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

• Centers For Medicare & Medicaid Services Longterm Enhanced ACO Design (LEAD) Model Frequently Asked Questions
• Iowa Pharmacy Sues State Medicaid After Fraud Investigation Ends Without Charges
• Oregon Medicaid Launches Nutrition Benefits For Members With Complex Health Conditions
• California’s San Luis Obispo County Awards Crestwood Behavioral Health $4.6 Million Contract To Operate New Youth Psychiatric Facility
• Missouri Rebids Medicaid Managed Care Contracts Including Plan For Special Needs Children
• Federal Medicaid & Medicare Spending For Services Provided In Assisted Living Facilities Totaled At Least $12 Billion In 2024
• Iowa Judicial Branch Court Of Appeals Opinion In Rashid Pharmacy, P.L.C. v. Iowa Department Of Health And Human Services
• Author Health Expands, Brings Specialized Behavioral Health Services To Pennsylvania & New Jersey
• 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
• 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

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

• 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

To sign-up for monthly Medicaid alerts, you must be signed in to your account.