Medicaid

CMS has introduced a new model to support whole-person care for children up to age 21 enrolled in Medicaid and the Children’s Health Insurance Program.  The Accelerating State Pediatric Innovation Readiness and Effectiveness Model will run for 10 years and…

CMS approved Minnesota’s plan to tackle Medicaid integrity concerns, according to a March 19 letter to the state’s Medicaid director. In January, CMS informed Minnesota of “several deficiencies” in the state’s Dec. 31 plan submission to resolve integrity concerns, which…

The Trump administration is widening its Medicaid fraud crackdown to Florida, with CMS sending a letter March 17 to Gov. Ron DeSantis and other state leaders that requests information on how the state identifies, prevents and addresses Medicaid program integrity…

A Kansas Senate bill introduced in February is aiming to broaden Children’s Health Insurance Program eligibility in the state. SB 271 strives to raise the income threshold for CHIP eligibility from 250% of the federal poverty line, removing the prior…

On March 12, Indiana Gov. Mike Braun signed a bill that would transfer nursing home residents with a stay duration of at least 100 days from Medicaid managed care to fee for service. The transitions will begin July 1, 2027.…

Medicaid spending on outpatient prescription drugs has climbed sharply in recent years even as utilization remained relatively flat and enrollment declined. A March 12 report from KFF outlines the key drivers of the increase and the early impact of new…

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…

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…