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State Medicaid & Medicaid Managed Care

CURES Medicaid Implementation

As of October 2018, AAHomecare has developed the following CURES Medicaid Implementation Analysis:

States Already At Or Below Medicare Rates (6)
DC – Mississippi  –  Nevada [will be reducing to 2018 rates] –  Virginia  –  West Virginia - California
States Changing Rates to Medicare (11)
Vermont [all HCPCS] –  Montana [ll HCPCS but CRT] – Washington [all HCPCS but CRT] – Colorado [CURES codes only] –  Kentucky [Cures codes only] -Alabama [CURES codes only] – North Dakota [CURES codes only] – Connecticut [CURES codes only] – Maine [need information on which codes] – Massachusetts [need Information on which codes]  - Tennessee [Cures codes directive to MCO plans]
States Not Changing Rates (13)
Florida – Georgia – Hawaii – Michigan – Minnesota – New York – North Carolina – Ohio – Pennsylvania – South Carolina – Iowa – Texas – Indiana – Rhode Island
States Accepting Proposal on Limited HCPCS/Multi Year Roll Out (2)
Missouri - Wisconsin

States Currently Analyzing Fee Schedule and Data (10)
Oregon – Illinois – Kansas – Oklahoma – New Hampshire – Wisconsin – Nebraska – South Dakota - Alaska

**Information based on meetings and/or discussions with state Medicaid plans or State Plan Amendments filed with CMS. Listing is subject to change as further analysis occurs. States not listed have not discussed their plans or filed State Plan Amendments.  

Below you will find links to resources for engaging payers on rate negotiations and other issues. 

Please contact Laura Williard, vice president of payer relations, or David Chandler, director of payer relations, for more information. You can also follow their travels and work on Twitter, @WilliardLaura and @DavidCHME

Medicaid Category         

Medicaid Cures

  1. Federal Match for DME Expenditures & Medicaid Payment Rates Analysis-Legal Opinion from Brown & Fortunato (January 2017)
  2. CURES HCPCS-2019
  3. Cures HCPCS-2018  
  4. CURES Scorecard July 2020
  5. Cures Scorecard-Will have to be updated regularly
  6. AAH Issue Brief-DME Medicaid Cap Final (Legislative use)
  7. AAH Comments to CMS on RFI for Cures Medicaid
  8. CMS State Medicaid Director Webinar Presentation Cures Follow Up 2-26-18
  9. State Medicaid Director Letter 

11. Medicaid Cures and MCO State Comments

Medicaid Face 2 Face

  1. Medicaid Face to Face Regulation 

Medicaid (Overall)

  1. CMS Information Bulletin to States for strategies to ensure access to DMEPOS 
  2. GAO report-Medicaid Managed Care July 2018 
  3. NAMD Bailit Health Value Based Purchasing in Medicaid
Sole Source Category
  1.  White Paper