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

• Addressing Appropriate Access To Residential Behavioral Health Treatment For Children In Medicaid
• North Dakota Medicaid Adds Host Homes For Children With I/DD As New Waiver Service
• West Virginia To Launch PACE-Aligned Programs As Part Of Rural Health Transformation Program
• Alaska Awarded $160 Million In Federal Funding To Add Cutting-Edge Technology To Its Rural Health Transformation Program
• Louisiana To Raise I/DD Services Reimbursement By 3% On October 1, 2026
• The Autism Stats Tell It All
• North Dakota Approved Request For An Amendment To A §1915(c) Home & Community-Based Services Waiver
• California & Illinois Have Largest Dollar Exposure To New Medicaid Hospital State-Directed Payment Limits
• Child Welfare Involvement Linked To 24% Lower Emergency Department Use Among Substance-Exposed Infants
• Providence Health Plan To Exit Most Health Insurance Business Lines Starting In 2027
• Colorado Medicaid Finalizes Weekly Caregiver Limits As Part Of LTSS Cost-Containment Initiative
• Medicaid Utilization & Spending For Autism Spectrum Disorder: An OPEN MINDS Market Intelligence Report
• Arizona Medicaid Spending For Supports For Children With Developmental Disabilities Increased 150% In Last Two Years
• Arizona Medicaid Issues New Long-Term Care RFP After Terminating Prior Procurement
• Arkansas Requests Temporary Extension In Response To CMS Waiver Renewal Denial; Plans To Redesign ARHOME Medicaid Expansion Model

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

• Indiana Medicaid To Cover GLP-1 Obesity Medications Through Federal BALANCE Model
• Arizona Health Care Cost Containment System Slides For the ALTCS E/PD #YH27-0001 Request For Proposal Pre Proposal Conference 
• AmeriHealth Caritas Backs Michigan I/DD Managed Care Startup, Deon Health
• St. Vincent Behavioral Health Campus In Los Angeles, California Opens With Help From A $6 Million Investment By Health Net & Centene
• Health Plans Deny Between 12% & 18% Of Prior Authorization Requests

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