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

• 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
• WelbeHealth Announces Opening Of Two New PACE Centers, In Sacramento County & San Bernardino County, California
• 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
• Medicaid MLTSS Programs Covered 71% Of Dual Eligibles In 2022, Up From 39% In 2012
• One In Three Medicaid Expansion Adults Who Are Working Or In School Could Lose Coverage Under Work Requirements Due To Unstable Employment
• California Lessons
• OneWell Health Care Expands To Massachusetts As An Approved DDS Provider Organization
• Medicaid Coverage For Co-Occurring Chronic Pain & Opioid Addiction Varies Widely By State
• North Carolina Plans Medicaid Provider Rate Cuts If Budget Shortfall Not Addressed
• Louisiana Gained Improved Outcomes For Families, Reduced Emergency Room Visits With Medicaid MCO Value-Based In-Home Primary Care
• Northwest Kansas Area Agency On Aging Launches $6 Million Contract To Provide Administrative Case Management For Three HCBS Waivers
• North Carolina Blues To Launch Medicaid Children’s Specialty Plan In December
• Genetic Testing For Developmental Disabilities Underutilized For Children Enrolled In Medicaid
• CMS Approves Moving The Healthy Texas Women Demonstration Waiver From Fee-For-Service To Managed Care, With A Five-Year Extension

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

• Medicaid Expansion Reduced Mortality Among Low-Income Adults By 2.5% Between 2010 & 2022
• 90% Of Medicaid Expansion Beneficiaries Already Work, Are Looking For A Job, Are In School, Have A Disability, Or Have Health Issues
• EHR Strategy in a Changing Behavioral Health Landscape: A Discussion with Brian Craft, Vice President of Product, Radicle Health
• CMS Approves Arkansas 1115 Medicaid Waiver To Cover Short-Term Inpatient Psychiatric Hospital Stays
• Michigan Issues First-Time Competitive Procurement For Regional Behavioral Prepaid Inpatient Health Plan Services

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