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Rebecca Nielsen

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Executive Sponsor Rebecca Nielsen, MBA is a managing director at LP, where she designs and oversees major strategy and public health engagements. She aids both public and commercial clients in developing strategies, assessing new markets, and identifying opportunities for service expansion. Ms. Nielsen has aided payers, providers, health information technology, telecom, and other entities in … Read More

Pennsylvania releases community HealthChoices (CHC) Medicaid managed care RFA

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This In Focus section reviews the request for applications (RFA) that the Commonwealth of Pennsylvania Department of Human Services (DHS) released January 30, for the Community HealthChoices (CHC) Program. CHC is the mandatory managed long-term services and supports (MLTSS) program, which serves five CHC zones that cover all 67 counties in the commonwealth.   Notably, this procurement, as compared … Read More

Julie Rose

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Julie Rose is a seasoned healthcare leader with 10 years of experience in operations, project management, and digital innovation. Whether navigating complex regulatory landscapes or driving innovation in healthcare delivery, Julie’s strategic vision and hands-on approach have consistently delivered tangible results. Prior to joining HMA, Julie held project manager roles at Aetna Better Health of … Read More

Zeroing in on Medicare Advantage policies set to transform the SNP landscape beginning in 2025

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Regulatory policy changes finalized by CMS aim to increase the percentage of dual-eligible individuals enrolled in integrated plans  This week, our In Focus section delves into important and complex regulatory policy changes that affect coverage and services for the 12.9 million individuals who are dually enrolled in both Medicare and Medicaid. These policy changes—which were finalized as part … Read More

March 29, 2023

In Focus: HMA Community Strategies Conducts Evaluation for the City of Los Angeles FamilySource SystemAlabama Releases RFP for Medicaid Enterprise Data Services Solution Arizona Releases Strategic Roadmap to Modernize Medicaid Enterprise System Florida Medicaid Disenrollment Could Impact Up to 1.8 Million Households Florida Senate Committee Approves Bill to Place Restrictions on PBMs Georgia Senate Committee Misses Deadline, Imperiling Mental Health Bill Kentucky Governor Vetoes Bill that Would Block Expanded Dental, Vision, Hearing Benefits for Medicaid Beneficiaries Louisiana Governor Proposes $196 Million for Medicaid Redeterminations Process New York Providers File Lawsuit to Delay Transition of Medicaid Pharmacy Benefits from Managed Care to FFS North Carolina Enacts Medicaid Expansion Tennessee Legislature Considers Bill to Block State from Contracting with Medicaid Plans Covering Gender-affirming Treatment in Any State Medicaid, CHIP Enrollment Tops 92.3 Million in December 2022 Mosaic Dental Collective Partners with Audax Private Equity BCBS-NM Names Nancy Smith-Leslie as Vice President of Medicaid

October 5, 2022

In Focus: New Mexico Releases Medicaid Managed Care RFPColorado Releases Medicaid, CHIP Enrollment Broker Services RFP Louisiana to Begin Auto Assignment of Medicaid Beneficiaries into Managed Care Plans Maine Looks to Renew NEMT Waiver, Release RFP Minnesota Awards Medicaid Managed Care Contracts Covering Individuals Outside Twin Cities, Elderly, Disabled Nebraska Seeks Funds to Cover Aduhelm, Reduce Waiting List for Individuals With Development Disabilities New York Medicaid Fraud, Waste Reduction Efforts Yield Results North Carolina Delays Implementation of Behavioral Health IDD Tailored Plans to April 2023 North Dakota Leads Country in Rate of Physicians Accepting New Medicaid Patients, Analysis Finds Ohio Governor Looks to Expand Medicaid Eligibility for Pregnant Women to 300 Percent of Poverty Oklahoma Implements 25 Percent Rate Increase for Developmental Disability, HCBS Providers HCSC Names Anne Rote President of Medicaid Division Federal Grants Topping $346 Million Awarded to Address Healthcare Staffing ShortagesEnsign Group May Soon Become Largest Nursing Home Provider in U.S.

HMA helps Justice Involved/Behavioral Health services implement the Sequential Intercept Model (SIM)

Key Benefits of Implementing SIM Guides ongoing stakeholder meetings and county programming by establishing a common language for justice and diversion programs to support sustainability and adaptability over time. Supports community analysis and integration of new policies by providing a clear visualization of system resources and gaps. Facilitates collaboration and ensure efficient use of resources … Read More

The Policy, Implementation and Operations of Medicaid Personal Responsibility Initiatives: An Introduction

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This week, our In Focus section highlights HMA Medicaid Market Solutions (MMS), formerly SVC, Inc., which is at the forefront in supporting state flexibility in designing and implementing initiatives including Section 1115 Demonstration Waivers promoting member engagement and personal responsibility. Over the coming weeks, HMA MMS will present a series of articles providing an in-depth … Read More

CMS Increases Monitoring and Evaluation Requirements for Section 1115(a) Medicaid Demonstrations

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This week, our In Focus reviews the implications of the new federal guidance for state waivers with community engagement, premiums, non-eligibility periods, and other personal responsibility provisions. Background On March 14, 2019, the Centers for Medicare & Medicaid Services (CMS) issued several new guidance documents that significantly increase the level of monitoring and evaluation required … Read More

HMA’s Smith Part of NAMD Panel Reviewing Medicaid at 50

HMA Managing Principal Vern Smith was one of four experts who took part in the plenary panel discussion “Medicaid at 50: Past, Present and Future” at the National Association of Medicaid Directors (NAMD) fall conference Tuesday. He was joined by: Thomas Betlach, NAMD President, Arizona Medicaid Director, AHCCCS Deborah Bachrach, Partner, Manatt, Phelps & Phillips … Read More