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

• The Next Generation Of Managed Care: Integrating Health & Social Care For Vulnerable Populations – A Discussion With Nestor Plana
• Arkansas DHS I/DD Supported Living Rates 23% Below Cost, Milliman Analysis Finds
• Ohio Advances Statewide MyCare Expansion With Phase 2 FIDE-SNP Rollout
• TenderHeart Advances Value‑Based Durable Medical Equipment Models Aligned With CMS Priorities To Reduce Fraud, Waste & Abuse
• U.S. I/DD Spending Reached $105 Billion In 2023, Driven By Medicaid Growth
• State Medicaid Fraud Control Units Recovered $4.64 For Every $1 Spent On Investigations In Fiscal Year 2025
• Florida Health Plan Sunshine Health Awards $100,000 In Child Care & Transportation Grants To Support Workforce Access
• Wellpoint Invests More Than $2 Million To Strengthen Community-Based Care Across Arizona
• Nevada Medicaid Issues Notices Of Intent To Award CO D-SNP Contracts To Five Health Plans
• CMS Unveils ASPIRE Pediatric Whole-Person Care Model For High-Risk Youth, Limited To Five States
• Louisiana Department Of Health Ends Medicaid Contract With UnitedHealthcare
• OIG Finds Nursing Homes Inappropriately Diagnosed Residents With Schizophrenia To Mask Misuse Of Antipsychotic Drugs
• Nebraska Audit Identifies Billing Irregularities And Potential Fraud In Medicaid Personal Care Program
• Nursing Homes’ Inappropriate Use Of Antipsychotic Drugs Poses A Risk To Residents
• Washington State Medicaid Community First Choice Offers ElliQ AI Smart Care Device For LTSS Beneficiaries

Nevada Medicaid Issues Notices Of Intent To Award CO D-SNP Contracts To Five Health Plans

Nevada Medicaid has issued notices of intent to award contracts to five health plans for its Coordination Only (CO) Dual Eligible Special Needs Plans (D-SNP) program. The selected organizations are United/Sierra Health, Centene/WellCare, Elevance/HMO Colorado-HMO Nevada, CVS/Aetna, and Prominence Health Plan. Contract negotiations are currently underway, with implementation expected to begin January 1, 2027. A CO D-SNP is a type of Medicare Advantage (MA) Plan, designed for dual eligibles, that coordinates care between Medicare and… Read

• New York OPWDD Launches Home-Enabling Supports Program To Expand Use Of Assistive Technology For I/DD Population
• Indiana To Rebid Contracts For Its Four Medicaid Managed Care Programs In A $68 Billion Procurement Expected In August 2026
• House Medicaid Fraud Probe Extends To 10 States
• Superior HealthPlan Names Cute Pediatrics As The First Rio Grande Valley Provider To Earn Foster Care Distinction
• New York Legislation & Provider Organizations Propose Medicaid Behavioral Health Carve-Out

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