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

• CMS Revises Budget Neutrality Requirements For Medicaid 1115 Demonstrations
• Medicare Spending Projected To Continue Rising Through 2034; Medicaid & Private Insurance Growth To Slow
• Maryland Medicaid Hold Continues For Select Behavioral Health Organization Enrollments Amid Ongoing Fraud Investigation
• Trillium Health Resources & Southeastern Integrated Care Launch Mobile Integrated Care Clinic In North Carolina
• Nursing Home Closure Rates Averaged 0.9% Before COVID & 1.1% During Public Health Emergency
• Wesley Glen Ministries Brings Services For Those With Developmental Disabilities To Columbus, Georgia
• Trillium Health Resources Commits $10 Million To Peacehaven’s ‘Meg’s House’ Adult Respite Home For Individuals With I/DD
• Illinois Selects Six Organizations For $431 Billion HealthChoice Illinois Medicaid Managed Care Contracts
• Ohio Suspends Medicaid Payments To 57 Home Health Providers & Workers Over Suspected Fraud
• Georgia Medicaid Expansion Work Requirements Linked To Worse Mental Health Outcomes
• Kentucky General Assembly Budget Cuts Force Lee Specialty Clinic For People With I/DD To Scale Back Outpatient Services
• DOJ Opinion Reinterprets Olmstead & State Requirements To Provide Community-Based Services
• Child Medicaid/CHIP Enrollment Drops By More Than 2 Million Nationwide; Indiana Reports Largest Decline At 19.8%
• Community Behavioral Health Did Not Comply With Requirements When Denying Prior Authorization Requests Report Highlights
• Community Behavioral Health Did Not Comply With Requirements When Denying Prior Authorization Requests

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

• Department Of Justice, Office Of Legal Counsel Opinion: Application Of The Rehabilitation Act & Americans With Disabilities Act To State Institutionalization Of Patients With Severe Mental Illness Or Disabilities
• Trillium Health Resources Launches Gold Standard Certification Program For Behavioral Health Treatment Provider Organizations
• Ohio Medicaid Standardizes Behavioral Health Prior Authorization Requirements Across Managed Care Plans
• Massachusetts Medicaid To End Community Partner Program Serving 35,000 High-Need Beneficiaries
• 87% Of Medicaid HCBS Programs Cover At Least One Category Of Assistive Technology

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