The National Committee for Quality Assurance has named the highest-quality and most-effective health plans of 2026 based on clinical quality, patient experience and health plan accreditation status. The ratings were released Sept. 15 and draw on 2025 data from commercial,…
Medicaid
The California Department of Health Care Services notified Centene’s Health Net of a corrective action plan and potential sanctions Aug. 25, according to a letter shared with Becker’s. Health Net is ending the Assisted Living Facility Transitions service for Medi-Cal…
A recent audit found California did not log or return the proper federal share of overpayments determined by the state’s Medicaid Fraud Control Unit for fiscal 2023. A report from HHS’ Office of Inspector General, published Sept. 8, said California…
South Carolina failed to ensure that insurers administering its Medicaid program complied with federal requirements prohibiting stricter prior authorization limits on mental health services compared to medical services, an audit report published Sept. 8 by the HHS Office of Inspector…
The Louisiana Department of Health’s Medicaid managed care contract with Healthy Blue, formed as a joint venture between Blue Cross and Blue Shield of Louisiana and Elevance Health, will end Dec. 31. More than 290,000 Medicaid members currently have Healthy…
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Of employed adults who could be enrolled in Medicaid expansion and face upcoming work requirements, 19.8% are at risk of noncompliance due to their hours. Under HR 1, many expansion enrollees will need to work, attend school or volunteer for at least 80 hours…
Maryland Attorney General Anthony Brown has filed a lawsuit against UnitedHealth Group and Optum, seeking $380 million in damages stemming from alleged issues administering a Medicaid behavioral health program. “Marylanders in crisis and the providers who care for them rely…
Medi-Cal enrollment decreased by 730,000 members from June 2025 to March 2026. The data came from the California Department of Health Care Services. A July analysis from California Health Care Foundation Senior Program Officer Diana Camacho said overall Medi-Cal enrollment…
Arizona failed to ensure that insurers administering its Medicaid program complied with federal requirements prohibiting stricter prior authorization limits on mental health services compared to medical services, an audit report published Aug. 24 by the HHS Office of Inspector General…
Nine months after President Donald Trump announced a deal offering states discounted pricing on GLP-1 drugs for Medicaid patients, most states are declining to participate, according to an Aug. 22 Politico report. Only Indiana has publicly signed on, while 29…