The Moran Company, an HMA Company Principal聽Clare Mamerow, will be a featured speaker in the upcoming聽Foley Hoag聽LLP webinar titled, “The New Technology Add-on Payment (NTAP) Program: What Life Sciences Companies Should Know 黑料网 Medicare’s Time-Limited Program.”
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The re-envisioned role of primary care in FQHCs: accelerating APMs to drive access, patient experience and outcomes
In October 2021, the Center for Medicare & Medicaid Innovation (the Innovation Center) published a outlining its strategic vision and direction of the healthcare delivery system for Medicare and Medicaid beneficiaries through 2030. This included a focus on high-quality primary care, which they identify as the , to achieve equitable, whole-person, integrated care and outcomes.
HMA experts outline scenarios for transitioning from the COVID-19 PHE
This week our In Focus section reviews scenarios in which the federal Public Health Emergency (PHE) may expire. In the weeks ahead, the U.S. Secretary of Health and Human Services (HHS), Xavier Becerra, will be faced with the decision of whether to extend the PHE or to allow it to expire. Dozens of critical waivers and coverage flexibilities are currently linked to the federal PHE and have enabled patients, providers, and payors to receive, deliver, and pay for health care for nearly two years. To date, the PHE has been extended eight times, each for the maximum allowed 90 days. However, declining COVID-19 infection rates and actions by state governors to relax COVID-19-related public health measures have renewed pressure on the Biden Administration to signal how they will choose to act on April 16, 2022 when the current federal PHE expires.
CMS to accept applications for new Medicare ACO REACH model
This week our In Focus section reviews the Centers for Medicare & Medicaid Services鈥� (CMS) Innovation Center鈥檚 newly announced model 鈥� Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH). CMS will accept applications from organizations interested in participating and is particularly interested in partnering with provider-led organizations and similar groups with direct patient care experience and a strong track record serving underserved populations that focus on primary care to better manage Medicare beneficiaries鈥� health. Applications are due by April 22, 2022.
Iowa releases Health Link Medicaid managed care RFP
This week, our In Focus section reviews the Iowa Health Link request for proposals (RFP) for Medicaid managed care organizations (MCOs) to serve the state鈥檚 traditional Medicaid program, the Children鈥檚 Health Insurance Program (CHIP) known as Healthy and Well Kids in Iowa (Hawki), and the Iowa Health and Wellness Plan (IHAWP). The RFP was released by the Iowa Department of Human Services on February 17, 2022. Contracts are set to begin July 1, 2023, and are worth approximately $6.5 billion annually.
California releases Medi-Cal managed care RFP for three plan models in 21 counties
This week, our In Focus section reviews the California Medicaid (Medi-Cal) managed care request for proposals (RFP) released by the California Department of Health Care Services (DHCS) on February 9, 2022. DHCS is procuring contracts for commercial plans for three of the Medi-Cal managed care plan models in 21 counties, serving approximately 3 million beneficiaries. Contracts will be awarded to one managed care organization (MCO) in each of the Two-Plan model counties, two MCOs in each of the geographic managed care (GMC) model counties, and two MCOs in each of the Regional model counties. This procurement is the largest released by California, rebidding contracts for commercial plans statewide.
CMS payment notice signals shift in COVID-19 policies for Medicare Advantage, Part D
This week our In Focus section reviews the Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies by the Centers for Medicare & Medicaid Services (CMS) on February 1, 2022. The Advance Notice includes proposed updates to MA payment rates and guidance to plan sponsors as they prepare their bids for CY 2023. It also shows CMS鈥� updates to Part D benefit parameters. Comments are due by 6:00 PM EST on March 4, 2022. The final Rate Announcement will be published by April 4, 2022.
Delaware Releases Medicaid Managed Care RFP
This week our In Focus section reviews the Delaware request for proposals (RFP) for Diamond State Health Plan (DSHP) and Diamond State Health Plan Plus (DSHP Plus), the state鈥檚 Medicaid managed care programs. The RFP was released by the Delaware Department of Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA) on December 15, 2021.
Minnesota releases Medicaid RFP for 80 counties outside Twin Cities
This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state鈥檚 traditional Medicaid managed care program, and MinnesotaCare, the state鈥檚 Basic Health Program (BHP), in 80 counties outside of the Twin Cities seven-county region. The RFP was released by Minnesota Department of Human Services, Purchasing and Service Delivery Division on January 18, 2022. Contracts will begin January 1, 2023, covering approximately 470,000 members.
CMS seeks new direction for Medicare Advantage and Part D on health equity and dual eligible integration
This week, our In Focus section highlights the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) and Part D programs for contract year 2023 and how these changes may impact plan applications, bid submissions, and market dynamics for future years. The analysis and insight reflect the combined expertise of HMA and its companies including the Wakely Consulting Group and The Moran Company.
Federal guidance clarifies the opportunity to include mobile crisis intervention services
HMA Federal Policy Principal Andrea Maresca, Managing Principal Gina Eckart, Principal John Volpe, and Senior Consultant Suzanne Rabideau weigh in on the recent changes and HMA experience in crisis intervention services.
CMS changes boost overall Medicare Advantage star ratings
This week, our In Focus section highlights a Wakely white paper titled, . Authored by Suzanna-Grace Sayre and Dani Cronick and published January 2022, this paper outlines the CMS modifications to the 2022 Star Ratings due to COVID-19, quantifies the estimated impact on 2023 MA spending, and discusses how these changes could influence the MA market in 2023.