Medicaid

The Medicaid program is a state and federally funded public health insurance program for low-income individuals, including older adults, individuals with disabilities, children, pregnant women, and those in need of home health or long-term care services. For health and human service provider organizations operating in the Medicaid space, there are new opportunities for serving this complex consumer population, while also navigating challenges related to changes to state-specific Medicaid programs, health plans and enrolment, and new rules.

Latest Resources

• Pair Team Announces Nevada Expansion To Deliver Whole-Person Care For High-Risk Medicaid Members
• myPlace Health Expands Integrated Senior Care Model To South Los Angeles Area With Second PACE Center
• Half Of Children Enrolled In Medicaid & CHIP Did Not Receive A Followup Visit Within A Week of Hospitalization Or Emergency Department Visit for Suicidal Thoughts Or Behaviors
• Illinois Issues New Procurement For Medicaid HealthChoice Illinois Managed Care Contracts
• Ohio’s Peer Recovery Support Workforce Adds Over 800 Workers Between 2023 & 2025, Despite Sustainability Challenges
• WelbeHealth Announces Opening Of Two New PACE Centers, In Sacramento County & San Bernardino County, California
• Connecticut Agrees To Raise Medicaid Reimbursement Rates For Community Health Centers
• Texas Hospitals Report More Than 100,000 Hospital & Emergency Department Visits By Individuals Not ‘Lawfully Present’ In The United States During State Fiscal Year 2025
• Community Health Center Association of Connecticut Petition To The Connecticut DSS For A Declaratory Ruling On Medicaid Rates For Federally Qualified Health Centers & Community Health Centers
• Dually Eligible Individuals Received 91% Of Outpatient Care From Clinical Settings Other Than FQHCs & RHCs
• 11.9% Of Mental Health Emergency Visits For Medicaid-Enrolled Youth Resulted In ‘Boarding’ In 2022
• Medicaid MLTSS Programs Covered 71% Of Dual Eligibles In 2022, Up From 39% In 2012
• One In Three Medicaid Expansion Adults Who Are Working Or In School Could Lose Coverage Under Work Requirements Due To Unstable Employment
• California Lessons
• OneWell Health Care Expands To Massachusetts As An Approved DDS Provider Organization

Arizona Proposes Medicaid Work Requirements & Lifetime Coverage Limits

The Arizona Health Care Cost Containment System (AHCCCS), which is Arizona’s Medicaid agency, is developing a waiver amendment to add work requirements, cost-sharing requirements, and to implement a five-year lifetime coverage limit based on Arizona Senate Bill 1092: Relating To The Arizona Health Care Cost Containment System that was passed in 2015. The cost-sharing requirements would be focused on discouraging non-emergency use of emergency services. “Able-bodied” adults would be subject to the lifetime coverage limit.… Read

• Medicaid Coverage For Co-Occurring Chronic Pain & Opioid Addiction Varies Widely By State
• North Carolina Plans Medicaid Provider Rate Cuts If Budget Shortfall Not Addressed
• Louisiana Gained Improved Outcomes For Families, Reduced Emergency Room Visits With Medicaid MCO Value-Based In-Home Primary Care
• Northwest Kansas Area Agency On Aging Launches $6 Million Contract To Provide Administrative Case Management For Three HCBS Waivers
• North Carolina Blues To Launch Medicaid Children’s Specialty Plan In December

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