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

• Colorado Medicaid: New Updates To Community Connector Rate, Policy & Limits In The Children’s Extensive Supports (CES) & Children’s Habilitative Residential Program (CHRP) Waivers
• Zócalo Health Raises $15 Million To Scale Community-Based Care For High-Need Populations
• Autism Learning Partners Closes New York Medicaid Panels As Reimbursement Falls Below National Benchmarks
• CMS Delays Enforcement Of Medicaid HCBS Fee-For-Service Grievance Requirements From July 2026 To December 2027
• Saint Anthony Hospital In Chicago Now Offering Outpatient Adult Behavioral Health Services & Walk-In Therapy Appointments For Children
• Fostering Health
• Mindful Therapy Group Expands Medicaid Participation In Washington State
• New York OPWDD Awards $8 Million Contract To Expand Supported Decision-Making Model For Individuals With I/DD
• National Health Expenditure Fact Sheet
• Medicare & Medicaid By The Numbers
• Utah Medicaid Audit Finds About Half Of $1 Billion In Nursing Facility Payments Retained As Administrative Fees
• Health Care Access For Children In Foster Care
• Idaho Restores Medicaid Assertive Community Treatment & Peer Support Services For People With Serious Mental Illness
• Indiana To Exclude Long-Stay Nursing Home Residents From Medicaid Managed Care Starting July 1, 2027
• Medicaid Foster Care Enrollment Updates, 2022-2024: An OPEN MINDS Market Intelligence Report

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

• Pennsylvania Replaces $10,000 Lifetime Assistive Technology Cap With $3,000 Annual Limit In I/DD Waivers
• California Reports Progress On 167 Developmental Service Reforms Focused On Access, Equity, Workforce & Accountability
• Memorandum Of Opinion In UnitedHealthcare Of Pennsylvania, Inc. v. Department Of Human Services
• CMS Center For Program Integrity Crushing Fraud: Annual Report 2025 January 1 – December 31, 2025
• CMS Request For Information (RFI) Related To Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH)

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