Medicare FY 2021 Hospital Inpatient Proposed Rule, Federal Flexibilities for COVID-19

May 17, 2022May 21, 2020 by Kristin Allen

This week, our In Focus section reviews recent announcements and actions by Congress and the Centers for Medicare & Medicaid Services (CMS) that have significant financial and operational implications for the hospital industry. This brief begins with the most recent of these actions by providing a summary of the key provisions of the CMS Fiscal … Read More

3-22-18 State of the States LTSS Webinar

State of the States_LTSS webinar_03.21.18_FINAL_Update_5.10.18

CMS finalizes 2023 landscape for Medicare payment and policy

November 3, 2022 by Kristin Allen

This week, our In Focus section reviews the remaining Medicare payment and policy rules, finalized over the last several days by the Centers for Medicare & Medicaid Services (CMS), that will shape the landscape for the Medicare program in 2023 and beyond. These include the Physician Fee Schedule (PFS), the Hospital Outpatient Prospective Payment System … Read More

September 6, 2023

Virginia Releases Cardinal Care Medicaid Managed Care RFPCalifornia Medi-Cal Contracts Are Scheduled to Begin January 1 PBMs Face Lawsuit from Los Angeles County Over Opioid Crisis Georgia Receives Approval of Waivers to Streamline Medicaid Unwinding Process Montana Medicaid Providers Face Further Delay in Receiving Increased Rates New York Managed Long-term Care Plan Is Closing Down Oregon to Step Up PBM Regulation After Audit Finds Lax Oversight Pennsylvania Senate Passes Bill to Raise Reimbursement Rate for Ambulance Services Tennessee Awards Findhelp Contract to Connect Medicaid Beneficiaries with Social Services West Virginia Receives CMS Approval for Medicaid Mobile Crisis State Plan Amendment CMS to Provide Funding to Help States Implement AHEAD Total Cost of Care Delivery System Model Molina Acquires My Choice Wisconsin

December 7, 2022

In Focus: The Impact of the 340B Program on Drug Prices Charged by Manufacturers and Covered EntitiesNorth Carolina Appeals Ruling on Additional Community Services for Individuals with Disabilities New Mexico Health Plan Submits Bid for New Medicaid Managed Care Contract New York SMI Treatment Programs Face Over 1,000-Person Waiting List Oregon Reaches $17 Million Settlement with Former PBM Tennessee to Release Dental Benefit Management RFP in Late 2023 Texas Releases STAR & CHIP Managed Care Services RFP Wisconsin Receives Approval to Continue Exchange Plan Reinsurance Program Through 2028 HHS Releases Medicaid, CHIP FMAP for Fiscal 2024 Defense Misses Deadline for Announcing Tricare Contract Awards Prime Therapeutics Completes Acquisition of Magellan Rx Management from Centene

June 5, 2024

In Focus: Ohio Releases Next Generation MyCare Ohio Program RFAArkansas to Transition Medicaid Managed Care Dental Program Back to Fee-for-ServiceColorado Governor Signs Bills Addressing Housing, Nutrition Support Funding, Prescription Drug AccessFlorida Governor Signs Bill to Establish Rural Emergency HospitalsIndiana Receives Federal Approval to Transition LTSS to Managed CareMichigan Selects Eight PIHPs for Substance Abuse Recovery Incentives Pilot ProgramMinnesota Releases Medicaid, MinnesotaCare IHP RFPTennessee Awards Medicaid Dental Contract to Renaissance Life & Health Insurance CompanyCMS Releases ACO Primary Care Flex Model RFAHHS Selects Ten Additional States to Participate in CCBHC DemonstrationEvolent Health to Acquire AI Assets from MachinifySolarity Announces Strategic Growth Investment from Private Equity Firm TA AssociatesMore News Here

September 18, 2024

In Focus: New HMA Analysis: Options for Improving California’s Substance Use Disorder Treatment SystemArizona Extends ALTCS-EPD Program Contracts for Another YearColorado Announces Intent to Award Regional Accountable Entity ACC Phase III ContractsNew Hampshire Receives Federal Approval for Mobile Crisis Intervention TeamsPennsylvania Lawmakers, Advocates Look to Reverse Medicaid Dental PolicyWashington Marketplace Insurance Rates to Increase Nearly 11 Percent in 2025Hospitals File Lawsuit Against HHS Over Medicare Advantage Calculation in DSH PaymentsMedicare Health Plan Ratings Drop for NCQA’s 2024 Equity MeasuresCigna Sues FTC Over PBM Drug Pricing ReportMore News Here

September 28, 2022

In Focus: HMA Perspectives on the 2022 Federal Policy LandscapeArizona Medicaid Director to Step Down at the End of 2022 Colorado Appoints Adela Flores-Brennan as Medicaid Director Centene Names Bill Wilson CEO of Delaware Medicaid Plan Kansas Begins Distributing $51 Million in Bonuses for Direct Care Workers at Medicaid HCBS Providers Massachusetts Receives Federal Approval to Extend MassHealth 1115 Waiver Through 2027 Nebraska Awards Medicaid Managed Care Contracts to 3 Health Plans Nevada Releases Electronic Visit Verification System RFP Oregon 1115 Waiver Renewal Is Approved by Federal Regulators Texas Report Recommends Transitioning Medicaid-Only Services into Managed Care for Dual Eligibles Virginia Medicaid Provider Sets Up Neighborhood Clinics to Expand Access to Preventive Health Care OIG Calls For Increased Oversight of Medicaid Plan MLR Reporting DentaQuest Commits $275,000 to Initiative Connecting Children to Dental Care

May 17, 2023

In Focus: Illinois Requests Section 1115 Waiver Extension to Respond to HRSNs and Eliminate InequitiesArkansas Is Urged by Healthcare Groups to Pause Medicaid Redeterminations Delaware Medicaid Expenses Are Projected to Increase Despite Redeterminations Florida Releases Medicaid Prepaid Dental Program RFI, To Release RFP Summer 2023 Florida Releases D-SNP RFI, Considers Moving 300,000 Medicaid Members from D-SNPs to SMMC Illinois to Address Social Determinants of Health in 1115 Behavioral Health Waiver Amendments Indiana Enacts Legislation to Reform Long-term Care North Dakota Releases Medicaid Enterprise Technical Systems Integrator RFP Ohio Releases PACE Expansion RFP Virginia to Release Medicaid NEMT RFP in September 2023 Virginia Disenrolls 20,000 Medicaid Beneficiaries During Redeterminations Federal Appeals Court Temporarily Blocks Overturning of ACA Preventive Services Requirement Wisconsin Approves Humana’s Proposed Purchase of InclusaSentara to Consolidate Medicaid Plans in Virginia

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