Medicaid

Wisconsin’s Medicaid program is projecting a $213.2 million shortfall through fiscal year 2027, driven largely by higher-than-expected enrollment in long-term managed care programs, according to a Jan. 5 report from the state Department of Health Services. The projected deficit, which…

Youth mental health has been a pressing issue in recent years. With Medicaid as the country’s largest payer for mental health services, the program’s role is all the more essential. The National Academy for State Health Policy evaluated state Medicaid…

Optum has begun reviewing Minnesota Medicaid claims as part of an enhanced prepayment audit, state officials said, as the state grapples with a widening fraud crisis in its public assistance programs. On Jan. 5, Minnesota Gov. Tim Walz said he…

Medi-Cal no longer covers GLP-1s for weight loss as of Jan. 1. Wegovy, Zepbound and Saxenda have been removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for weight loss or weight-loss indications. The…

Asset limits will return to California’s Medicaid, Medi-Cal, next year, and new enrollments are on pause for those lacking “satisfactory immigration status,” according to the state Department of Health Care Services. While income is the only factor for Medicaid eligibility…

State Medicaid agencies have made an estimated $289 million in improper capitation payments to managed care organizations on behalf of deceased enrollees since 2016, according to a series of audits from the HHS Office of Inspector General. The latest OIG…

The Board of County Commissioners in Multnomah County, Ore., approved $2.4 million Dec. 11 to partially address a $4.6 million budget gap left when the state’s largest Medicaid provider, CareOregon, rolled back spending for behavioral healthcare, according to a Dec.…

Children continuously enrolled in Medicaid had lower emergency department use, according to a study published Dec. 22 in Pediatrics. The study was led by researchers from Ann Arbor-based University of Michigan, Atlanta-based Emory University, Minneapolis-based University of Minnesota and Columbia…

The Louisiana Department of Health is extending UnitedHealthcare’s Medicaid contract through March 31, the insurer confirmed to Becker’s in a Dec. 18 statement. The state previously decided to cut the contract, which would have expired Dec. 31, thanks to an…

The One Big Beautiful Bill Act will bring sweeping changes to Medicaid beginning in 2027, while enhanced ACA premium tax credits are set to expire at the end of this year, creating uncertainty for millions of enrollees. California stands to…