Medicaid

The Medicaid program is a state and federally funded public health insurance program for low-income individuals, including older adults, individuals with disabilities, children, pregnant women, and those in need of home health or long-term care services. For health and human service provider organizations operating in the Medicaid space, there are new opportunities for serving this complex consumer population, while also navigating challenges related to changes to state-specific Medicaid programs, health plans and enrolment, and new rules.

Latest Resources

• Alaska Creates New Behavioral Health Residential Care License To Address Complex Care Needs
• 26 States Sue To Block Medical Frailty Provisions In Interim Medicaid Work/Community Engagement Rules
• 44% Of New York Medicaid Home Care Agencies Report Week-Long Waits For Eligibility Evaluations
• Maryland Expands Medicaid Housing Supports To Address Homelessness & Health Outcomes
• Author Health Expands, Brings Specialized Behavioral Health Services To Pennsylvania & New Jersey
• Massachusetts et al., v Centers For Medicare & Medicaid Services
• Enrolled Alaska House Bill 73: An Act Relating To Complex Care Residential Homes & Providing For An Effective Date
• OIG Audit Finds Pennsylvania Behavioral Health MCO Failed To Meet Prior Authorization Requirements
• CVS Health Foundation Invests $2.24 Million To Expand Community-Based Care Through Health Impact Ohio
• Stop-Gap Funding Prevents Outpatient Service Cuts At Kentucky’s Lee Specialty Clinic For People With I/DD
• Florida Pediatric Group Sues State Over Medicaid Payment Rate Cuts Following ABA Transition
• Young Adults With Autism & Intellectual Disability Had Higher Health Care Costs Than Those With Autism Alone
• Medicaid, CHIP & ACA Enrollment Drops By More Than Eight Million
• CMS Revises Budget Neutrality Requirements For Medicaid 1115 Demonstrations
• Medicare Spending Projected To Continue Rising Through 2034; Medicaid & Private Insurance Growth To Slow

Florida Pediatric Group Sues State Over Medicaid Payment Rate Cuts Following ABA Transition

A large pediatric provider organization in Florida is suing the state Medicaid program in an effort to recover primary care funding it alleges was lost after the state revised Medicaid payment rates. The complaint, filed by Pediatric Associates, seeks an order requiring the Florida Agency for Health Care Administration (AHCA) to recalculate the payment rates. The organization serves about 15% of all child Medicaid beneficiaries in the state representing more than 300,000 children, according to… Read

• Maryland Medicaid Hold Continues For Select Behavioral Health Organization Enrollments Amid Ongoing Fraud Investigation
• Trillium Health Resources & Southeastern Integrated Care Launch Mobile Integrated Care Clinic In North Carolina
• Nursing Home Closure Rates Averaged 0.9% Before COVID & 1.1% During Public Health Emergency
• Wesley Glen Ministries Brings Services For Those With Developmental Disabilities To Columbus, Georgia
• Trillium Health Resources Commits $10 Million To Peacehaven’s ‘Meg’s House’ Adult Respite Home For Individuals With I/DD

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