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

• 24 Hour Home Care To Lay Off 738 California Employees After Medicaid MCO Discontinues Coverage Of Personal Care & Homemaker Services
• Indiana Implementing Legislation To Regulate Non-Profit Hospital Pricing
• Maryland Sues Optum & UnitedHealth Group For $380 Million Over Medicaid Behavioral Health Contract
• Nebraska Medicaid To Cover IMD Services For Serious Mental Illness
• California Medicaid To Cut Asset Limit For Certain Eligibility Groups To $21,000
• Indiana Releases $68 Billion Procurement For All Four Medicaid Managed Care Programs
• Alaska Awarded $160 Million In Federal Funding To Add Cutting-Edge Technology To Its Rural Health Transformation Program
• H.R. 1 Projected To Reduce Medicaid Home Care Enrollment 9.4% By 2034
• Behavioral Health Diagnoses & Treatment Services For Children & Youth Involved With The Child Welfare System
• 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
• 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

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

• 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

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