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

• New York Medicaid Imposes Six-Month Moratorium On New Enrollments In ‘High-Risk’ Provider Organization Categories
• State Medicaid & Children’s Health Insurance Program Applied Behavior Analysis Toolkit
• The Economics Of Innovation
• Two Sides, Same Coin
• Alliance Health Launches AI-Powered Provider Directory Search To Help Members More Easily Find Care
• Kentucky Governor Reverses Planned 4% Medicaid Rate Cut Using $255 Million In State Surplus
• Georgia Restructures Public Behavioral Health Community Service Boards
• About Half Of Adult Medicaid & SNAP Beneficiaries Worked Full-Time In 2024, Less Likely Than Non-Participants To Have 50 Full-Time Weeks
• Wisconsin Medicaid Selects Six MCOs For Family Care & Partnership Contracts In GSR 3
• Nebraska Grants Dawson County A Temporary Exemption From Medicaid Work Requirements Due To High Unemployment Rate
• Vaya Health & Partners Health Management To Form Vaya Partners, North Carolina’s Largest LME/MCO
• Maryland Medicaid To Cut Rates For Family Caregivers Of Beneficiaries With Disabilities
• HHS Defers More Than $1 Billion in Medicaid Payments To California & Minnesota Pending Review Of High-Risk Claims For Fraud
• States With SUD IMD Waivers Report Higher Utilization Of Inpatient & Residential SUD Treatment
• Colorado Medicaid Cuts Rates By 2%, Changes Behavioral Health Safety Net Reimbursement 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

• Colorado House Bill 26-1410: 2026-27 Long Appropriations Bill
• Colorado Medicaid Provider Rate Reductions 
• CMS Is “All In” On Value
• Overview: Proposed Amendment To The Community Pathways Medicaid Waiver
• CMS Deferral Letter To California Medicaid Program Citing Program Integrity Concerns

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