Medicaid

Minnesota’s House of Representatives passed HF3378 in a 107-27 vote March 12, which aims to grant lawmakers access to the full, unredacted Optum report on the state’s Medicaid program. Optum has been acting as a third-party auditor for Minnesota in…

New Jersey Gov. Mikie Sherrill proposed that employers with at least 50 workers on Medicaid should either cover the workers’ healthcare or pay a fine, she said in her 2027 budget address March 10. The governor said the fines would…

Ten states have still not expanded Medicaid under the ACA. If those states were to move toward expansion, 2.3 million people would secure health insurance coverage. While Medicaid expansion has long been a possibility, there is still some room for…

Montana is slated to roll out Medicaid work requirements July 1, according to a Department of Public Health and Human Services presentation on March 9. Under HR 1, Medicaid expansion states, such as Montana, must install community engagement requirements —…

Gov. Tim Walz unveiled a proposal March 10 to eliminate managed care organizations from the state’s Medicaid program and replace them with a single statewide organization. Currently, about 45% of the state’s Medicaid spending and nearly 80% of basic care…

Idaho Republican state lawmakers have introduced a bill to repeal Medicaid expansion, the Idaho Capital Sun reported March 9.  Four things to know:  1. The proposed legislation would repeal Medicaid expansion on Jan. 1, 2028, removing about 90,000 Idaho residents…

L.A Care Health Plan is the largest Medicaid managed care organization in the U.S. with nearly 2.4 million enrollees, according to KFF. KFF used CMS data reflecting enrollment totals as of July 1, 2024 across the 42 states and Washington,…

The Republican-controlled House Committee on Energy and Commerce sent letters March 3 to ten states — California, Colorado, Massachusetts, Maine, Nebraska, New York, Oregon, Pennsylvania, Vermont and Washington — requesting information on fraud, waste and abuse, as well as integrity…

Managed Medicaid plans have gone from above-target profit margins during the pandemic-era enrollment boom to aggregate underwriting losses, with early 2025 data suggesting the losses aren’t slowing, according to a February analysis from Wakely. The consulting group analyzed MCO financial…

On Feb. 25, Centene offered CMS seven Medicaid reforms that would allow managed care organizations to take the reins in targeting fraud, waste and abuse in Medicaid. The letter called on CMS to: 1. Permit proactive payment suspensions without a…