Elevance Health is working to mitigate rising costs in its Medicaid business amid what executives describe as a challenging year ahead. The company reported its third-quarter earnings on Oct. 21, with senior leadership telling investors that escalating Medicaid costs, driven…
Medicaid
Trillium Community Health Plan, a Centene subsidiary, will take over PacificSource’s Medicaid population in Oregon’s Lane County, according to statements shared with Becker’s Oct. 17. In September, PacificSource decided not to renew its Medicaid contract, affecting about 92,000 people in…
Sens. Ron Wyden, Elizabeth Warren, Bernie Sanders and Raphael Warnock sent a letter Oct. 10 to Deloitte, Conduent, General Dynamics Information Technology and Gainwell Technologies probing how they determine Medicaid access. The letter comes amid broader legislation that enforces stricter…
The Rhode Island Executive Office of Health and Human Services proposed pulling back on Medicaid’s coverage of GLP-1s for weight loss, according to a budget document acquired by the Rhode Island Current. In April, the Trump administration said it will…
West Virginia may have paid managed care organizations up to $32.4 million for ineligible Medicaid participants, according to an October audit report. The audit examined payments from 2019 to 2020 and was inspired by Louisiana audits involving Aetna. MCOs get…
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The Maryland Department of Health is streamlining three Medicaid waiver programs overseen by the Developmental Disabilities Administration into a single program, according to an Oct. 6 news release. The unified waiver program aims to help those with intellectual and developmental…
Older, medically complex Medicaid beneficiaries are among those most at risk of losing coverage due to work requirements, according to a study published Oct. 1 in JAMA. A team led by researchers at Yale University in New Haven, Conn., used…
Work requirements for Medicaid eligibility are set for 2027, but states can request short-term exceptions for counties with high unemployment. By assessing county-level data in Medicaid expansion states, KFF found only 7% of counties meet the exception criteria using a…
On Sept. 25, Georgia Gov. Brian Kemp shared how CMS extended the state’s Pathways to Coverage program through 2026, despite a recent finding from the U.S. Government Accountability Office that the Medicaid work requirement program had spent over twice as…
The National Committee for Quality Assurance has named the highest-quality and most-effective health plans of 2025 based on nearly 50 factors that include patient experience and clinical performance. The ratings were released Sept. 16 and draw on 2024 data from…