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MM Curator summary    Biden's has officially selected his nominee for the top CMS job.    The article below has
MM Curator summary The protest stage of the OK MCO procurement has begun, with Aetna batting first.    The article
MM Curator summary    Biden has asked SCOTUS to cancel a planned case on work requirements.    The article below
MM Curator summary    States will now have to report more information on Medicaid supplemental payments to providers.    The
MM Curator summary    Nevada has a new record for Medicaid enrollment, and its nearly 15% higher than the previous
MM Curator summary A new NC audit showed the Medicaid agency has extensive problems with using banned providers.    The
   MM Curator summary    One of the Medicaid components of the $2T pandemic bill would be a 7% for
MM Curator summary    Under the current bill, Medicaid will get $350B (18%) of the pandemic relief package. Vaccines and
   MM Curator summary    WA state senators are targeting multiple fixes to the state Medicaid program, with a focus
MM Curator summary OK managed care appears safe, with the legislature struggling to get the votes needed to overturn the
MM Curator summary    Biden dangles $20B+ in front of non-expansion states.    The article below has been highlighted and
   MM Curator summary    As MO took some time to figure out how to pay for expansion, it may
   MM Curator summary    SD's work requirement request will not have to be un-approved, because CMS never responded to
   MM Curator summary    SC is another state that will be denied the opportunity to test their CMS-approved work
MM Curator summary    Biden's CMS has let 10 states that requested and received approval for their work requirements features
MM Curator summary    Biden administration nullified the work requirements requested by GA (and approved by CMS), citing COVID as
MM Curator summary    GAO dings CMS for not monitoring vendor payments in the PR Medicaid program.    The article
MM Curator summary    Anthem will pick up more than 500,000 lives with the purchase.    The article below has
MM Curator summary    The new HHS administration has been ordered to review the Public Charge rule designed to reduce
MM Curator summary    Pennsylvania continues the rollout of its program to connect Medicaid members who want to work to
MM Curator summary    Kansas Governor Kelly is proposing to fund Medicaid expansion with marijuana taxes.    The article below
MM Curator summary    The Texas effort to block state funds to the abortion chain is working its way through
MM Curator summary    A Manatt consultant and former Bacerra associate is being heralded as the next head of CMS.
MM Curator summary    Governor Little dropped a planned $30M cut to Medicaid because he says the enhanced federal funds
MM Curator summary    The state is considering a new $1 tax to cigarettes and redirect 40% of the existing
MM Curator summary    A Georgia Senator has introduced a bill to expand Medicaid at 100% federal costs for states
MM Curator summary    The Aetna decision to block CVS competitor Walgreens from Medicaid payments has left members with less
MM Curator summary    Nevada Medicaid is getting members to their vaccination appointments and also providing gas costs reimbursement for
MM Curator summary    CMS did not use a method recommended by OIG for preventing payments to providers known to
MM Curator summary    More than 1/3rd of states have registered their support of their right to use work requirements
MM Curator summary    Humana will begin serving South Carolina Medicaid members July 1, 2021.    The article below has
MM Curator summary    The website that hosts the application for multiple Florida Medicaid programs had a data vulnerability for
MM Curator summary    The new HHS administration has been instructed to open a special enrollment period for the exchanges
MM Curator summary    KFF is unable to tell if the economy impact of COVID or the moratorium on eligibility
MM Curator summary    Winners include BCBS of Oklahoma, Humana, Centene and UnitedHealthcare.    The article below has been highlighted
MM Curator summary    The new HHS administration has been ordered to review all policies and waivers that may restrict
MM Curator summary    NC awards Legal Aid contract to help members navigate issues during the transition to managed care.
   MM Curator summary    NJ is looking to contract with a third party entity to address risks of polypharmacy.
MM Curator summary Nevada Medicaid enrollment grew 18.7% more than expected, and now the bill is coming due.    The
MM Curator summary Mississippi wants to take away Medicaid from the Governor.    The article below has been highlighted and
MM Curator summary    Lawmakers are looking for ideas on how to pay for what the voters decided.    The
MM Curator summary    Lawmakers frustrated with the court decision to squeeze in a sixth MCO are pushing back.  
   MM Curator summary    Azar filed a brief on his way out, reiterating the argument that applying enrollment controls
MM Curator summary    HCBS spending decreased 26% in 2018 compared to 2017.    The article below has been highlighted
MM Curator summary    Wisconsin has asked CMS to put all of the premium payments made by Medicaid members into
MM Curator summary    Medicaid now consumes more than 33% of the Nevada budget, and will spend $2B next year
MM Curator summary    Lawmakers do the normal "big bad managed care" dance on the eve of managed care coming
MM Curator summary    7,892 Amazon employees are on Nevada Medicaid now, up from 4,040 last year.    The article
MM Curator summary    43% of all people in New Mexico are on Medicaid now.       The article below
What is a Medicaid waiver? A Medicaid waiver program is a special program that allows a state to vary from
MM Curator summary The public health emergency was extended to April, sending $130M more to FL alone.    The article
MM Curator summary Gainwell will become the new PBM in Ohio, beating out 5 other bidders including Express Scripts and
   MM Curator summary The latest COVID relief bill also delays DSH reductions another 4 years (they have been continuously
MM Curator summary California wants to add $12M in the next fiscal year's budget to pay for CGM for adults
MM Curator summary Illinois lawmakers are ready to be done with MCOs.    The article below has been highlighted and
MM Curator summary Industry opposition has officially killed the last effort to reform entrenched Medicaid financing schemes.    The article
MM Curator summary North Carolina is set to roll out managed care for the first time this July.    The
MM Curator summary New Jersey legislation would raise home-based nursing care rates by about 50%.    The article below has
MM Curator summary A data breach in Wisconsin may have revealed personal health information of 1,200 members.    The article
MM Curator summary A bot submitted half the public comments on a proposed Medicaid program change.    The article below
MM Curator summary The Colorado public option is back on the table, with perhaps a few changes since we last
MM Curator summary   The 51-page new guidance layouts several details CMS will use to assess whether state programs are
What are waiting lists? Waiting lists are used to ration services for severely disabled Medicaid members who need them. These
MM Curator summary CMS guidance on priority focus areas for SDH efforts in Medicaid is now out. The article below
MM Curator summary Despite industry opposition, hospitals will now have to report the prices they accept from insurers as payment.
MM Curator summary A recent CMS audit of wages paid in hospitals will likely be used to increase the wage
MM Curator summary The health insurance giant continues its payer and provider services build out with the $13B purchase of
MM Curator summary TN received approval for its first-of-its-kind innovation waiver to share savings it creates in its Medicaid program
MM Curator summary Analysts speculate that the move is simply CVS excluding a top competitor. The article below has been
MM Curator summary Humana is arguing that Passport did not have the right to sell future enrollment to Molina, as
MM Curator summary CMS officially withdrew the Medicaid Financial Accountability Regulation after a year of intense industry protest on the
MM Curator summary PA has seen a 10.6% increase in Medicaid enrollment during the pandemic and a 5.6% increase in
MM Summary Centene adds a giant pharmacy services component with the purchase of Magellan. M&A activity continues to pick up
MM Summary Centene adds a giant pharmacy services component with the purchase of Magellan. M&A activity continues to pick up
What is the Medicaid Loss Ratio? Medical Loss Ratio is the proportion of premium revenues spent on clinical services and
Summary While MACPA puts out a Medicaid and CHIP data book each year, this one is especially important because it
MM Curator summary- Georgia has gone from reporting 75% of CMS program measures to only 25%. The article below has
MM Curator summary- an incorrect facility type designation lead to $11M in inappropriate payments for a Virginia behavioral health facility.
MM Curator summary: Funding for Medicaid services in the Marshall Islands may resume at higher levels under the latest coronavirus
MM Curator summary: Tennessee reported a data breach for members that occurred when mailings were sent to the wrong address
MM Curator summary:    Maryland will begin paying BH and LTC providers more January 1 via a rate increase of
MM Curator summary: Tennessee has not given up his efforts to get its first-of-a-kind Medicaid block grants approved by CMS.
MM Curator summary: The author of this Forbes op-ed argues that ACA underprojections and the rich FMAP for expansion enrollees
MM Curator summary: The NC Reach and Read program just got more funding to partner with pediatricians to encourage early
MM Curator summary: CMS has begun the process to define value based purchasing arrangements for drugs in the Medicaid program,
MM Curator summary A judge has ruled that the latest round of DC MCO contract awards must be re-evaluated. The
MM Curator summary      The first MacPac data book with T-MSIS data is now available.         
      MM Curator summary    Florida Medicaid will cost 19% more this year- but the state will have a
MM Curator summary    Provider groups that can currently use the 340B program to redirect millions of surplus dollars are
MM Curator summary    A new CMS direct contracting model will allow Medicaid health plans to provide more services in
   MM Curator summary    COVID and unemployment drove most of the 5.6% increase in the Medicaid rolls seen from
   MM Curator summary    North Carolina Medicaid expansion is tied to whether the state can have a work requirement,
MM Curator summary CMS will start allowing health plans that serve duals to participate in shared savings on the Medicare
MM Curator summary    A new federal DHS rule will require payers to implement technology that reduces complexity and delays
MM Curator summary    COVID has driven a dramatic surge in Louisiana Medicaid enrollment, but the current DHS Director says
MM Curator summary Idaho Medicaid expansion will cost the state 50% more than projected this year and 100% more than
Texas releases its annual report of fraud recoveries made my Medicaid health plans. Clipped from: https://oig.hhsc.texas.gov/sites/default/files/documents/annual-report-on-certain-fraud-and-abuse-recoveries-fy-2020.pdf    
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
Clipped from: https://www.statnews.com/pharmalot/2020/12/09/florida-pbm-pharmacy-medicaid/  As states struggle to control the cost of prescription medicines, a new report found pharmacy benefit managers
Curator, Rx, Roundtable show   The article below has been highlighted and summarized by our research team. It is provided
Curator, KY, Managed Care, Roundtable Show    Clipped from: https://www.bizjournals.com/louisville/news/2020/11/18/medicaid-mediation-starts-at-loggerheads-over-memb.html    The article below has been highlighted and summarized by
Curator, Managed Care, North Carolina    The article below has been highlighted and summarized by our research team. It is
CMS sent a new State Medicaid Director letter (read it here) in early June to help agencies understand options to
The article below originally appeared in the Baltimore Sun. Reprinted with kind permission from the author Dr. Dan Morhaim (whom
1. Which segment of the industry are you currently involved? A:  I lead a Cleveland based “think tank” called the
Helping you consider differing viewpoints. Before it's illegal.    Article 1:   The Opioid Epidemic and Medicaid's Role in Facilitating
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