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

• Ohio Launches Additional Anti-Fraud Initiative With A New Medicaid Data Intelligence Platform
• CMS Imposes Nationwide Six-Month Moratorium On New Hospice & Home Health Enrollment
• U.S. Health Insurance Enrollment Declined By 2.3 Million Between 2024 & 2025
• Recovery Center USA Agrees To A $15.2 Million Civil Judgment To Resolve Medicaid Fraud Allegations Related To Its Children’s Day Treatment Programs Serving Two States
• CMS Directs States To Expedite Revalidation Of High-Risk Medicaid Provider Organizations
• Maryland Limits Procedural Medicaid Disenrollment For Beneficiaries With Developmental Disabilities
• North Carolina Selects Five Regional Hub Leads For $1 Billion Rural Health Transformation Program
• Nebraska Launches Medicaid Work Requirements For Expansion Population
• Hawaii Medicaid Awards AlohaCare $180 Million Contract To Manage Adult Community Mental Health Services Through 2029
• Kentucky Launches Medicaid Reentry Coverage For Individuals Preparing For Release From State Custody
• CareSource Georgia Cuts Medicaid ABA Rates 20%
• Medicaid Member Use Of MOUD Increases to 69% 
• Pennsylvania Issues Executive Orders To Limit Disability Data Sharing & Expand Oversight Councils
• Colorado Medicaid Cuts Community Connector Rates & Annual Service Limits Amid $1 Billion Budget Shortfall
• Colorado Medicaid: New Updates To Community Connector Rate, Policy & Limits In The Children’s Extensive Supports (CES) & Children’s Habilitative Residential Program (CHRP) Waivers

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

• Saint Anthony Hospital In Chicago Now Offering Outpatient Adult Behavioral Health Services & Walk-In Therapy Appointments For Children
• Autism Learning Partners Closes New York Medicaid Panels As Reimbursement Falls Below National Benchmarks
• Zócalo Health Raises $15 Million To Scale Community-Based Care For High-Need Populations
• CMS Delays Enforcement Of Medicaid HCBS Fee-For-Service Grievance Requirements From July 2026 To December 2027
• Fostering Health

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