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

• Oregon Medicaid CCOs Had Mixed Financial Results & Higher Costs Due To Higher Health Care Utilization
• Maryland Health & Human Services System State Profile Report
• Maryland Medicaid System: An OPEN MINDS State Profile
• Maryland Dual Eligible System: An OPEN MINDS State Profile
• Clearing The LTSS Landscape
• CMS Issues Preliminary Guidance For Medicaid Managed Care State-Directed Payments
• Who Pays For Long-Term Services & Supports?
• Delaware Seeks New Targeted Case Management Services For Adjudicated Youth Before & After Release
• Largest Health Plans, By Estimated Enrollment Through December 2024: An OPEN MINDS Market Intelligence Report
• Pair Team Announces Nevada Expansion To Deliver Whole-Person Care For High-Risk Medicaid Members
• myPlace Health Expands Integrated Senior Care Model To South Los Angeles Area With Second PACE Center
• Half Of Children Enrolled In Medicaid & CHIP Did Not Receive A Followup Visit Within A Week of Hospitalization Or Emergency Department Visit for Suicidal Thoughts Or Behaviors
• Illinois Issues New Procurement For Medicaid HealthChoice Illinois Managed Care Contracts
• Ohio’s Peer Recovery Support Workforce Adds Over 800 Workers Between 2023 & 2025, Despite Sustainability Challenges
• WelbeHealth Announces Opening Of Two New PACE Centers, In Sacramento County & San Bernardino County, California

Arizona Proposes Medicaid Work Requirements & Lifetime Coverage Limits

The Arizona Health Care Cost Containment System (AHCCCS), which is Arizona’s Medicaid agency, is developing a waiver amendment to add work requirements, cost-sharing requirements, and to implement a five-year lifetime coverage limit based on Arizona Senate Bill 1092: Relating To The Arizona Health Care Cost Containment System that was passed in 2015. The cost-sharing requirements would be focused on discouraging non-emergency use of emergency services. “Able-bodied” adults would be subject to the lifetime coverage limit.… Read

• Connecticut Agrees To Raise Medicaid Reimbursement Rates For Community Health Centers
• Texas Hospitals Report More Than 100,000 Hospital & Emergency Department Visits By Individuals Not ‘Lawfully Present’ In The United States During State Fiscal Year 2025
• Community Health Center Association of Connecticut Petition To The Connecticut DSS For A Declaratory Ruling On Medicaid Rates For Federally Qualified Health Centers & Community Health Centers
• Dually Eligible Individuals Received 91% Of Outpatient Care From Clinical Settings Other Than FQHCs & RHCs
• 11.9% Of Mental Health Emergency Visits For Medicaid-Enrolled Youth Resulted In ‘Boarding’ In 2022

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