Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly roundup focuses on developments, research, and legislation that relates to Medicaid program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse. Below is a summary of last month’s Medicaid news.

The Centers for Medicare & Medicaid Services’ (CMS’) new proposed rule would make it easier for millions of eligible people to enroll in and retain their Medicaid coverage. The rule would reduce red tape and simplify applications, verifications, enrollment, and renewals for health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP). The proposed rule responds to President Biden’s January 2021 and April 2022 Executive Orders to…   read more


Iowa Public Radio, August 31
State officials have announced they have selected Molina Healthcare of Iowa to join the state’s Medicaid program starting next year. In an announcement Wednesday, officials said they intend to offer the California-based company a contract to be the state’s third managed care organization. It will join the Iowa two current MCOs — Iowa Total Care and Amerigroup Iowa — and is expected to start providing services in July of next year. State officials said they also intend to award…  read more


Louisiana selects Magellan for Medicaid pharmacy benefits   Becker’s Payer Issues, August 31
Louisiana intends to contract with Magellan to administer pharmacy benefits for the state’s Medicaid managed care program. The state’s health department said in a news release Aug. 30 it received proposals from Centene’s Magellan, CVS’ Caremark and MedImpact. A 14-day protest period began Aug. 31, with the contract award expected to be finalized after that.  read more


Medicaid to host provider webinars about new MCO contracts Louisiana Department of Health, August 30 
Louisiana Medicaid is hosting a series of provider webinars on upcoming changes to Medicaid’s managed care program and the potential changes in health plan enrollment for Medicaid members. All providers that file claims with Louisiana Medicaid are invited to attend. Six webinars are scheduled, but providers need only attend one of the webinars. The information shared will be the same for all webinars, focusing on the addition of a sixth health plan to the managed care…   read more


The Nebraska Department of Health and Human Services (DHHS) has announced its plan to interview each of the five bidders who responded to the state’s request for proposals (RFP) to provide Medicaid managed care services. These interviews are an optional part of the procurement process and add to each bidder’s written proposals submitted to the state. Medicaid will interview representatives from each of these five bidding companies the week of September 12.  read more


Medi-Cal is the largest Medicaid program in the U.S., covering more than 14.6 million low-income Americans as of this year. Holding a competitive procurement for commercial managed care plans reflects California’s objective to hold managed care companies and their subcontractors more accountable for high-quality care, DHCS said. With the new contracts, DHCS wants to reshape how care is delivered to Medi-Cal beneficiaries, 99% of whom will be enrolled in managed care by 2024.  read more


The Washington Informer, August 24 
The awarding of the District’s nearly $3 billion Medicaid contract remains in limbo until D.C. Mayor Muriel Bowser formally submits her recommendations for D.C.’s selected managed care organizations to the D.C. Council for approval. Managed care organizations (MCO) CareFirst BlueCross Blue Shield, Amerigroup DC, AmeriHealth Caritas and MedStar Family Choice District of Columbia each hope to be awarded the contract to serve the 230,000 residents who count as Medicaid patients. Medicaid, a federal government health…  read more


HealthcareDive, August 23 
Health policy experts have been sounding the alarm about potential coverage losses for millions of Americans, including children, when pandemic protections expire. The nation’s uninsured rate fell to a historic low of 8% in the first quarter of this year, due in large part to the suspension of Medicaid coverage terminations that has swelled the number of participants in the program. To help mitigate the disruption, the CMS issued guidance to assist states in November 2021 for…  read more


A federal judge has sided with Georgia that the Biden administration unfairly struck down the state’s Medicaid work requirements program. The ruling, issued late Friday, overturns the Centers for Medicare & Medicaid Services’ (CMS’) decision to a controversial program first approved by the Trump administration. “Despite the left’s efforts to claw back good policy for partisan politics, this week the judiciary ruled the Biden administration erred in striking down our innovative…  read more


BusinessWire, August 12 
Humana Inc. (NYSE: HUM) announced today that it will acquire substantially all of the assets of Inclusa, Inc., a Managed Care Organization (“MCO”) in Wisconsin that provides long-term care services and supports to approximately 16,600 older adults and adults with disabilities through the state’s Family Care program. For more than 20 years, Inclusa has partnered with local healthcare providers and community resources to connect members with the support and services they need.  read more


Cision PR Newswire, August 10 
Centene Corporation ( NYSE: CNC) announced today its Mississippi subsidiary, Magnolia Health Plan (Magnolia), has been awarded the Mississippi Division of Medicaid (DOM) contract. Under the new contract, Magnolia will continue serving the state’s Coordinated Care Organization Program, which will consist of the Mississippi Coordinated Access Network (MSCAN) and the Mississippi Children’s Health Insurance Program (CHIP)., August 3 
The Department of Human Services (DHS) today ​reminded all Medicaid recipients enrolled in a physical health managed care plan to select a new plan by August 16. While no consumers will lose coverage, if someone who needs to choose a new plan does not do so by the deadline, they will be auto-assigned to a new plan. “I am urging any Medicaid recipient who has not yet done so to review their options, look for plans… read more


The rate of low-income Virginians without health insurance dropped more than seven percentage points since state lawmakers voted to expand Medicaid in 2018, according to a new report from the U.S. Department of Health and Human Services. Virginia was one of five states, including Maine, Utah, Idaho and Nebraska, that extended Medicaid and subsequently recorded an increase in coverage among some of its poorest residents, researchers found.  read more


Today, the U.S. Department of Health and Human Services (HHS) released a new report showing that the national uninsured rate reached an all-time low of 8 percent in early 2022, with 5.2 million people having gained coverage since 2020, coinciding with the beginning of the Biden-Harris Administration in January 2021. The report, which analyzes data from the National Health Interview Survey and American Community Survey, shows the dramatic impact of Biden-Harris Administration’s efforts…  read more