Medicaid

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…

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…

The Trump administration is rolling out a Medicaid enrollment oversight initiative that will direct states to remove individuals who cannot verify their citizenship or immigration status. CMS said Aug. 19 it has started providing states with reports identifying Medicaid and…

CMS will not approve any new waivers for states to allow continuous enrollment for Medicaid or CHIP beneficiaries longer than 12 months.  CMS has “concerns about the appropriateness of providing continuous eligibility,” said Drew Snyder, deputy CMS administrator and director…

UCare will withdraw from 11 counties in Minnesota where it offers Medicaid plans beginning in September through the end of 2025, the company said in a statement shared with Becker’s.  The company made the “difficult decision” to withdraw from several…