ProjectsOptum Health to Acquire LHC Group for $5.4 BillionNew this week on HMAIS

May 4, 2022

HMA Conference on the New Normal for Medicaid, Medicare, and Other Publicly Sponsored Programs to Feature Insights from Health Plan Leaders, State Medicaid Directors, ProvidersIn Focus: CMS’s Hospital Inpatient Regulation Proposes the Use of Novel Methods to Calculate 2023 Payment Rates California Medicaid Plan to Pay Providers for Performance for Some ServicesCalifornia Exchange Automates Enrollment for Medicaid Members Losing CoverageColorado Bills to Protect Medicaid Behavioral Health Providers from Clawbacks District of Columbia Mayor to Apply for Federal Funds for Health DisparitiesGeorgia Proposal to Bypass Healthcare.gov Is Rejected by Federal RegulatorsLegislature Approves Bill to Delay Reprocurement of KanCare Contracts Until 2023Michigan Launches Initiative to Improve Behavioral Health Services for ChildrenMinnesota Submits Request to Expand Self-Directed Personal Care OptionsNebraska Establishes Advisory Committee for State Medicaid ProgramNew Hampshire Legislature Passes Medicaid Adult Dental BillNorth Carolina HCBS Medicaid Waiver Access Varies by Race, Study FindsOhio Delays Launch of ‘Next Generation’ Medicaid Managed Care ProgramRhode Island Senate Committee to Hear Medicaid Rate LegislationSouth Carolina Extends Telehealth Flexibilities Beyond PHETennessee House Panel Clears Bill to Renew D-SNP Contracts with Losing BiddersTexas Seeks Comment on Criteria for Selecting Medicaid Managed Care PlansTexas 10-Year Medicaid Waiver Extension to SurviveMACPAC Announces New Executive Director, MembersBow River Capital Completes Investment in Amazing Care Home Health ServicesHCA Healthcare to Acquire BetterMed

July 13, 2022

Indiana Releases MLTSS RFPCalifornia Legislature Considers Bill Allowing Medi-Cal Reimbursement for Eyeglasses from Retail Labs Delaware Awards Medicaid Managed Care Contracts to 3 Plans Florida Governor Issues Order Increasing Audits of PBMs, Preventing Clawbacks in Future Contracts Maine Expands Medicaid, CHIP Coverage to Individuals Under 21, Pregnant Women Regardless of Immigration Status Massachusetts Selects 25 Community Behavioral Health Centers to Expand Treatment for Mental Health Conditions Minnesota Releases RFP for Medicaid, MinnesotaCare Accountable Care Model Montana Receives Approval for 1115 HEART Demonstration Nebraska Receives Five Bids for Medicaid Managed Care Contracts New Hampshire Releases Adult Medicaid Dental Benefit RFI Oklahoma Proposes 25 Percent Rate Increase for Medically Fragile Medicaid Services Pennsylvania Governor Approves Nursing Home Medicaid Reimbursement Rate Increase South Dakota Medicaid Expansion Ballot Campaigns to Join Forces Texas Health Plan Awards $2.1 Million in Grants to Address Social Determinants of Health Insurers Propose Exchange Plan Premium Rate Hike of 10 Percent in 2023, Says ACASignups.net Molina to Acquire My Choice Wisconsin Ensign Group Acquires Skilled Nursing Facilities in Texas, Nevada, California

April 3, 2024

In Focus: CMS Releases Medicare Advantage and Part D Payment Policies for CY 2025 Arkansas Releases Medicaid Sustainability Review Aimed at Containing CostsIdaho Re-enrolls 22 Percent of Medicaid Beneficiaries Disenrolled During RedeterminationsIowa Cancels Dental RFP for Iowa Dental Wellness Plan, HawkiMolina, Cityblock Offer SDOH Resources to Dual Eligibles in MassachusettsMississippi Senate Passes Medicaid Expansion Bill with Work RequirementsNebraska Governor Signs Bill to Increase Medicaid Payment Rates for HospitalsNew Mexico Open Enrollment Begins for Turquoise Care Managed Care ProgramOklahoma Launches SoonerSelect Medicaid Managed Care ProgramRhode Island Medicaid Managed Care Procurement Attracts Four BiddersVirginia Reissues Notice of Intent to Award Medicaid Managed Care ContractsCMS Marketplace Final Rule Adjusts Network Standards, Enrollment Period, Access to Dental CareKaiser Permanente Acquires Geisinger HealthFTC Issues Injunction to Block Novant Health’s Acquisition of North Carolina Hospitals

November 8, 2023

CMS Issues Final 2024 Provider Payment Rules HMA Information Services Names Andrea Maresca as Managing DirectorArizona to Award $47.5 Million to HCBS Providers in Second Round of ARP Grant Funding California Minimum Wage Increase for Healthcare Workers Estimated to Cost $4 Billion in Fiscal 2025Florida Releases Comprehensive IDD Managed Care Pilot Program ITNIdaho Health Data Exchange Lacked Accountability Measures, Report FindsIowa Releases Medicaid Quality Improvement Organization Services RFPMissouri Disenrolls 52,000 Children From Medicaid During First Four Months of Redeterminations Nebraska Medicaid Director ResignsNorth Carolina Order Dissolves Sandhills Behavioral Management Entity, Consolidates Two OthersGuideWell Names Thurman Justice President, CEO of Triple-S ManagementMedicare Advantage Plans Enjoy Higher Payments than FFS, MedPAC ReportsMedicaid Disenrollments Top 10 Million Following RedeterminationsCigna Explores Sale of Medicare Advantage Business

April 5, 2023

In Focus: Medicare Advantage Capitation Rates and Part C and Part D Payment PoliciesHealth Management Associates Acquires Crestline AdvisorsArizona to Award $40 Million to HCBS Providers California, Michigan Consider Legislation to Ensure Preventive Care Coverage at No Cost to Individuals Colorado Legislature Debates Fiscal 2024 Budget Bill with $80 Million to Replace Enhanced FMAP Connecticut House Committee Advances 2 Bills to Increase Income, Asset Limits for HUSKY C Indiana Legislature Extends Medicaid Reimbursement Rate Hike for Out-of-state Children’s Hospitals Iowa House Committee Holds Hearing on Bill to Create Eligibility Verification System for Medicaid Michigan Launches Enhanced Medicaid Dental Benefits, Increased Dental Provider Reimbursement Rates Montana House Passes Bill to Increase Medicaid Reimbursement Rates to Ambulance Providers New York Implements Medicaid FFS Pharmacy Benefit Program Redeterminations News: Oregon, Pennsylvania, Texas, VirginiaCMS to Increase Medicare Advantage Payments by 3.3 Percent in 2024 CMS Proposes Increasing Medicare Reimbursement Rates for Skilled Nursing Facilities by 3.7 Percent in 2024 HouseWorks Acquires Associated Home Care UnitedHealth Group to Reduce Use of Prior Authorizations

January 11, 2023

In Focus: Congress Sets Date for Medicaid “Unwinding”: What Now? Multiple Industry Experts to Lead Sessions at HMA's Healthcare Quality ConferenceArizona Medicare Plan Receives $60 Million Investment from Chicago Pacific Founder to Launch ESRD C-SNP California Revises List of Medicaid Managed Care Award Winners in Several Counties Connecticut Expands Medicaid Eligibility for Children Effective January 1 Florida Appoints Jason Weida as Interim Secretary Georgia Releases RFQC for Medicaid Managed Care Plans Georgia Establishes State Exchange Directing Buyers to Brokers, Insurers Idaho Legislators to Review Medicaid Expansion Maine to Seek Renewal of Waivers for Adults in Need of Home and Community-based Services Maryland Releases Behavioral Health ASO RFP Maryland Implements Medicaid Comprehensive Dental Coverage Massachusetts Selects 20 Community Partners for ACO Behavioral Health, LTSS Nevada Receives Federal Approval for SUD Treatment Waiver New Hampshire Legislature to Vote on Reauthorization of Medicaid Expansion Funding New York Governor Announces $1 Billion Plan to Address Behavioral Health North Dakota Releases Medicaid Enterprise Technical Systems Integrator RFP Oklahoma Faces Lawsuit from Provider-led Entity Regarding Managed Care Procurement Oregon Approves Amazon Acquisition of One Medical Rhode Island Releases NEMT Program RFQ Wisconsin Names Jamie Kuhn as Medicaid Director HHS Extends Public Health Emergency Until April 11 CMS Allows States, Medicaid Plans to Spend 5 Percent of Premiums on Social Determinants of Health CVS Health Considers Acquisition of Oak Street Health

May 24, 2023

In Focus: HMA Annual Conference on Innovations in Publicly Sponsored HealthcareCalifornia Proposes Increasing Medicaid Reimbursement Rates for Providers Florida Disenrolls 250,000 Medicaid Beneficiaries Since Redeterminations Began Iowa Releases Dental RFP for Iowa Dental Wellness Plan, Hawki Iowa Expects 3,000 Individuals to Lose Medicaid Coverage by June 1 Massachusetts Considers Increasing Medicaid Reimbursement Rates for Substance Use Disorder Treatment Providers Minnesota Legislature Passes Bill to Set Minimum Wages, Benefits for Nursing Home Staff Nebraska Passes Certified Community Behavioral Health Clinic Act Nevada to Transition to Medicaid Managed Care in Rural Areas Nevada Senate Considers Bill to Reimburse Rural Hospitals at Cost for Outpatient Services New Hampshire House Committee Subdivision Votes to Hold Medicaid Reauthorization Bill for a Year Texas Senate Passes Bill to Extend Postpartum Medicaid Coverage Vermont Lawmakers Approve 50 Percent Increase in Fiscal 2024 Medicaid Reimbursement Rates for Dental Services Washington Legislature to Increase Medicaid Reimbursement Rates for Nursing Homes by 14 Percent for Two Years CMS Releases Regulatory Requirements for State MES Modules HCA Healthcare Acquires TX Urgent Care Centers from FastMed