Curator Our research team reads a LOT about the Medicaid space. And they highlight and summarize it for you. For FREE! All Topic Data Enrollment Finance Medicaid Managed Care Medicaid Reform Mental Health / Behavioral Health Pharmacy Providers Quality RegWatch State News Tech REFORM- State senator suggests new health system with Medicaid block grants to local governments REFORM (CA)- Health Care ‘Game-Changer’? Feds Boost Care for Homeless Americans REFORM (VT)- Vermont officials seek Medicaid benefits for incarcerated people, but federal approval could be a long time coming EXPANSION- A gradual rise, not a flood, from Medicaid expansion FRAUD, EXPANSION (NC)- Scams reported ahead of N.C. Medicaid expansion FRAUD (AK)- Alaska Medicaid fraud investigation leads to indictment for Kenai doctor and staff FWA (KY)- Oxygen Plus to pay $200,000 to resolve allegations of bilking Medicare, Medicaid FRAUD (FL)- 20 arrested, accused in $5 million Medicaid transportation scheme involving Jacksonville company TECH- Waymark Secures Additional $42M to Scale Tech-Enabled, Community-Based Care for Primary Care Providers and People Enrolled in Medicaid TECH – Gainwell Enables Breakthrough Southern Methodist University Research on Hospital Readmissions for Medicaid Diabetes Patients STATE NEWS (AZ)- Arizona seeks to cover traditional Native healing practices under Medicaid STATE NEWS (CO) – Medicaid audit finds unclear messaging, inaccuracies MCO – Elevance Health Reports $1.3 Billion Profit And Insurer Ups Forecast Once Again MCO- Medicaid Managed Care Organizations face scrutiny over prior authorization denials PHE (FL)- State Fights Medicaid Eligibility Allegations PHE (TX)- Texas extends Medicaid redetermination deadlines As Hospitals Consolidate, Medicaid Patients Have Fewer Options Arizona’s Medicaid program isn’t giving suspected fraudsters due process, critics say Molina loses anticipated Indiana Medicaid contract Dive New Hampshire seeking Medicaid contract bids Centene lays off 3% of workforce Casey Urges Medicaid Agency to Crack Down on Health Insurers Who Harm Patients by Denying Coverage of Medically Necessary Care Edgewater Systems to pay $1.25M in Medicaid claims settlement Carr: Child Behavioral Health Counselor Convicted of Medicaid Fraud FRAUD (WA)- West Richland WA couple accused of $700,000 in Medicaid fraud MCO (FL) – CareSource and Spark Pediatrics Partner to Serve Florida Medicaid Enrollees PROVIDERS (Financing)- Oklahoma Receives CMS Approval and Advances Medicaid Transformation with SoonerSelect MH/BH- Report Shows Discrepancies in MOUD Utilization Among Medicaid Enrollees EXPANSION (NC) North Carolina Expands Medicaid RX- Renalytix surges 28% on Medicaid news TECH – Instacart integrates with Medicare, Medicaid plans TECH- Optum inks operational partnership with Wisconsin health system, will hire 800+ employees States Received Enhanced Medicaid Funding During Covid Despite Wrongly Terminating Coverage TECH (IN)- Breach exposes information of 200,000+ Hoosier Medicaid members MCOS (NY)- New York managed Medicaid plan shutting down, prompting layoffs MH/BH- HHS Awards $127.7 Million to Expand CCBHC Program MH/BH- Biden-Harris Administration Announces More Than $200 Million To Support Youth Mental Health MH/BH- Joe Biden’s taking on insurers to address America’s mental health crisis REFORM- New CMMI Model Supports Health Equity in States, Shifts Care to the Community REFORM (ME)- Maine parents, providers weigh in on proposed ‘Lifespan Waiver’ REFORM (WA)- Experts discuss implementation of Medicaid MTP waiver’s component allowing for re-entry coverage for Washingtonians leaving incarceration REFORM (NC)- Medicaid pilot uses groceries to boost health, lower food insecurity REFORM (OR)- Historic Move: Oregon’s medically necessary Medicaid benefit REFORM (MO) Report: Nearly 85% maternal deaths in Missouri were preventable STATE NEWS (ID)- Idaho disability advocates stress need for more Medicaid staff, direct care workers RX (OR)- Audit finds lack of transparency in Medicaid prescription system PHE- COVID-19 Provider Relief Fund: HRSA Continues to Recover Remaining Payments Due from Providers PHE- CMS requires 30 states to pause Medicaid disenrollments after systems error PROVIDERS / FINANCE- As clock ticks toward massive Medicaid disproportionate share hospital cuts, proposed bill would bring relief SDH / TECH – Uber Eats to accept SNAP benefits for grocery deliveries in 2024 PROVIDERS (LTC)- Biden’s nursing home staffing proposal is dangerously inadequate FRAUD (TX)- Texas couple allegedly scammed Medicaid out of $14 million by fixing the same wheelchairs hundreds of times FRAUD (MN)- Ellison’s office has charged 18 with Medicaid fraud that netted nearly $10 million PROVIDERS (LTC)- “Crackdown”: Proposed Nursing Home Minimum Staffing Rule to Cost the Industry $4.23 Billion and Would Directly Impact For-Profit Facilities PROVIDERS/LTC- HHS Proposes Minimum Staffing Standards to Enhance Safety and Quality in Nursing Homes STATE NEWS- RI Medicaid call delays are New England’s highest STATE NEWs- Cameron calls for eliminating income tax, imposing Medicaid work requirements STATE NEWS (GA)- Georgia Medicaid agency asking to add oversight workers EXPANSION (NC)- Medicaid expansion delayed because of no final budget MCOs (MI)- Michigan to rebid contracts for health plans under Medicaid and MIHealthyLife MCOs (LA)- State officials scrutinize BCBS Louisiana sale to Elevance MCOs (GA)- CareSource Georgia rolls out mobile clinics to help Medicaid recipients maintain health coverage FWA (CA)- Office of Public Affairs | Health Care Provider Agrees to Pay $5 Million for Alleged False Claims to California’s Medicaid Program FWA (MN)- Charges filed against 18 people in alleged $9.5 million Medicaid caregiver fraud case WA (MI)- Eastern District of Michigan | Michigan Doctor to Pay $6.5 million to Resolve False Claims Act Allegations FWA (CT)- District of Connecticut | Somers Man Pleads Guilty to Charge Stemming from Medicaid Fraud Scheme Justice FWA (NY)- DiNapoli: Three Arrested in Connection With Over $1 Million Medicaid Transportation Fraud Scheme FWA (DC)- District of South Carolina | Greenville Woman Pleads Guilty to Making Fraudulent Statements to Medicaid in Connection with the Delivery of Autism Spectrum Disorder Services PHE- Florida Medicaid eligibility: Lawsuit seeks to halt state from terminating some residents’ benefits PHE- Arkansas Medicaid recipients share concerns with federal and state officials PHE- HHS Moves to Restore Medicaid Coverage to 90,000 in Texas (Correct) RX- Oregon audit finds lack of transparency in Medicaid prescription system RX- Walgreens must face Medicaid fraud lawsuit over hepatitis C drugs, says appeals court REFORM- Georgia Medicaid program with work requirement off to slow start even as thousands lose coverage REFORM- MDHHS seeks bids for pilot to provide incentives to Medicaid enrollees who meet substance use disorder recovery goals REFORM/EXPANSION- Medicaid expansion failing rural hospitals TECH- Data breach exposes personal information of more than 700,000 Medicaid clients in Indiana MCOs-Ohio Medicaid rejects Mercy Health’s request to have members changed from Anthem plan MCO- Congressman Launches Investigation into Medicaid Prior Authorization Denials FWA- Audit: LDH paid millions of dollars on behalf of Medicaid recipients who didn’t appear to live in La. OP-ED (FWA)-Medicaid’s Dark Money STATE NEWS (NY) = Migrants, Medicaid, and More: NY’s Widening Budget Gap – Empire Center for Public Policy FWA- District of Connecticut | Former Southeastern Connecticut Counselor Pleads Guilty to Health Care Fraud and Kickback Charges FWA-Bolingbrook woman filed $2.5 million in false Medicaid claims FWA-Worcester dental office manager sentenced for Medicaid fraud FWA- Eastern District of Louisiana | Destrehan Man Pleads Guilty to $11.4 Million Medicare and Medicaid Fraud Scheme FWA- Mississippi couple to pay over $315K after submitting false Medicaid forms MCOs- The Hidden Fee Costing Doctors Millions Every Year Are Medicaid cuts heartless? Republicans aren’t villains for right-sizing it after COVID. PHE- Got Insurance? You May Be on Medicaid Too STATE NEWS (CA)- This is reform? California wants to let its billionaires go on Medicaid REFORM- Home Visits With A Registered Nurse Did Not Affect Prenatal Care In A Low-Income Pregnant Population RX- Medicaid Drug Proposal Sets Up Likely Constitutional Challenge CMS Issues Proposed Rule Regarding Medicaid Drug Rebate Program PHE- Biden administration warns states as millions lose Medicaid Feds Say Hospitals That Redistribute Medicaid Money Violate Law | California Healthline Human Services Department Announces Intent to Award Medicaid Contracts Carter, Dunn introduce Medicaid Staffing Flexibility and Protection Act STATE NEWS (NC)- Medicaid gives NC district free school meals FWA (AK)- Anchorage assisted-living home operator charged in Medicaid fraud case FRAUD (NC)- Attorney General Josh Stein Announces $1.9 Million Medicaid Settlement with Cary Lab FRAUD (VT)- Attorney General Investigating Brattleboro Retreat for Medicaid Fraud MCOs- Elevance Health reaches $1.9B in profits in strong Q2 Elevance rebrands Amerigroup segment as Wellpoint MCO- Centene aims to enroll back some lost Medicaid members State News (NJ, DE) – Nemours may exit NJ Medicaid STATE NEWS (CA)- Industry groups in California vie for new Medicaid money FWA (CA)- Pain clinic chain to pay $11.4M to settle Medicare and Medicaid fraud claims FWA (KS)- AG’s Medicaid fraud unit recoups $42,000 in restitution FWA (TX)- Texas Attorney General’s Medicaid Fraud Control Unit Helps Secure 49-Month Sentence and Over $5 Million Restitution in Orthopedic Supplies Fraud Case FRAUD (OH)- Valley doctor gets probation, ordered to pay $75K for Medicaid FWA (NC)- Former Charlotte housing provider sentenced in $15M Medicaid fraud scheme FRAUD (VA)- Audit finds Virginia paid nearly $22 million for dead Medicaid patients FWA (MD)- Maryland Physician Sentenced In Felony Medicaid Fraud Investigation FRAUD (CT)- DCJ: Former East Hartford man accused of defrauding CT Medicaid FWA (MA) – MedStar Ambulance pays $2.6 million in false Medicaid billing case TECH (LA)- Medicaid ID cards are available on LA Wallet REFORM (?)- Walmart has major new discount for SNAP, SSI, Medicaid recipients REFORM- States Renew Push for Medicaid Work Requirements REFORM – Where the government draws the line for Medicaid coverage leaves out many older Americans who may need help paying for medical and long-term care bills REFORM- Hospitals ask Congress (again) to delay ACA Medicaid funding cuts REFORM (KY)- GOP nominee says he would renew push for Medicaid work requirement if elected governor in Kentucky EXPANSION (GA)- Georgia Medicaid program aims to expand access to benefits for those in need EXPANSION (NC)- N.C. governor sets Medicaid expansion date, pressuring Republicans to act STATE NEWS (FL)- Judge rules against state on children in nursing homes STATE NEWS (NC)- NC House Democrats criticizes budget delay. Final plan may be weeks away. STATE NEWS (NJ and DE) – N.J. giving Delaware hospital $20M to cover kids on Medicaid, but there’s no guarantee it will PHE- Florida one of two states declining waivers to help with Medicaid unwinding PHE- This Little-Known Corporation Is Making a Fortune Kicking People Off Medicaid PHE- CMS: Marketplaces are ready to be ‘landing spot’ for those losing Medicaid coverage REFORM (PROVIDERS)- What Share of Nursing Facilities Would Meet Possible New Staffing Requirements? REFORM (PROVIDERS)- Provider group seeks 2-year moratorium on HCBS settings rule enforcement REFORM- DACA recipients’ Medicaid eligibility slammed by U.S. House Republicans REFORM (MT)- A plan to cut Montana’s Medicaid waiting list was met with bipartisan cheers. Then a veto. FWA (NY)- Pharmacy owner and manager accused of stealing millions from Medicaid FWA (MD) -Owner of Health Care Company Pleads Guilty to Federal Charge for Conspiracy to Commit Health Care Fraud STATE NEWS (WA)- CMS approves Washington’s Medicaid Transformation Project waiver extension request for five more years MCOs- Elevance (Anthem) Earnings: 2023 Outlook Increased Despite Utilization and Medicaid Redetermination Trends STATE NEWS (NC)- State officials delay rollout of specialty Medicaid plans — again STATE NEWS (MS) Presley announces health care plan, takes shot at Medicaid chief PHE (CMS)- Medicaid unwinding paused in some states as CMS finds violations STATE NEWS (ID, MCOs)- Idaho looks to restructure Medicaid funding. But clear answers are hard to find STATE NEWS (TX)- ADA Admits Report Comparing State Medicaid Reimbursement Rates with Private Insurance Is Flawed STATE NEWS (OR)- Oregon expands free health insurance for low-income residents – regardless of immigration status STATE NEWS (MD)- Maryland Medicaid expands benefits to include community violence prevention, pregnancy care for non-U.S. citizens STATE NEWS (NC)- Medicaid tailored plans delayed again by state REFORM – Medicaid and Emergency Room Use REFORM (OH)- Ohio to seek work requirement (again) for Medicaid enrollees MCOs (FL)- State modifies Medicaid procurement, answers 520 questions MCO News – A Closer Look at the Five Largest Publicly Traded Companies Operating Medicaid Managed Care Plans FWA (VA)- Chester woman sentenced by DOJ for Medicaid, healthcare fraud FWA (VA)- Health Connect America Gets Fined $4.6M for Wrongful Billing of Medicaid PHE (MCOs)- Molina, Elevance Health Medicaid membership grew by over 50% during continuous enrollment TECH- Medicaid security breach affects over 2,600 Arizonans, agency says RX- Antipsychotic Medication Use In Medicaid-Insured Children Decreased Substantially Between 2008 And 2016 MCOs (ID)- Idaho awards $1.2 billion contract for behavioral health. Both losing bidders sue MCO NEWS (FL)- State won’t answer Medicaid procurement questions until after July 4 holiday STATE NEWS (NH)- Adults on Medicaid now have dental benefits. Many can’t get appointments. REFORM (GA)- Georgia’s push for work requirements on some Medicaid coverage set to start STATE NEWS (PA)- PA to Provide Health Care to the Homeless by Expanding Medicaid Coverage for “Street Medicine” EXPANSION (NC)- Is Medicaid expansion in trouble? Cooper urges lawmakers to separate expansion from state budget. FWA (RI/NY)Nursing home chain owners charged with stealing $83M in Medicaid money FWA (MI)- Medicaid Fraud Investigation Turns Up Two in Michigan City FWA (IN) – Columbus nurse charged in nationwide health care fraud investigation FWA (TX)- Texas Attorney General’s Medicaid Fraud Control Unit Helps Take Down $6.9 Million Medicaid Fraud Scheme FWA (NV)- Nevada Medicaid fraud case ends in probation, $110,000 in restitution ordered OP/ED- Despite Rising Costs, Big Health Insurers Should Do Just Fine TECH – Startups Should Stop Being Afraid of Innovating the Medicaid Space, Exec Says STATE NEWS (WA)- State to continue Medicaid waiver for five years STATE NEWS (TX)- Governor explains why Medicaid coverage of doulas was vetoed from budget STATE NEWS (OR) – Search launches for new head of Oregon Health Authority STATE NEWS (NC) – Officials give update on tailored Medicaid plans STATE NEWS (MT) – OPI to use Medicaid data for school meal programs STATE NEWS (AZ/TRIBAL NATIONS)- Navajo Nation declares widespread Medicaid scam in Arizona a public health state of emergency FWA (CT)- Brookfield Counselor Sentenced to 30 Months in Federal Prison for Defrauding Medicaid of More than $1 Million FWA (PA) Former physician’s assistant from Altoona charged with $40k Medicaid fraud EXPANSION (SD)- Medicaid expansion in South Dakota begins July 1 STATE NEWS- California poised to spend $19 billion on Medicaid and other health care programs PHE- The $74,000 Question: Cancer, Medicaid and the Urge to Purge the Rolls PHE- Medicaid disenrollment is happening faster than anyone thought, says former Medicaid deputy director PHE – More than 1 million dropped from Medicaid as states start post-pandemic purge of rolls MH/SA- Many Medicaid patients lack access to opioid addiction treatment OP/ED- An Idaho Without Medicaid MCO NEWS (KS)- Blue KC, partners will compete for $3.9B Kansas Medicaid contract OP/ED- Texas Was Right to Reject Medicaid Expansion MCOS- Iowa Medicaid contract triggers legal action over alleged conflicts of interest EXPANSION- NC will get $1 billion Medicaid expansion ‘bonus,’ but there’s disagreement on how to spend it PROVIDERS- Montana governor boosts Medicaid payments for health care providers by hundreds of millions RX- Inflationary Rebates for Generic Drugs Offset Medicaid Spending RX- 340 B Medicaid MCO Duplicate Discount Confusion and HHS TECH- Colorado Medicaid members’ data may have been stolen in cyberattack TECH Personal data for 233,000 Iowa Medicaid members compromised in cyber attack FINANCE- CMS Office of the Actuary Releases 2022-2031 National Health Expenditure Projections PROVIDERS- The Supreme Court Delivers an Unexpected Win for Medicaid Recipients PHE- Biden administration urges states to slow down on dropping people from Medicaid PROVIDERS (KY)- Beshear increases Medicaid reimbursement rates for home and community-based services and long-term care facilities PHE- Fiscal Implications for Medicaid of Enhanced Federal Funding and Continuous Enrollment FWA (NY)- NY brings fresh allegations of a for-profit nursing home “pocketing” Medicaid funds FWA (OH)- Owner of Eye for Change sentenced in $3.4M Medicaid fraud FWA (NC)- Eastern District of North Carolina | Fayetteville Cardiologist Agrees to Pay Over $5 Million to Resolve Allegedly False Medicare and Medicaid Claims MCOs (ID) – Idaho looks at farming out Medicaid MCOs (OK)- OHCA Selects Organizations to Assist in Serving Oklahoma Medicaid STATE NEWS (TN) Tennessee to be the first to offer diapers through Medicaid: Here’s what to know PHE- Early numbers show nearly 70% of Oregonians keep Oregon Health Plan benefits in first round of renewals STATE NEWS (CNMI)- CNMI Medicaid to limit, reduce, or suspend services RX- Biden-Harris Administration Announces Proposal to Advance Prescription Drug Transparency in Medicaid FWA (GA) Atlanta man, healthcare provider indicted on Medicaid fraud FWA (NC)- Attorney General Josh Stein Reaches $150,000 Medicaid Fraud Settlement with Rockingham Health Care Provider FWA (KY) – Boyle County woman pleads guilty to Medicaid fraud 3 Memphis women indicted in TennCare fraud scheme FWA (MS) – Mississippi man sentenced for $1.4 million in fraudulent medical charges EXPANSION (NH)- House Finance Subcommittee Wants to Hold Medicaid Expansion Bill for a Year TECH – CSG Government Solutions Selected by the Department of Vermont Health Access to Provide IV&V for the Medicaid Enterprise System Modernization Project PROVIDERS (WA)- Washington Ambulance Companies Faring Better After Medicaid Boost CMS NEWS- CMS-proposed HCBS rules elicit request for extension of comment period from 5 associations PHE/ RTNO (FL) 250,000 Florida residents kicked off Medicaid; more expected PHE/RTNO (AR) – Medicaid Redetermination, Sanders’ Healthcare $$$ Plans & AI for Mental Health PROVIDERS (NH)- Senate Finance votes to reduce Medicaid payment increase for providers by $15 million PROVIDERS (RI)- Medicaid and leadership challenges, as state takes over nursing home MCOS (TX)- Bonnen’s Deal To Prioritize Profit In Medicaid Coverage OP ED (PHE) – Why is Medicaid still treating COVID-19 as a public health emergency? FWA (PHE)- Phone scam targets New Yorkers enrolled in Medicaid amid renewal push. What to know EXANSION (NC)- NC Senate budget: Where does Medicaid expansion stand IL to Spend $1B on Medicaid for Undocumented Seniors PROCUREMENTS (FL) – State prepares for Medicaid dental procurement FWA (AR) Governor Hobbs Announces Actions Against Fraudulent Medicaid Providers FWA (TX) – Paxton’s Medicaid Fraud Control Unit Helps Secure Swift Conviction of Healthcare Marketer for Illegal Kickback Scheme FWA (SC) – South Carolina autism clinic director indicted by federal jury for allegedly defrauding Medicaid out of thousands REFORM- The US debt ceiling negotiations could hinge on Medicaid work requirements REFORM- Biden-Harris Administration Takes Action to Help Schools Deliver Critical Health Care Services to Millions of Students New resources and proposed regulations REFORM – Biden refuses to accept work requirements for Medicaid in GOP debt ceiling talks REFORM- Debt Breach Risks $71 Billion in Medicare, Medicaid Pay Delays PHE/RTNO (WV) – SNAP work requirement, Medicaid redetermination to restart in West Virginia REFORM- CMMI Describes Progress on Addressing Health Equity PHE (AR)- Arkansas disenrolls 44,667 extended Medicaid beneficiaries; 72,802 total CHINA REPORTS ON MEDICAID- ‘I can neither afford commercial insurance nor get Medicaid benefits’ – CGTN (China Global Television Network) PHE- Up to 500,000 at risk as Georgians must requalify for Medicaid STATE NEWS (IL) – Expected cost for Illinois’ noncitizen health care program hits $1.1B PHE – Medicaid work requirements may result in 1.7M in coverage losses PROVIDERS (VA)- Judge scraps federal assent to Virginia Medicaid rule RX- Lilly ordered to pay millions more in False Claims Act case FWA (CT)- Connecticut Psychologist Pays $658K to Settle Allegations She Received Payments from Medicare and Medicaid for Services Not Provided FWA (CT) Hartford Woman Charged With Stealing Medicaid Benefits FWA (KY) – Kentucky companies pay $1.7M to settle fraud Medicaid claims MCOs (VA)- Virginia Premier Medicaid members shifting to Optima Health PROVIDERS (NC)-Medicaid expensive for free clinics STATE NEWS (FL)- Florida will reject Medicaid coverage for immigrants STATE NEWS (NV)- Expanded hospital tax could boost Medicaid rates, fund behavioral health services STATE NEWS (CO)- Parents still battling Medicaid over in-home nursing care for kids STATE NEWS (ME)- Tackling a Long-Standing Financing Issue in MaineCare STATE NEWS (NY)- Budget deal increases state-share Medicaid spending by 13 percent REFORM- Blue states put the brakes on health care for undocumented immigrants REFORM- Viewpoint: Federal Medicaid work requirements are unconstitutional REFORM- CMS proposes national standards for Medicaid and CHIP REFORM- GOP candidates discuss Medicaid work requirements in debate OP-ED- Don’t expand Medicaid to noncitizens PHE- Cleaning Up Medicaid Rolls After COVID OP ED- Medicaid Expansion Won’t Stop Rural Hospital Closures GAO Makes MACPAC Appointments, Designates Vice Chair MH/BH- How to Protect Integration Progress As Medicare-Medicaid Plans Sunset STATE NEWS- Copays no longer required for Mississippians on Medicaid STATE NEWS- Nevada Medicaid gets $2.5 million to expand dental services for the disabled STATE NEWS- Tentative deal would raise Medicaid spending in New York FWA- California physician pays $24M to settle Medicare, Medicaid overbilling allegations FWA (TX)- Investigation by Paxton’s Medicaid Fraud Control Unit Leads to 60-Month Prison Sentence for Home Health Care Fraudster and Over $3 Million in Restitution FWA (TX)- MCO overpaid durable medical equipment vendors by more than $18,000 FWA (AR)- Hospital agrees to pay $1.1 million in Medicaid fraud settlement FWA (MO)- Former Missouri pharmacy owner pleads guilty to paying kickbacks for prescriptions FWA (NH)- Kyle Perkins Indicted for Medicaid Fraud FWA (NY)- Two Pharmacy Owners Charged with $29M Health Care Fraud Scheme FWA (NY)- Real Estate Investor Convicted Of Defrauding Government Rental Assistance And Medicaid Programs FWA (NY)- Fraud Week: NY Transportation Company Owners Jailed, Fined FWA (PA)- Former Philly city worker found guilty of Medicaid fraud FWA (PA)- Case Update: Bradford County Nurse Practitioner Sentenced to 10 Years of Probation for $450K in Prescription Fraud FWA (NC)- Greensboro clinic owner indicted in 4.7M fraud scheme MH/BH (OR)- Oregon pays Medicaid mental health providers relatively well, OHSU study finds MCOs (RI) – Sen. Ujifusa introduces bill to audit Medicaid middlemen MCOs (FL)- AHCA releases invitation to negotiate for Statewide Medicaid Managed Care Program MCOs (GA) Georgia Medicaid insurer denied psychotherapy for thousands PROVIDERS (NY)- Zocdoc Adds FQHCs to Marketplace To Support Medicare, Medicaid Beneficiaries REFORM (fed)- GOP eyes new work requirements for millions on Medicaid, food stamps FWA (fed)- Comer Requests GAO Review Improper Payments in Medicaid Program FWA (GA)- Special Medicaid Funds Prompt Oversight Concerns FWA (NY)- Berks personal care agency accused of getting $488,000 in Medicaid-billing scheme FWA(AR)- An Arkansas psychiatrist held patients against their will and fraudulently billed Medicaid to the point it skewed the state’s data, investigators say FWA (TX)- Paxton’s Office Investigates and Successfully Prosecutes Woman Who Attempted to Defraud Medicaid of Over $615,000 MH/BH – Few Americans on Medicaid receive residential treatment for opioid addiction RX (NY)- DiNapoli: State missed out on more than $180 million in Medicaid drug rebates FWA- Advanced Bionics Must Pay $12.6 Million to Settle Medicaid Fraud Allegations EXPANSION: Cooper signs North Carolina Medicaid expansion bill REFORM- Prescription for housing? California wants Medicaid to cover 6 months of rent REFORM- Why Medicaid is ‘ripe for innovation’ How Louisiana plans to spend $196M during Medicaid redeterminations TECH- House moves toward using Medicaid data to enroll families in free and reduced-price lunch program PROVIDERS (NH)- ‘We’re teetering on the edge.’ Are Medicaid rates making it harder to age at home? Safety-net providers sue to stop Medicaid carveout RX- Another Voice: Medicaid pharmacy program reform is greatly needed FWA- If the government cut Medicare fraud, it wouldn’t have to cut Medicare MCOs- UPMC Review Confirms PA Medicaid as National Model for Behavioral-Physical Health MH/BH- SAMHSA Gives $1M to 15 States Competing for Spot in CCBHC-Medicaid Demonstration FWA (NY)- Schenectady ambulette service pays $800K over Medicaid fraud FWA- Northern District of Ohio | Jury Convicts Pair of Fraud and Health Care Fraud in Toledo FWA- Queens Man Sentenced To 121 Months In Prison For Laundering Millions Of Dollars Of Fraud And Hacking Schemes And Committing Bank Fraud FWA- Man Pleads Guilty to $1.9M Baby Formula Fraud Scheme FWA- Massachusetts officials find $2.7 million fraudulently obtained SNAP, TAFDC, EAEDC benefits FWA- Social security numbers of 4.2million Americans exposed in breach of Miami healthcare system Leader Of $8 Million Medicaid Fraud Scheme Sentenced To 95 Months In Prison EXPANSION- Medicaid agreement in North Carolina closes in on passage REFORM- Republicans take aim at Medicaid as budget talks heat up STATE NEWS (MS)- Medicaid to provide less than expected for Mississippi hospitals MCOs (NM)- State was prepared to notify providers on Medicaid contracts before canceled procurement MCOs (IN)- Centene comes up short on new Indiana Medicaid contract PHE- How Aetna is using CVS stores to warn members about Medicaid redeterminations REFORM- How Medicaid Managed Care Orgs Can Better Invest in SDOH Interventions FWA (MO)- Moberly doctor pleads guilty to defrauding Medicare, Medicaid FWA (MA) -Lab charged with Medicaid fraud FWA (FL) – Jelly Bean Communications Design and its Manager Settle False Claims Act Liability for Cybersecurity Failures on Florida Medicaid Enrollment Website FWA (IL)- Hoffman Estates doctor charged with faking Medicaid, insurance claims FWA- How Medicare and Medicaid fraud became a $100B problem for the U.S. EXPANSION- Medicaid Expansion Fails to Deliver on Promises EXPANSION- Medicaid expansion recognized as significant missed opportunity PHE- Google search update aims to ease Medicaid redeterminations STATE NEWS (MT) – Amendment to fund Medicaid provider rates to benchmark fails PHE; STATE NEWS; FWA- Auditors find hundreds of ineligible RI state workers on Medicaid rolls PHE- Arizona House’s Health Committee approves bill to shorten Medicaid redeterminations by three months, despite concerns over condensed timeline REFORM- CMS Proposes to Implement Changes to Medicaid DSH Calculations MCOS- Lujan Grisham intervenes in Medicaid procurement process | NM Political Report MCOs- CareSource partnering with Walmart on new benefits for CareSource Medicaid members STATE NEWS- State plan to shift Medicaid expenses would cost St. Lawrence County taxpayers $3.8 million STATE NEWS- Insider named director of Medicaid, which serves nearly 1.5 million Oregonians STATE NEWS (PA)- Despite major Medicaid boost, lack of staff still limits nursing home admissions STATE NEWS (MT)- House Human Services advances bill to fully fund Medicaid rates in Guidehouse study FWA- CT psychologist who submitted false Medicaid bills totaling over $148K gets prison FWA- Man from Oklahoma pleads guilty to Medicaid fraud FWA- Investigation by Paxton’s Medicaid Fraud Unit Results in $1.1M in Restitution to Health Care Programs FWA- Missouri should refund $34 million in Medicaid payments, federal agency says FWA (AR)- doctor’s Medicaid billing suspended after fraud allegations FWA- South Plainfield health care provider ordered to repay $1 million in Medicaid overpayments REFORM (SD) – Work requirement resolution for expanded Medicaid recipients killed in committee REFORM- Medicaid Buy In, Other Health Legislation Advances During Saturday Session STATE NEWS (RI); SDH- Activists, legislators hope Medicaid, ‘Pay for Success’ can help alleviate the housing crisis in Rhode Island REFORM- Trump’s Former Budget Director Is Advising GOP to Cut Medicaid by $2 Trillion REFORM- U.S. to Allow Medicaid to Pay for Drug Treatment in Prisons MH/BH- A Look at Substance Use Disorders (SUD) Among Medicaid Enrollees PHE- More than 60% of Adults Unaware of Medicaid Eligibility Redetermination MCOs- CareSource, HAP’s joint venture to expand Medicaid coverage RX- Medicaid, with planned payment pilot, girds for influx of pricey gene therapies FWA- Stacey Hayes Arrested for Medicaid Fraud FWA- Detroit man, 47, gets 2-20 years in prison for Medicaid fraud FWA (NY)- Show me the money. Years later, NYS Medicaid overpayments still not recovered PHE; STATE NEWS (NH)- Fiscal Committee Votes to Accept $51.5M in Federal Medicaid Money STATE NEWS (FL)- Senate panel Ok’s bill exempting Medicaid patients with mental health disorders from ‘step therapy’ STATE NEWS (OH)- Ohio Home Care Agencies to Seek Boost in Medicaid Reimbursement Rates in Biennial State Budget REFORM; SDH- A Look at Recent Medicaid Guidance to Address Social Determinants of Health and Health-Related Social Needs PHE (OH)- Women, Chronically Ill Shielded as Oklahoma Medicaid Checks Near REFORM- Are Medicare and Medicaid too bloated to survive without changes? REFORM- Chuck Schumer Vows No Cuts To Medicaid Amid Debt Limit Fight REFORM- How vulnerable is Medicaid in the debt ceiling battle? REFORM- Sanders announces proposed work requirement for Arkansas’ Medicaid expansion program REFORM- Bill could make Iowans with cars, savings ineligible for SNAP, Medicaid PHE- Maximus eyes growth as states restart Medicaid initiatives MCOS- Molina expects contract wins to offset Medicaid losses RX- U.S. proposes Medicare, Medicaid programs to cut drug costs, including $2 generics TECH- New Mexico Awards Contract for New Medicaid Management DUALS- Two New Reports Provide an Overview of the 12.5 Million People Enrolled in Both Medicare and Medicaid REFORM- County governments in NY push back on Medicaid shift REFORM- Medicaid on groceries? ‘Food as medicine’ programs to cut medical costs MCOS- Big payers ranked by Medicaid membership MCOS/PHE- The Role of Medicaid Managed Care Organizations in the PHE Unwinding STATE NEWS/ENROLLMENT- Mark Farrah Associates Assessed Medicaid Market Share in Texas PROVIDERS- Dental care rose among low-income pregnant women after 2015 Medicaid change MH/BH- Hundreds of thousands of Medicaid patients seek mental health care in emergency rooms FWA- Tennessee Medicaid pursues felony charges against some members FWA- The Pill Club reaches $18.3M settlement for alleged Medicaid fraud in California FWA- NY OMIG Finalizes Omnibus Regs Impacting Medicaid Providers’ and Plans’ Compliance Obligations MEDICARE/FWA-Public Health & Policy Reading Room | CMS Rule Means Medicare Advantage Plans Will Pay Back Billions in Overpayments REFORM- California prison inmates to get some Medicaid care REFORM- RUSH, CVS Health Launch ACO Targeting Health Equity for Medicaid Members REFORM (SD)- Medicaid work requirement proposal passes South Dakota House committee REFORM (IA)- House panel advances bill to change who qualifies for SNAP, Medicaid RX- Medicaid commission calls for flexibility in drug coverage TECH- CMS Improves Medicaid Reimbursement for Digital Health Consults MCOS- Human Services Department to cancel procurement process for the selection of managed care organizations to deliver Medicaid services Town Hall Ventures’ Andy Slavitt on how to invest in Medicaid DENTAL- Utah bill proposes expanding dental care coverage to adults under Medicaid PROV- Without 20 percent Medicaid boost, state’s providers say bed reductions will continue MEDICARE- CMS Issues Final Rule to Protect Medicare, Strengthen Medicare Advantage, and Hold Insurers Accountable ENROLLMENT- CMS releases latest enrollment figures for Medicare, Medicaid, Children’s Health Insurance Program (CHIP), and ACA Marketplaces MCOS- Centene will pay Indiana $66.5 mln to settle Medicaid overcharge allegations PHE- Alaska is scrambling to clear a monthslong food stamp backlog as major Medicaid change looms FWA- Father, daughter get near identical sentences in Medicaid fraud scheme FWA- Eastern District of North Carolina | Illinois Medical Device Manufacturer Agrees to Pay $500,000 to Resolve Allegedly Fraudulent Medicaid Claims FWA- NY Comptroller audit reveals months totaling billions in improper Medicaid payments Expansion (MS)- Every Medicaid expansion bill dies without debate or vote RX- Medicaid Net Drug Spend HIts Double-Digits for the First Time, Says Magellan Rx Report TECH- Insurers, states can now text Medicaid beneficiaries MCOs- Elevance Health Reports $949 Million Profit Thanks To Medicaid Enrollment Growth FWA (KS)- Johnson Co. woman ordered to pay $31K in restitution for Medicaid Fraud FWA (PA)- Three Montgomery County dentists bilked Medicaid for millions, a federal indictment says FWA (MN)- In-home care provider investigated for $4M in Medicaid fraud FWA (NH)- Nashua man indicted on Medicaid fraud charges FWA (MA)- DePuy Synthes, Inc. Agrees to Pay $9.75 Million to Settle Allegations Concerning Kickbacks Paid to Massachusetts Orthopedic Surgeon FWA(MA): Mother of disabled young man collected more than $120K while he was in jail, group home REFORM; STATE NEWS- Why One State Is Pushing Back Against Medicaid’s IMD Exclusion REFORM- RI Legislators Want to Use Medicaid Waiver Funds to Provide Homeless With Housing STATE NEWs- Governor, Ohio Medicaid launch maternal care program MCOS; STATE NEWS- State dodges questions about Medicaid procurement during latest update PROVIDERS- Hospitals Face Significant Medicaid DSH Cuts This Year EXPANSION- Georgia won’t take up full Medicaid expansion anytime soon, lawmakers say MH/BH; STATE NEWS- Human Services Department announces Behavioral Health Day at New Mexico Legislature on January 25 MH/BH; RX- California Medi-Cal Contracts With Pear to Treat Stimulant Use Disorder PROVIDERS; LTC- ‘A ticking time bomb’: NY nursing homes push for Medicaid rate increase PROVIDERS (OP-ED); FINANCE- 72% of Private Practice Dentists Plan to Raise Fees This Year, Will Texas Do the Same for Medicaid Dentists With $32.7 Billion Extra in the Kitty? MH/SUD- How State Medicaid Programs Address the Behavioral Health Workforce Shortage TECH- Chances of State Medicaid Programs Bringing Telehealth Services Into ‘23 are High MCOS- Connecticut Bucks the Medicaid Managed Care Trend MCOS- Illinois Medicaid contractor Centene Corp. under federal scrutiny after report Illinois YouthCare program failed foster kids with ‘unacceptable’ medical care MCOs- Highmark Wholecare boosts Medicaid membership by over 70,000 MCOS; FWA; MEDICARE- Insurers Are Fighting To Protect Their Medicare Fraud MEDICARE- CMS data: Medicare Advantage tops 30M STATE NEWS- Key Roles Filled for WDH Healthcare Financing Division – Wyoming Department of Health STATE NEWS- Texas Medicaid: Pediatric formula prior authorizations FWA- Ob-gyn can keep $205,000 in Medicaid pay that state tried to recoup FWA- Birmingham company to pay $153,300 on false Medicaid claim allegations FWA- Healthcare billing fraud: 13 recent cases FWA- $6.2 million in benefit overpayments recovered during first quarter of fiscal year FWA- Buffalo man sentenced to one-year probation, defrauded Medicaid of thousands PHE- Navigating the New FMAP Glidepath – FMAP Changes in the Consolidated Appropriations Act of 2023 MCOs, CA- Medi-Cal adds more insurance plans after pushback MCOs; PayVider- JPM23: CVS weighs next steps in its primary care ambitions FWA NC- Charlotte man convicted in multimillion-dollar Medicaid scheme FWA- District of South Carolina | Greer Man Sentenced in Multimillion Dollar South Carolina Medicaid Scheme FWA MS- Mitias to pay $1.87 Million to settle allegations of Medicare and Medicaid overbilling FWA MI- Three men charged with millions in Medicare, Medicaid fraud FWA NY- Former Executive Director of Long Island Charity Sentenced to Over Two Years in Prison for Embezzlement FWA; DE- Delaware to Receive Nearly $56,000 for Alleged False Claims Caused by Respiratory-Related Medical Equipment FWA CO- 3 charged in Medicaid scheme claiming inmate was providing in-home care FWA OR- Former Co-Owner and Sales Manager of defunct medical testing lab sentenced to prison PHE- Nebraska Medicaid to resume regular reviews of Medicaid eligibility PHE- As Congress Sunsets a Covid-Era Medicaid Program, Millions Could Lose Coverage PHE; MCOS- JPM23: Centene gears up for Medicaid redeterminations to begin MCOs; IN- New contract for Medicaid operator AK- Average wait time 90 to 120 days for state to process Medicaid applications NMI’s 83 pct. federal match rate for Medicaid is now permanent WY- Legislators explain Medicaid opposition REGs; Prior Auth- CMS Proposed Rule Seeks to Provide Transparency and Efficiency in Preauthorization Process Op-Ed- California should accept the federal government’s invitation to trim Medi-Cal rolls Abortion- Montana DPHHS proposes new regulations on Medicaid-reimbursed abortions Expansion- NC may be the last state to expand Medicaid for a while Reform- Georgia establishes its own health insurance portal, Georgia Access Fin/Budget: Colorado HCPF requests $14.8 billion budget, plans to increase provider reimbursements and eliminate Medicaid copays in FY 2023-2024 Fin/Budget- Nebraska hospitals ask for record Medicaid reimbursement bump MH/BH/ Fin/Budget- Medicaid and mental health programs big winners in $1.7 trillion federal spending law PHE/Elig: Budget Act Includes Items on Medicaid Eligibility, Telehealth, Mental Health PHE: Citing Medicaid, DeSantis joins other governors seeking to end the COVID health emergency MCOs: Centene Bounces Back With California Medicaid Contracts MCOs- Amerigroup Maryland is Now Wellpoint MCOs- Scan Group Merges with Oregon Managed Medicare and Medicaid Nonprofit Tech- Wyoming Receives CMS Certification for Its Medicaid Provider Management System Delivered by HHS Technology Group Fraud/Waste- Medicaid: Improper Payments Caused by Mismanagement, Broken Priorities Texas, red states consider expanding Medicaid after abortion restrictions Enrollment- UPDATED: ACA enrollment increases 18% over last year, fueled by Inflation Reduction Act tax credits Reform- MassHealth Selects Community Partners for Medicaid ACOs Fin/Budget/Reform- Federal Budget Bill Permanently Increases Medicaid Funding For US Pacific Territories Reform- Ga. only state to require work for Medicaid NM- Study: Calls to Medicaid providers are mostly futile Report criticizes counties that continue to claw back Medicaid birth costs REFORM- Cessation of Medicaid funding for neonatal circumcision examined in new study SD- Gov. Kristi Noem, state departments begin process to implement ‘will of the voters’ in Medicaid expansion Opinion | What Comes Next for the War on Drugs? The Beginning of the End TECH- Inconsistent Medicaid coverage for remote patient monitoring hampers adoption MCOs- HHS IG Issues Audit Report on Documentation of Medicaid Managed Care Payment Review Determinations Made Under Payment Error Rate Measurement Program MCOs- CNC stock slips as Bank of America downgrades on Medicaid risk (NYSE:CNC) OR- Kotek names interim director for the Oregon Health Authority FWA (NY) Attorney General James Secures Over $3 Million from Home Health Agency for Cheating Workers and Medicaid Fraud FWA- Ohio Medicaid ripped off for millions, and counties could have stopped it, auditor says FWA (CT) – Greenwich Psychologist Admits Defrauding Medicaid, Medicare and Private Insurers FWA (IL) – Owner Of Beverly Medical Center Charged In $224K Medicaid Scam FWA (NC) – Attorney General Josh Stein Announces Medicaid Fraud Pleading MCO News- Nonprofit Health Plans With $6.8 Billion in Projected Revenue Set to Combine Medicaid overspending costs taxpayers $16B a month, watchdog reports NY- Medicaid reimbursements inadequate to cover new $17 minimum for home health aides, agencies say MCOs (NC)- Study: Medicaid transition still facing problems TECH- CMS Proposes Rule to Expand Access to Health Information and Improve the Prior Authorization Process OP-ED (SDoH)- How Medicaid mission creep undermines real health care FWA (MA)- Two Individuals Charged With Defrauding MassHealth by Billing for Services Not Provided FWA (NJ)- Opioid Abuse Treatment Facility to Pay $3.15 Million for Kickback Violations, Obstructing Federal Audit, and False Claims Submitted to Government Insurance Programs FWA (NC)- Charlotte woman facing federal charges for Medicaid kickback scheme involving at-risk youth FWA (NY)- Two Individuals Arrested for Pharmacy Health Care Fraud Kickback Schemes FWA (CA)- Three Health Care Providers Agree to Pay $22.5 Million for Alleged False Claims to California’s Medicaid Program MCO – Oklahoma Reissues Medicaid Managed Care RFPs, Proposals Are Due February 8, 2023 TX- Non-Medical Home Remediation Study Could Be Game-Changer For Texas Medicaid Patients DeSantis urged to release plan for Florida’s looming Medicaid crisis Up to 18 million people could lose Medicaid coverage after COVID-19 PHE 19 States Must Align Medicaid Vaccine Coverage Policies with IRA MCOS- Centene to pay Oregon $17M in latest Medicaid overbilling settlement RX- Medicaid Spending on Antiretrovirals Increased Between 2007 and 2019 STATE NEWS- NC health agency appealing ruling on services for disabled REFORM- Georgia Set to Implement Medicaid Work Requirements OP/ED- Biden Turning Medicaid into Welfare For All – AMAC REFORM- More than 4 in 5 pregnancy-related deaths are preventable in the US, and mental health is the leading cause FWA (WV)- State Medicaid Fraud Office Expansion To Include CHIP Fraud Investigations FWA- Western suburbs OB-GYN pleads guilty to Medicaid fraud FWA- Maryland Man Pleads Guilty to Defrauding Medicaid of More than $700,000 in Scheme Involving Personal Care Services FWA- Group Home Owners Sentenced in $1 Million Medicare Fraud Scheme TECH- Google rolls out search features for Medicaid, Medicare patients MH/RX- Mental health declines as Medicaid funds record psychotropic drug use MH (LA)- Mental health providers decry ‘mind-numbing’ prior authorization burdens as Senate debates reforms MCOs- UnitedHealth Group expects to bring in nearly $360B in revenue for 2023 MCOs- Medicaid managed care merger starts Jan. 1 in Virginia MCOs- Analysts worry about long-term viability of ProMedica’s Paramount health plan MCOs- Centene in the headlines: 9 recent developments STATE NEWS- Louisiana Medicaid members can receive up to $400 for COVID-19 Vaccine PHE/Providers- Ongoing Impacts of the Pandemic on Medicaid Home & Community-Based Services (HCBS) Programs: Findings from a 50-State Survey Supreme Court hears case on Medicaid patients’ rights to sue Possible end of emergency spurs debate on Medicaid FWA- Plymouth woman admits roles in food, Medicaid scams FWA- Southeast Kan. women ordered to pay restitution for Medicaid fraud SD- South Dakota votes to expand Medicaid Providers ‘on notice’ as CMS pressures states to shift Medicaid pay metrics CMMI seeks to boost specialty, primary care coordination PHE/ AR- How Arkansas is boosting Medicaid outreach ahead of PHE expiration Missouri Medicaid application wait times down Arkansas Advocate : CMS OKs Arkansas’ experimental Life360 program for vulnerable Medicaid groups Borrego Health Files for Chapter 11 Bankruptcy Protection; an Analysis Medicaid and Medicare hotline workers strike for higher pay and support FWA (CO) Pueblo Woman charged for more than 500,000 dollars of fraud FWA (OH)- Mansfield Medicaid Fraud Case Yields Prison Sentence FWA (MN)- Federal Jury Finds Maple Grove Man Guilty of Wire Fraud, Aggravated Identity Theft in $1.4 Million Medicaid Fraud Conspiracy FWA (CT)- Woman who helped CT autistic kids gets 3 years for Medicaid scam FWA (NJ)N.J. wins $1.6M judgment against adviser who allegedly scammed nursing home residents seeking Medicaid FWA (CT)- $533K Settlement In Psychiatric Care Center Medicaid Fraud Case BH/SUD: Nearly Half Who Leave Rehab for Opioids Don’t Get Follow-Up Care NH- Delta Dental would begin Medicaid dental benefits for adults under $33.5 million contract CO- Medicaid denials for Colorado children with severe disabilities set off panic OP-ED: Podcasts – How Medicaid Compromised Long-Term Care (Guest: Stephen Moses) NC- Report claims NC hospitals made millions on Medicaid Cigna’s Express Scripts wins Centene’s $35B prescription drug contract Medicaid settings rule – New law protecting your rights Bowser fires official who took job at health insurer after Medicaid procurement Medicaid expansion groups raises $2.3 million for Amendment D race Oswego Hospital to pay $98K for improperly billing Medicare, Medicaid, feds say CNY doctor to pay $900,000 for overcharging Medicaid services Transport provider convicted of Medicaid fraud Aetna, Waymark partner on managed care for Virginia Medicaid members States brace for Medicaid spending surge Medicaid’s 340B has grown beyond original intent | Mississippi Politics and News OIG Lauds UPIC Program and Recommends Expansion, Additional Targeting of Medicaid Providers Kentucky offers expanded Medicaid health coverage for adults DC Council approves Medicaid insurers after heated debate HHS approves Medicaid housing intervention program in Arizona Alabama Medicaid Removes Sobriety Requirements for Hepatitis C Treatment Centene Gave Thousands to Georgia Leaders’ Campaigns While Facing Medicaid Overbilling Questions Lawsuits, challenges and debates: Where California’s controversial Medicaid contract process stands Nebraska Medicaid will have multiple changes starting in 2024 Food insecurity and the end of the public health emergency Medicare Plans- ‘Straight Up Fraud’: Data Confirms Private Insurers Use Medicare Advantage to Steal Billions CA – ‘Separate and unequal’: Critics say Newsom’s pricey Medicaid reforms leave most patients behind TN- Parkinson: Nursing home sector pinning hopes on ‘Medicaid adequacy’ rule Potential Data Disclosure May Have Affected Certain Wisconsin Medicaid Members | Wisconsin Department of Health Services Fraud (AR)- Rutledge Announces Record-Breaking Medicaid Year – SWARK Today Fraud- Dentist reaches $750k settlement in Medicaid fraud suit over unnecessary ‘baby root canals’ Fraud- Michigan AG Dana Nessel Charges Detroit Man with Using Stolen Identities to Commit Medicaid Fraud Fraud- Jacksonville Health Care Provider Physicians Group Services Agrees To Pay $700,000 To Resolve Civil Healthcare Fraud Allegations Fraud- Foreign medical student found guilty in home health fraud scheme Fraud- Jackson Man Sentenced to 30 Months, Ordered to Repay $7.5 million For Health Care Fraud Scheme Fraud- Lauderhill Woman Arrested for Nearly $9K Welfare Fraud: Police MCOs- Health care company Amerigroup is at center of D.C. Medicaid saga MCOs-Minnesota awarding contracts worth $5 billion to Medicaid health plans Rx- NYOH calls on NYSDOH to reverse Medicaid policy change Rx- HCA delays Medicaid drug payment change – Washington State Hospital Association MS- Medicaid: Proposed pay increase could help in-home nurses SDoH- Doctors Prescribe Healthy Meals to Keep Patients Out of the Hospital Op-Ed- Biden’s Medicaid plans will send the program completely off the rails Rx- Nebraska Medicaid officials seek $16 million a year for new Alzheimer’s drug MA- Feds approve five-year, $67 billion Medicaid waiver WA- Providence plans to reimburse Medicaid recipients who were mistakenly charged for care OR- Oregon is guaranteeing kids won’t get kicked off Medicaid until at least age 6 Tech- Cognosante Customer Experience Business Sector to Support CMS Enrollment Assistance Program for Medicaid Unwinding Op-Ed- Rein in Medicaid, Medicare spending NM- New Mexico Medicaid releases request for proposals for new Turquoise Care contracts Providers- Marion County agency wants SCOTUS to strip protections for millions of vulnerable Americans Hochul donor, Medicaid contractor cost NY taxpayers up to $195 million Fraught early rollout of cash payments to Medicaid, SNAP recipients Medicaid providers ask circuit court to protect them from $15 minimum wage-related lawsuits Former CEO of Health Clinic Convicted of Medicaid Fraud Nebraska awards Medicaid managed care contracts to 3 insurers Kansas has begun distributing $51 million in bonuses to Medicaid providers Senate leader: NC hospitals’ Medicaid proposal not ‘serious’ Medicaid and the Inflation Reduction Act of 2022 St. Charles woman sentenced for $2.5M Medicaid fraud Settlement reached in Parkview Health Medicaid fraud case Centene settles Medicaid fraud claims with Texas for $165 million Medi-Cal providers fear disruption to patient care Colorado’s new Medicaid Director focused on partnering with RAEs to prepare for end of PHE New Rule Makes Clear that Noncitizens Who Receive Health or Other Benefits to which they are Entitled Will Not Suffer Harmful Immigration Consequences Google adds Medicaid, Medicare enrollment info to Search Which states process Medicaid applications the fastest Insurance Policies May Drive Diagnoses for Medicaid Patients Maryland seeks Medicaid non-emergency medical transportation contractor West Virginia Recognized for Innovations in its Medicaid Program New poll shows South Dakota voters are leaning toward expanding Medicaid HHS Approves 12-Month Extension of Postpartum Medicaid and CHIP Coverage in Indiana and West Virginia CareSource partners with Texas company in bid to serve Texas Medicaid members Clawback: Feds say NYC Improperly Billed Medicaid for $84.3M TennCare: Update may have disclosed personal information of Medicaid recipients Colorado to receive over $1M in Medicaid fraud settlement with optical lens company A physician’s perspective on Medicaid expansion Walmart, UnitedHealth Group form 10-year value-based care partnership CVS Health to Acquire Signify Health Proposed CMS rule would streamline Medicaid, CHIP enrollment FWA- U.S. Attorney Settles Fraud Lawsuit Against Non-Profit For Inflating Medicaid Reimbursements By Falsely Reporting Millions In Costs MCOs- MetroPlus Health Plan: COVID-19 Enrollment Trends | Office of the New York State Comptroller MS- Letters create confusion about correct MS Medicaid coverag FWA- Philipsburg Woman Sentenced for Social Security, Medicaid Fraud The Territories- Medicaid becomes clashing point in Northern Mariana Islands governor’s race MT/BH providers- Study proposes increases to Montana’s Medicaid provider rates NC/SDH- New housing program faces hurdles MCOS- Medicaid and CHIP Financial Statistical Report Agreed Upon Procedures Results FWA- Medicaid Recipients Agree to Pay $130,000 to Resolve False Claims Act Allegations of Health Care Benefit Fraud MCO- Nebraska officials delay selection of contractors managing $1.8 billion program MCOs- Molina, Elevance, Centene win big with Medicaid contracts in California Homegrown Medi-Cal plan misses out in state’s new contracting program MCOs- Medicaid managed care plans send big checks to increase access to health care services MCOs – Aetna Medicaid donates $450K to support Texas communities MCOs- Iowa’s $7 billion privatized Medicaid program will work with 3 health insurance companies FWA- Alabama pill mill doctor’s sister said she obeyed him due to Nigerian cultural norms; sentences upheld LA- Louisiana Medicaid implementing new payment model for hospitals FWA- Montana Claimed Federal Medicaid Reimbursement for More Than $5 Million in Targeted Case Management Services That Did Not Comply With Federal and State Requirements FWA- California suspends Medicaid payments to Borrego Health for 2nd time in 2 years FWA- Southwest Idaho woman gets jail, fines for Medicaid fraud MCO- UPMC Health Plan adds more than 11,000 Philadelphia-area Medicaid members OP ED Grab-Bag: Medicaid work requirements aren’t inherently a bad thing OP ED Grab-Bag: School is where health care happens for kids. Changes in Medicaid can help FGA Files Lawsuit Against the Centers for Medicare and Medicaid Services (CMS) for Stonewalling Requests Regarding Hospital Price Transparency Federal Judge reinstates Georgia Medicaid work requirements CMS aims to mandate state quality reporting for Medicaid, CHIP California county, three health systems pay $70.7 million for Medicaid fraud TX- Two charged in $6M pediatric dental Medicaid fraud/kickback scheme Lawrence woman to pay $7K+ for fraudulent Medicaid claims Centene guilty of overcharging state Medicaid program, owes WA $19 million D.C. Medicaid Contract Remains in Limbo Texas lawmakers ask feds to reconsider Medicaid expansion proposal Humana inks deal to expand in Medicaid managed care MN- 90,000 more MN students to get free school meals based on Medicaid enrollment Medicaid Changes Could Provide a Big Boost to School Mental Health Services MO – Former state vendor awarded $23M in lawsuit over Missouri Medicaid system implementation GA- Gov. Kemp Dedicates More Than $1 Billion for DHS to Provide Cash Assistance to Medicaid, SNAP, and/or TANF Recipients HHS Approves 12-month Extension of Postpartum Medicaid and CHIP Coverage in Hawaii, Maryland, and Ohio North Carolina Medicaid expansion legislation falls through GA- Former Gainesville doctor sentenced to house arrest, probation in Medicaid fraud case GA- Kyle Wingfield: Expanding Medicaid isn’t the silver bullet MS- Division of Medicaid to contract with nonprofit backed by state hospitals to administer benefits GA- Carr: Medicaid Fraud Division Secures $650,000 Settlement with Atlanta Behavioral Medicine MO- Missouri officials vow progress as Medicaid applicant wait time remains at 100 days PHE- MACPAC: Only 3% gained exchange coverage after leaving Medicaid PHE- Medicaid/CHIP enrollment rose 23.9% during the pandemic, KFF report shows DC- CareFirst Questions D.C. Medicaid Contract Process AR- Hutchinson seeks expansion of Medicaid coverage for pregnant women NC Medicaid providers say they’re owed big bucks while children go without care DE- Judge upholds auditor effort to subpoena Medicaid records FL- Medicaid managed medical, dental and children’s plans targeted for October rate reductions IL- State Filing on Medicaid Delays Asks Court to Reconsider MS- Centene Subsidiary Selected to Continue Serving Mississippi’s Medicaid Managed Care Members Texas Medicaid coverage for moms under review Massachusetts Suit Over Circumcision Medicaid Payments Fails Nebraska Medicaid Announces Requests for Proposal For New Health Insurance Contracts INDIANA- Local businessman accused of medicaid fraud, counterfeiting Patient-level factors influencing adherence to follow-up imaging recommendations GDIT Wins $65 Million Medicare and Medicaid Cloud and Data Integration Contract New York Office of Medicaid Inspector General Proposes Regulations on Medicaid Provider Compliance Programs Mark Farrah Associates Noted More Than One-Quarter of U.S. Population on Medicaid CareOregon helping Medicaid members stay cool in extreme heat Humana to reorganize, launches executive search With Medicaid Waiver Plan, Washington State Envisions 10 Community Hubs Medicaid expansion faces hurdles in South Dakota Silver Spring woman sentenced to 10 months in prison for defrauding D.C. Medicaid program of over $100K Twin Falls provider sentenced for fraud and obstruction of medicaid fraud investigation NC man arrested for fraud in Columbia: SC Attorney General Diagnostic Laboratory to Pay $10 Million to Resolve Self-Referral and Kickback Allegations HHS putting $49 million toward increased healthcare coverage for children Study assesses the acceptance of Medicaid insurance among patients diagnosed with cancers No-bid Medicaid contract for Kaiser Permanente is now California law, but key details are missing DC’s Medicaid managed care mess ad nauseam Ossipee Woman Pleads Guilty to Theft of Medicaid Funds Medicaid fraud case continues MT Medicaid patients to see greater access to substance use disorder treatment Access to Urological Care for Medicaid-Insured Patients at Private Equity-Owned Urology Practices Virginia lawmakers boosted Medicaid payments for primary care. Providers say it’s not enough Colorado mental health providers say they were “blindsided” again South Dakota Medicaid expansion groups join for constitutional amendment Biden admin will allow TennCare’s controversial block grant, with some caveats Federal audit forces New Hampshire to repay $7.9M Medicaid funds Molina to pay $150M for Wisconsin Medicaid firm in latest acquisition DHSS Announces Organizations Selected to Operate Medicaid Managed Care Program Medicaid program did not recover $292M in overpayments Medicare Telehealth Services for 2023 – CMS Proposes Substantial Changes Nearly 200K disabled Texans are waiting for help, some for a decade KS- Gubernatorial candidates at odds on approach to Medicaid expansion in Kansas State budget goes to Gov. Cooper Maryland Man Charged With Defrauding Medicaid in Scheme Involving Personal Care Services FL- State awards seven-year, $140M Medicaid IT contract Washington State plan aimed to lower Medicaid pharmacy payments is rescinded CMS wants Tennessee to change Trump-approved Medicaid block grant plan IL- St. Anthony Hospital can sue Illinois over Medicaid payments SD- Concerns arise as dueling ballot measures both seek to expand Medicaid coverage in South Dakota ‘Phantom’ provider lists limit Medicaid mental healthcare access, study finds States should protect caregivers’ Medicaid funds from union skims NC- House passes Medicaid expansion study bill Tuscaloosa Mayor Walt Maddox: Expand Medicaid for Alabama in wake of Roe v. Wade decision How the Hyde Amendment Is Related to the Overturn of Roe V. Wade PA- Wolf pushes $91 million for nursing homes to offset costs of proposed new staffing regulations, but industry says it’s not enough Vermont Medicaid Section 1115 Demonstration Extended Until 2027 Fraud- Three More Defendants Sentenced for Their Roles in Wide-Ranging Medicaid Fraud Conspiracy MCOs- Medicaid: State Directed Payments in Managed Care | U.S. GAO Arizona Medicaid Director Points to Success of Supportive Housing Virginia budget increases reimbursements for Medicaid dental care CT- How much would it cost to insure undocumented Connecticut residents? A new report gives an estimate. Kentucky Psychiatrist Sentenced for Health Care Fraud Related to Referrals for Drug Testing at Greensburg Lab KY- Pilot program at Nulu farmer’s market provides free produce to pregnant women on Medicaid LA- Nursing home magnate Bob Dean arrested on counts of cruelty to the infirm, Medicaid fraud Dept. of Justice: DOJ announces Mallinckrodt to pay $230 million agreement in underpayment of Medicaid drug rebates lawsuit CMS: More than 250,000 have gained access to postpartum coverage through Medicaid extensions NC- Lawmakers: House unlikely to take up Medicaid legislation Molina to pay $4.6M to settle False Claim Act allegations Centene raises profit forecast betting on higher Medicaid premiums Tech startup Circulo Health switches focus, lays off a quarter of its staff Ohio Announces Three-Stage Medicaid Managed Care Transformation Roll-Out KS- LaTurner introduces legislation to require volunteer hours for Medicaid benefits Montana lawmakers probe new Medicaid director on privatization Georgia seeks input on new Medicaid contracts Gainwell Technologies Selected to Provide Full Suite of Cost Containment Solutions to State Medicaid Agencies through NASPO ValuePoint Cooperative Contract Katy woman accused of defrauding Medicaid out of more than $600K using her ex-husband’s therapist information Helena clinical counselor pleads guilty to felony Medicaid fraud North Dakota woman ordered to pay $75K in Medicaid fraud case Oklahoma company inflated prices for Medicaid equipment Key Steps to Improve Coverage Integration for Dually Eligible Individuals Rethinking The Budget Neutrality Requirement For Medicaid 1115 Demonstrations Medicaid managed long-term care complaints are increasing in Florida Centene settles with New Mexico on PBM overcharging allegations Medicaid Covers Nonmedical Services as Part of Initiative to Address Social Determinants of Health DPHHS audit raises questions about Medicaid, foster care, child care Texas Medicaid: Temporary prior authorization waiver for pediatric formula during shortage OHIO- Humana Healthy Horizons Commits $4.6 Million to Improve Health of Ohioans HHS Extends American Rescue Plan Spending Deadline for States to Expand and Enhance Home- and Community-Based Services for People with Medicaid Colorado’s Medicaid data on race and ethnicity deemed ‘poor’ quality by CMS NC Medicaid bill causes stir over changes to how hospitals compete NJ – Linden woman charged in a years-long Medicaid fraud scheme FL – Prison Time Handed Down To Tampa Man Convicted Of Medicaid Fraud NY: Dansville doctor settles Medicare, Medicaid fraud allegations Ohio House approves bill allowing doula services to be covered by Medicaid U.S. Supreme Court rules in Florida Medicaid expense case Colorado expands Medicaid access to undocumented pregnant people and their babies South Dakota Voters Reject GOP Effort Aimed At Derailing Medicaid Expansion Mostly Medicaid Announces Medicaid Solution Provider Innovations Awards Submissions A big obstacle remains for NC Medicaid expansion Feds Push Forward With New Medicaid Waiver Rule Biden Administration Announces $1.5 Billion Funding Opportunity for State Opioid Response Grant Program Machine Learning May Help Predict Opioid Overdoses in Medicaid Patients State again delays announcing winners of two Medicaid-related IT contracts Pro-unionization language dropped from Pennsylvania multi-billion dollar Medicaid contracts Montana hires a medicaid director with a managed-care past Oklahoma adopts new system for Medicaid management Enrollment ticking up in Missouri’s expanded Medicaid program, but rollout still rocky Governor signs bill that gives nursing homes $700 million funding boost MA- Clinical Laboratory and Owner Charged in Medicaid Kickback and False Billing Scheme LA- Text messages for Medicaid members California Healthcare Foundation highlights important work done by MostlyMedicaid to integrate care for a Medicaid managed care plan PA’s long-term care crisis and how a push to increase Medicaid reimbursements could help Missouri Awards Medicaid Managed Care Contracts To Incumbents, Centene Awarded New Specialty Plan For Children In Foster Care CMS Approves Extension of Medicaid and CHIP Coverage for 12 Months Postpartum in Tennessee and South Carolina Republicans file bill to expand Medicaid in N.C. Kansas Legislature overrides veto, extends Medicaid contracts past election Judge strikes down CMS’ Medicaid copay rule, handing PhRMA major win Attorney General Moody Announces Arrest of Respiratory Therapist Falsifying Medicaid Reports and Stealing Thousands Springs woman charged with Medicaid fraud Medicaid fraud: Pennsylvania treatment facility owner pleads guilty to $12M kickback scheme Greensboro Resident Sentenced for Conspiring to Defraud North Carolina Medicaid System Mother and son charged with Medicaid fraud Defendants Sentenced in Tennessee for Multimillion-Dollar Nationwide Telemedicine Pharmacy Fraud Scheme Neligh pharmacist facing indictment for $573K health care fraud Former KY lawmaker pleads guilty to federal fraud charge RI cancels bid process for $7 billion Medicaid contract after insurer snafus Biden set to extend federal COVID-19 emergency: What it means for Ohio Medicaid Regains Power to Deduct From Home Health Workers’ Pay Social Security, SNAP, Medicaid and WIC Beneficiaries Could Receive $30 or More Off Internet Access Julie Beckett, who fought for change in Medicaid system, dies Health Plans Falter at Providing Medicaid Redetermination Info New Washington Medicaid director will ‘redetermine’ eligibility after pandemic emergency Pritzker signs bill that helps Medicaid patients UnitedHealthcare Selected by State of Missouri to Serve Medicaid Beneficiaries Virginia poised to review eligibility of 2 million in Medicaid ‘safe haven’ Milliman’s Jennifer Gerstorff appointed to Medicaid and CHIP Payment and Access Commission (MACPAC) MO- Centene Subsidiary Selected to Continue Serving Missouri’s Medicaid Managed Care Members and Wins Single Source Foster Care Specialty Contract Report finds western Iowa agency improperly billed Medicaid for some services Mental Health Bill Aims to Sync Substance Use, Medicaid Agencies OH- Rollout of Medicaid reforms delayed Anthem Announces Finalization of Integra Managed Care Acquisition OR- New Cancer Drug Access at Risk in Oregon Medicaid Proposal OK- Proposed Medicaid solution in legislation aims to improve efficiency and outcomes Contracted Medicaid Managed Care Providers Treated Few Beneficiaries Legislature delays negotiations of $4 billion Kansas Medicaid contracts until 2023 PSD rejoining Colorado’s Medicaid reimbursement program Biden administration drops fight over Texas’ Medicaid waiver Centene Profits Hit $849 Million On Medicaid, Medicare And Obamacare Growth CMS Guidance to Drug Manufacturers Reporting Medicaid Best Price CAO overbilled Medicaid $18.16 at a time; files $1M lawsuit for being ‘lulled into complacency’ New York State budget expands Medicaid eligibility for older adults Illinois Gov. JB Pritzker has law that would expand Medicaid coverage TennCare legislation requires renewal with providers that didn’t win contracts California investigating Centene over alleged Medicaid fraud UnitedHealth (UNH) Inflated Drug Costs, Louisiana AG Alleges in Suit Consulting firm that worked for the feds had conflicts. What about another that worked for Ohio? Pueblo West clinic Springbok Health settles fraudulent Medicare claims Medicaid to utilize centralized credentialing process for managed care providers this summer Shreveport area mental health workers sentenced in Medicaid fraud case Missouri struggles to process Medicaid applications Despite opposition, Pennsylvania Medicaid contracts keep unionization language Supreme Court nixes appeal on Arkansas’ Medicaid work requirements program Nearly 2,000 providers to receive $503M in Medicaid grants New York audit finds nearly $1B in Medicaid billing errors Providers still waiting for state to deliver $1.2B in supplemental Medicaid funds BayCare pays $20 million for improperly boosting Medicaid payments Bill could overturn Missouri Medicaid expansion US hospitals with the highest share of patients on Medicaid Renewal of Determination That A Public Health Emergency Exists Louisiana Medicaid launches phone campaign to encourage members to update contact information State to invest over $130 million for Medicaid home and community based service providers who care for vulnerable New Mexicans Medicaid expansion had little effect on obstetric service closures, study finds California Handed Its Medicaid Drug Program to One Company. Then Came a Corporate Takeover Alaska House votes to defund Medicaid abortion services despite court rulings requiring it That’s privileged: Medicaid won’t say what it did to justify denying records Tennessee Offers to Expand Dental Schools as Medicaid Coverage Stretches Need Maryland passes Adult Dental Care Medicaid Expansion Network adequacy standards vary widely between Medicaid, exchange plans Medicaid winds down coverage for PT & OT telehealth Rewrite of Florida’s Medicaid managed care system signed into law Colebrook woman charged with filing $148K in fraudulent Medicaid claim Woman charged with Medicaid fraud Las Vegas woman sentenced in Medicaid fraud case Controversial freeze on Medicaid contracts approved by legislature Senators Rick Scott and Tim Scott Request GAO Review of Medicaid RAC Program Government Accountability Office asks CMS to assess telehealth quality for Medicaid beneficiaries New Medicaid benefit aims to provide Washington’s homeless with housing Watchdog finds Medicaid-Legislature disconnect Supreme Court Refuses Medicaid Case, But Alito Makes Statement CA- Org Streamlines Billing, Authorizations in Public Payer Coverage OR- Oregon to pay $22.5M to settle Medicaid contractor dispute Compassionate Homecare to Pay $6.53M to Resolve Allegations; OIG Releases Medicaid Fraud Report Medicaid fraud bill introduced SC Dept. of Health and Human Services extends Medicaid coverage for new, expecting mothers KS- Kelly administration counters AG’s opinion on extending $4 billion Medicaid contracts Low COVID-19 vaccination rates among Medicaid beneficiaries cause for concern: senators Ohio Medicaid claims it’s more transparent than other states Florida Medicaid hits Sunshine Health with $9M sanction for not paying providers’ claims Texas gets respite on Medicaid, but not cure for the uninsured Questcor Whistleblower Awarded 20% of $233.7 Million False Claims Act NM- About 85,000 residents to lose pandemic Medicaid coverage Illinois Sets Aside $66 Million for Medicaid Innovation Collaborative California to eliminate Medicaid waitlists through assisted living waiver GA- The Down Syndrome Association of Atlanta on Medicaid waivers Texas Feud Over Medicaid Is Costing $7 Million A Day NV- State encourages school districts to pursue Medicaid repayments Kansas lawmakers try to limit changes to state’s Medicaid program OH- Roughly 200 Paramount employees to be laid off Kentucky House quickly advances bill putting tighter rules on food benefits, Medicaid DHHS cautions of state Medicaid funding shortfall for 2021-22; COVID-19 expenses biggest impact Idaho House passes 6.6% increase for 2023 Medicaid budget TennCare is preparing to expand dental benefits, but only 1 in 3 dentists accepts reduced payments Medicaid Spending on Home, Community-Based Services Up by $116B Statement Regarding Unauthorized Medicaid Data Access House speaker not budging on Medicaid extension for new moms Telehealth Utilization Increasing Medicaid Provider Reimbursement MACPAC releases Medicaid, CHIP report: 3 things to know Lawmaker Takes Aim at 1960s Law That Blocks Medicaid Funds for Psych Care Texas Medicaid Plan Must Get HHS Ruling by March 25, Court Says Arizona to resume disenrolling people from Medicaid program Call center to reach out to Medicaid clients to update contact information Jury acquits men of all counts in Medicaid fraud case Some Medicaid patients will start getting help with food and shelter Pennsylvania health systems may be compelled to unionize by Medicaid contracts CNSI’s Provider Services Module to Support Georgia Department of Community Health’s Medicaid Enterprise System Transformation Program Oregon takes step toward covering thousands set to lose Medicaid Mallinckrodt inks $260M settlement with US to resolve Medicaid underpayment and kickbacks allegations Officials: Lab pays $4.8 million for overcharging CT Medicaid patients Overbilling Medicaid is also aggravated identity theft, says full 5th Circ Higher Medicaid spending away from SNFs here to stay, official says FL- Will the Senate take up the House Medicaid managed care rewrite? Guidance Released on Medicaid and Children’s Health Insurance Program Medicare/Medicaid may not cover cost of new Alzheimer’s drug WI- DHS to Request 30-day Extension of Medicaid Coverage for Women After Pregnancy End of Public Health Emergency Triggers End to Medicare, Medicaid Flexibilities OH- Ohio Medicaid managed care plan enrollment begins Tuesday NC- Cooper administration makes new pitch for Medicaid expansion Eli Lilly’s Medicaid rebate payments under fire as whistleblower lawsuit heads to trial Oregon withdraws a waiver request to run a closed Medicaid formulary Las Vegas healthcare company convicted in Medicaid fraud case KY- Bill would let Medicaid to pay certified community health workers Improper Medicaid payments expand after ObamaCare and pandemic, studies find MO- Republicans seek new route to impose work requirements on Missouri Medicaid recipients WY-Wyoming Medicaid expansion budget amendment ruled unconstitutional FL- Bills would require Medicaid plans to provide much more data MS-State Medicaid director: Banning Centene contract would be hazardous DHS proposed rule would exclude Medicaid, other benefits from public charge determinations ME- LePage admits Medicaid expansion ‘good for Maine,’ but still wants cuts to program OR- Oregon agrees to sunset limit on benefits for kids on Medicaid – OPB Smokers in Medicaid Rarely Accessed Cessation Medication, Counseling Nonprofit hospitals’ unreimbursed Medicaid costs don’t warrant tax subsidies, study suggests Healthcare groups want advance notice on the end of PHE and Medicaid provisions MS- Mississippi could rethink a Medicaid managed care contract Planned Medicaid Work Rules’ Impact at Heart of Georgia Lawsuit OR- Oregon lawmakers consider bill to head off Medicaid disenrollments KS- Long-promised Medicaid Expansion bill introduced in Kansas legislature SD – Senate rejects Medicaid expansion, leaving it to election NC- Key NC Republican lawmakers weighing Medicaid expansion vote before November LA- Humana Selected by Louisiana Health Department to Serve Medicaid Beneficiaries FL- Governor, lawmakers differ on Medicaid ‘critical care’ funding – South Florida Business Journal FL- Hospital to pay $5.5M to settle improper Medicaid payments case IA- House scales back proposed changes to Medicaid, food stamp eligibility KS- House bill delays rebidding state’s $3.9 billion Medicaid contracts until after governor’s race OIG permits retailer to use Medicaid enrollment as qualification for discount program SD- Medicaid expansion fund gets Senate’s OK Centene Reports $599 Million Profit On Medicaid And Medicare Growth GA- Georgia Senate approves Medicaid expansion for new mothers MO- Missouri looks at changing Medicaid funding AR- State regulators give OK to Medicaid managed care company once dogged by investigations FL- Five Medicaid changes Florida lawmakers are considering in 2022 – State of Reform CA- ‘Somebody is gonna die’: Omicron hobbles California’s new Medicaid prescription system CA- California inks sweetheart deal with Kaiser Permanente, jeopardizing Medicaid reforms Vaccine mandate to kick in for first wave of health workers Georgia bill aims to limit profits of Medicaid managed-care plans Adolescents with SUDs in Medicaid Rarely Get Substance Abuse Care NJ Watchdog Says State Should Bar Poorly-Rated Nursing Homes From Medicaid Ohio Medicaid director says program change won’t disrupt health care Next big health crisis: 15M people could lose Medicaid when pandemic ends CNMI- Governor vetoes Medicaid personnel bill Medicaid expansion to get another crack in Wyoming after two defeats in 2021 MO- Funding still pending for Medicaid expansion Missouri GOP again pushes for Medicaid work rules despite setbacks elsewhere Missouri Medicaid expansion: long waits for applicants Oklahoma’s Medicaid costs surging Texas cut Medicaid staffing during the pandemic. Millions are now at risk of being dropped from the program. Anthem Profits Double To $1 Billion On Pandemic Medicaid Growth Insurers’ challenges to North Carolina Medicaid contracts are over with dismissals Georgia suing Biden administration over Medicaid rejection CMS Updates Healthcare Worker Vaccine Mandate Guidance FL- Florida Government Sued Over Alleged Medicaid Services Contract Breach MN- Minnesota woman admits to $860K Medicaid fraud – Duluth News Tribune OH- Improper Medicaid payments to prisoners and deceased top $118 million CO- Colorado is trying to increase Medicaid mental health providers WI- GOP bills add new unemployment, Medicaid job search rules NM- Medicaid coverage could be extended to 12 months for postpartum care FL- Applications keep rolling in for Medicaid home and community based grants KS Democrats mull new plan for Medicaid, marijuana reform FL: Medicaid health plans, Florida Healthy Start don’t provide same services California Would Expand Medicaid to People in U.S. Illegally Under Gavin Newsom Proposal Sixth state settles with Medicaid contractor IL- After legalizing midwives, Illinois lawmakers look to cover the service with Medicaid Biogen Shares Fall Premarket on Medicaid Coverage Plans for Aduhelm Molina closes $60M acquisition of Cigna’s Medicaid contracts in Texas Medicaid managed care bill drops on eve of 2022 Legislative Session Clinics Say California’s New Medicaid Drug Program Will Force Them to Cut Services AR/Rx- State officials announce Arkansas Medicaid pharmacy benefits expansion NY/ Expansion- ‘Medicaid for All’ is rapidly becoming a reality in New York NJ/Fraud- $3.6M Medicaid Fraud Allegations Tied To Ex-NJ Nursing Home Owner KY/Providers- Eligible Kentucky hospitals can get up to $1.1B more in Medicaid payments in 2022 NV/HCBS- Nevada leveraging federal funds for home care workers CA- Federal government approves California’s Medicaid overhaul OH/ Fraud- Company accused of overbilling Ohio Medicaid settles GA- Reform- CMS Reverses Approval of Work Requirements and Premiums for Georgia Medicaid AR- Premiums for Arkansas Medicaid expansion must end in one year AR- Attorney General announces multimillion dollar Medicaid fraud settlement with Empower Healthcare Solutions SD- Medicaid expansion to appear on SD ballot Ohio- Medicaid provider to drop legal action against state CMS Says Children’s COVID-19 Vaccine Counseling Visits Covered by Medicaid Neb. Medicaid Seeks Community Feedback On Programs Oregon wants to get out of covering drugs like Aduhelm in Medicaid Medicaid now certifies kids for free lunch in SC, several other states Centene settles with activist Politan, overhauls board, CEO to exit Medicaid DSH cuts nixed from Build Back Better Act State investigates managed care company in Medicaid fraud Expansion of Arkansas Medicaid system announced Backlog of Medicaid applications spurs Arkansas lawmakers to concur with hiring contract help for $29M Houston County counselor pleads guilty in Medicaid Fraud case Latest Medicaid Data Show A Deeply Broken Program Medicaid giant settles with fifth state CareSource part of joint bid with Mississippi Medicaid $1.8B in additional Medicaid funds headed to several Florida hospitals Louisiana Medicaid contractor search slower than planned Biden Administration To Expand Vaccine Education For Medicare, Medicaid As Omicron Hits U.S. Four Texas Democrats Call for Restoration of Medicaid Section 1115 Waiver Funding Public comment period open for draft Medicaid waiver renewal application Medicaid contractor stops trying to recoup payments from mental health providers NYS Comptroller: Department of Health paid over $100M in improper Medicaid payments Attorney General Ford Announces Sentencing of Las Vegas Medicaid Provider Randi Jewel Lewis in Fraud Case IL- Rate Increases to the Medicaid Fee Schedule (Dental) Size of Medicaid Expansion Influenced Administrative Spending State pushes back timeline for Medicaid bonuses; group home providers eye long-term solutions Advocates Build Back Betters CHIP Medicaid Changes Support NY Families Some Colorado therapists will no longer take Medicaid patients Judge stops federal COVID-19 vaccine mandate in Medicare, Medicaid facilities in 10 states Medicaid Change Sending up to 70 California Inmates in Nursing Home Care Back to Prison Missouri’s thin dental safety net stretched amid Medicaid expansion Florida- Medicaid modernization will take hundreds of millions and require more staff Long Predicted Medicaid Specialty Drug Trend Finally Surpasses 50% of Pharmacy Spend in the Latest Magellan Rx Management Medicaid Pharmacy Trend Report NY- Former Employees At State Administrator Of Medicaid Transportation And Business Owner Charged With Submitting Fraudulent Claims Anthem, Inc. to acquire Integra Managed Care Centene Will Address Serious Mental Healthcare in AZ Medicaid With big federal boost, Virginia shows Medicaid surplus this year, helping offset future costs Louisiana Lawmakers Try to Tighten Medicaid Cost Estimates Tennessee Republicans can’t stop Biden’s Medicaid expansion plan Attempt to block $22 billion Medicaid contracts dismissed – Ohio Capital Journal Closing Medicaid coverage gap could widen hospital margins, report says Medicaid managed care company sues outgoing corporate co-owner, alleging ‘sabotage’ Fact Sheet: Biden Administration Announces Details of Two Major Vaccination Policies | The White House South Dakotans will vote on Medicaid expansion in 2022, pending petition validation Delaware- State auditor presses for Medicaid information Illinois’ $16 billion health program is riddled with industry ties and potential conflicts of interest Oklahoma- Hospital officials don’t want to pay for Medicaid expansion Audit shows state Medicaid agency overpaid clinic by $4.7 million Assembly Health Committee taking testimony on Medicaid effectiveness, sustainability UnitedHealthcare to become first for-profit HMO in Minnesota’s Medicaid program After Ohio scandal, Medicaid managed-care giant to exit the pharmacy business Oregon Man Sues State As It Tries To Collect Medicaid From His Settlement Florida prepares for Medicaid disenrollment as end of PHE remains unclear Arkansas- Governor expects federal waiver approval for continuation of Medicaid expansion program Missouri: Close to 13,000 people have been enrolled in expanded Medicaid Maryland Department of Health announces new Medicaid rate increases LETTER: Proposed Medicaid assessment changes would jeopardize care Auditor: Iowa’s privatized Medicaid illegally denies care State: Technical ‘reporting errors’ caused data gap on kids’ Medicaid referrals Medicaid Enrollment & Spending Growth: FY 2021 & 2022 CMS Innovation Center Publishes Vision for Next 10 Years Aetna, an Ohio Medicaid contractor, accused of denying kids care in Pennsylvania Wyoming Senate squash look at Medicaid expansion during special session Democrats Mull Dropping Expanded Medicare, Medicaid in Unity Bid Portman, Finance Committee Republicans raise concerns with improper Medicaid payments Three months in, Medicaid managed care deals crushing admin burden Mass. Medicaid fraud case settled for record $25 million, AG’s office says Florida Medicaid, DOH, present FY 2022 budget requests CMS is reviewing Missouri’s new Medicaid licensure policy Medicaid remains sticking point between GOP, Dems in NC’s budget Adding SNAP Benefits for Older Adults in Medicare, Medicaid Can Reduce Hospital Visits, Healthcare Costs Six companies vying for latest $21B state Medicaid deal False Claims Act Complaint Against “Sophisticated” Medicaid Plan Allowed To Proceed State official announce new initiative that will fund mental health and addiction care through Medicaid DMAS prepares for post-public health emergency Medicaid disenrollment Missouri has enrolled 4,300 people in expanded Medicaid program Appeals court upholds Tennessee’s Medicaid reimbursement cap New Alzheimer’s drug could balloon state Medicaid budgets Health Care Industry Voices Concerns Over State’s Medicaid Plan Disappointed Medicaid bidder focuses on inconsistencies Ohio’s Medicaid director owns the stock of some major contractors, but won’t say how much SD- Current, past S.D. officials say 60% requirement would apply to Medicaid-expansion measures NY- DSS director: No relief in sight from New York State to alleviate county’s Medicaid burden DC Council expected to extend Medicaid benefits via emergency contract Democrats Eye Time Limit on Medicaid Expansion in Quest for Cuts NE- Gov. Ricketts Presents 2021 Medicaid Provider Awards Centene reaches $72M settlement with Illinois, Arkansas for alleged Medicaid overcharges MS- Fact check: Medicaid chief disputes expansion study MO- 275K Missourians Eligible for Coverage Following Medicaid Expansion LA- Mental health providers frustrated with state’s Medicaid managed care organizations Home care in Ohio to see federal, state funding increases Brooks-LaSure: ACA marketplace key to Medicaid redeterminations after COVID-19 PHE ends CO- Medicaid fails to provide reliable non-emergency medical transportation, state report finds Medicaid Behavioral Health: CMS Guidance Needed to Better Align Demonstration Payment Rates with Costs and Prevent Duplication FL- County votes 3-2 to levy Medicaid special assessment Agonizing choices as Dems debate shrinking health care pie Oregon Health Authority Wants Millions From Feds For Equity Spending FL- Medicaid waitlist remains long after $95 million infusion 15 million people may lose Medicaid coverage when public health emergency ends Indiana Medicaid Announces New Reimbursement for COVID-19 Ready Nursing Facilities CMS Investing $15M in Medicaid Mobile Health Crisis Intervention OIG: Most states not doing enough to monitor Medicaid telehealth fraud for behavioral health services Civil rights groups file complaint over DC Medicaid dispute Aetna misrepresented network to secure Pennsylvania Medicaid contract, lawsuit claims Aetna Barred From Suing Over North Carolina Medicaid Bid Denial New Hampshire Extends Partnership with Conduent to Maintain, Operate and Enhance Medicaid House Democrats unveil proposals on drug prices, Medicaid expansion Governor Lamont Announces Public-Private Initiative to Address Homelessness and Chronic Health Problems Ohio fighting Biden’s decision to eliminate work requirement for Medicaid DC Council hits pause button on Medicaid contract Medicare & Medicaid Facilities Are Put On Notice: Employees Must Be Vaccinated Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care? FL- County throws lifeline to hospitals drowning in Medicaid Colorado violating Medicaid mandate by not providing mental health services to children, lawsuit alleges Physicians booted from board after blocking Stitt Medicaid plan CO: Centers for Medicare and Medicaid offer funding for Colorado’s Reinsurance Program Medicaid Subscription-Based Payment Models Show Mixed Results Ohio looking at appealing federal government decision on banning Medicaid work requirements CMS, TX Dispute Over Medicaid Pay Programs Could Affect Provider Pay After Weeks Of Uncertainty, D.C. Medicaid Recipients Avoid Losing Access To MedStar Doctors Texans on Medicaid can now use Uber for non-emergency medical appointments Georgia Medicaid agency requesting nearly $500 million more in health spending Some Medical Clinics Are Hiring Lawyers To Improve Patients’ Health Overdose Risk More Than Tripled in 5 Years for NJ Medicaid Users Study: Carving Out Hepatitis C Therapies from Medicaid Managed Care Increases Use Medicaid Vaccination Rates Founder as States Struggle to Immunize Their Poorest Residents Pa. DHS wants to move Medicaid assessments to Maximus, angering legislators State funds for Oklahoma Medicaid expansion remain untouched Akron Children’s creates new company to care for 100,000 Medicaid patients D.C. plans to rebid its troubled Medicaid contracts, as risk of patients losing access to MedStar doctors looms Montana’s plan to end continuous Medicaid coverage sparks objections NY- DiNapoli: Medicaid Billing Errors Cost State More Than $1.5 Billion Iowa in ‘uncharted territory’ as Medicaid numbers swell Florida Medicaid Could Face Hefty Deficits Ambulance carveout is latest Illinois Medicaid managed care battleground Ohio Medicaid chief dodges when asked to explain business with company AG said “fleeced” taxpayers FL- Medicaid plans offer incentives to boost vaccinations Ohio children on Medicaid can get $100 gift card for first COVID shot MO- Medicaid expansion applications ‘will sit there’ until October, official tells Missouri state workers Ohio delays rollout of revamped Medicaid system to July 2022 Texas Wins Preliminary Victory Against Biden Administration in Medicaid Lawsuit Nevada awards Medicaid contracts to 4 insurers OREGON- Sen. Ron Wyden pledges Medicaid funding for air conditioners State to expand Medicaid eligibility following court ruling Centene’s Nevada Health Plan Awarded Medicaid Managed Care Contract Molina Healthcare Awarded Nevada Medicaid Contract Maryland Physicians Care Enlists Barbershops and Salons to Help Promote Medicaid Benefits CMS extends deadlines for Medicaid redeterminations after COVID-19 public health emergency ends Centene awarded Ohio Medicaid contract following $88M settlement Ohio’s Medicaid work requirement approved by Trump now overturned by Biden Biden to reopen public comment on TennCare block grant Court places Tennessee’s Medicaid block grant lawsuit on hold Framework for $3.5T Senate package seeks to close Medicaid gap, add new Medicare benefits and tackle drug prices PENNSYLVANIA- Wolf Administration Announces Plans to Expand Medicaid Postpartum Coverage Period for Mothers KANSAS- Audit reveals KDHE mistakenly paid $1.3 million to Medicaid contractors for care of dead people Feds to nix Montana’s Medicaid work requirement Feds withdraw approval for Ohio Medicaid work requirements Democrats oppose changes to Medicaid expansion eligibility Mandatory COVID-19 Vaccination for Health Care Workers as a Condition for Medicare and Medicaid Participation – Center for American Progress Medicaid Cost of Incomplete Payment Eats Into Physician Reimbursement California to offer vaccine incentive to Medicaid population ARKANSAS- The governor said only 4% of traditional Medicaid recipients have been vaccinated. That’s not correct. MISSOURI- DSS needs additional employees and two months to implement Missouri Medicaid expansion TMC leaving Medicaid provider tax pool Medicare And Medicaid Turn 56 Today. That’s Not Exactly Cause For Celebration. With 13K new members in Central Oregon, Medicaid will carry pandemic lessons Pritzker Administration Expands Medicaid Coverage for Critical Diabetes Prevention and Management Programs Georgia in line to recover $500 million in Medicaid overpayments NC calls Medicaid payment delays unacceptable NCDHHS Announces Medicaid Managed Care Regional Behavioral Health I/DD Tailored Plans- Bladen County Included MS may be paying out fraudulent Medicaid benefits Controller finds overpayments, money spent on yoga in Philly’s administration of Medicaid funding Virginia launches new behavioral health services for Medicaid members Massachusetts Scores 10% Medicaid Rate Hike Through American Rescue Plan Act Funding Kentucky Medicaid recipients get a $100 gift card with in-home vaccinations Ohioans on Medicaid Will Get $100 if They Get Their First COVID Vaccine by Sept. 15 Managed care group reports improved vax rate among W.Va. Medicaid recipients $3 million Medicaid reimbursement bump a ‘lifesaver’ for some assisted living providers NCDHHS announces Medicaid Managed Care Regional Behavioral Health I/DD Tailored Plans Aduhelm could be a strain on Medicaid Fired for comparing a mask reporting policy to Nazism, Medicaid exec sues Libertarian group sues government over information on $143 billion in improper Medicaid payments California Is Expanding Medicaid To Undocumented Residents Age 50+ Centene’s Medicaid Enrollment Rises By 1.3 Million As Pandemic Drags On Florida Medicaid enrollment tops 4.8 million, surpassing forecast growth Paxton Seeks Preliminary Injunction After Biden Administration Illegally Revoked Medicaid Waiver Arkansas submits plan for overhauling Medicaid expansion Hyde Amendment fight just the first step in changing abortion coverage Fate of Missouri Medicaid expansion in the hands of the state Supreme Court MetroPlusHealth ranks #1 in 2020 Medicaid Quality Incentive Program Senators seek Medicaid-like plan to cover holdout states Oregon Will Use Medicaid Funding For Mental Health Emergency Response Wisconsin Submits Plan to Enhance and Improve Medicaid Home and Community-Based Services A Medicaid boost gives Colorado a chance to re-do disability services Supreme Court Leaves Fight Over Medicaid Work Rules in Limbo Study: More Medicaid Enrollees Receiving Medication For Opioid Use Disorder, But Disparities Exist CMS Addresses Substance Use, Mental Health Crisis Care for Those with Medicaid Health network sues, claims NY Medicaid reimbursement not enough to treat substance abuse Paramount takes legal action to halt, end Medicaid procurement process Iowa Medicaid Officials To Seek Another Medicaid Managed Care Organization Division of Medicaid and Medical Assistance to Gather Feedback on Managed Care Organizations, Ways to Improve Program Florida applies for $1.1 billion in additional Medicaid funds U.S. Supreme Court To Hear Florida Medicaid Dispute Costs Watched as Medicaid Managed Care Begins in N. Carolina Oregon Will Start Purging 200,000 From Medicaid Rolls Next Summer Medicaid in NJ to cover undocumented kids IL- Pritzker signs bill making healthcare more affordable, accessible for Illinoisans on Medicaid Indiana Republicans oppose Biden administration’s block of Medicaid work rules Anthem completes acquisition of Puerto Rico-based MA, Medicaid plans New York Ends Telehealth Waivers; Issues New Medicaid Guidance Missouri Supreme Court to hear Medicaid expansion lawsuit D.C. – Gray Accuses Colleagues of Medicaid Contract Steering Dental services available through Medicaid Medicaid beneficiaries less likely to get COVID-19 shots Repeal of Medicaid Work Requirements Draws Praise and Complaints Big Change To NC Medicaid System Takes Effect Thursday Proposed Facelift For Arkansas’ Medicaid Expansion Sparks “Equal Access” Questions Many Louisiana residents may need to renew Medicaid benefits as COVID-19 emergency winds down Medicaid rebid stripped from Ohio budget. Other actions unclear CMS announces new director of Center for Medicaid and CHIP Services Georgia officials seek to postpone limited Medicaid expansion Pa’s Medicaid is so valuable that Aetna, Centene, Gateway sue to run it OHIO- Proposed budget changes said to threaten Medicaid reforms NC Medicaid providers to be reimbursed for COVID-19 vaccine counseling OHIO- Medicaid Contractor Data Breach Affected 334,000 Providers Medicaid boasts record enrollment, but a purge is coming Health insurers capitalize on pandemic-fueled Medicaid growth Judge rules Missouri doesn’t have to implement Medicaid expansion Florida Eliminates COVID-19 Flexibilities For Medicaid Texas Democrats propose bill to let local governments expand Medicaid without state consent Democrats are working on a ‘Plan A’ for finally getting full Medicaid expansion Mississippi is probing another Medicaid contractor over pharmacy benefits Ohio overhauling $20B Medicaid program, but budget could pump the brakes Senate Budget Derails Ohio’s Medicaid Managed Care Process Florida asks for more time on potential Medicaid boost VA- McAuliffe emphasizes health care with pitch for Medicaid buy-in plan Missouri lawmakers expect special session next week to renew important Medicaid tax Medicaid Spending on Hemophilia Therapies in US Tripled in 2005-19 Gov. Abbott Signs Bill Extending Medicaid Coverage For New Texas Mothers Former Iowa Department of Human Services Director Jerry Foxhoven files wrongful termination lawsuit Oregon Health Authority, Medicaid Insurers Haggle Over Vaccination Incentive Money Congress Weighs a “Fallback” for Medicaid Coverage Gap Centene agrees to settle Medicaid claims with Ohio, Mississippi for $143 million Supreme Court (SCOTUS) Upholds ACA (Obamacare) in 7-2 Decision – Bloomberg Louisiana Senate scuttles post-pregnancy Medicaid extension Illinois Selects CNSI to Support Ongoing Medicaid Modernization Efforts OHIO- Senate Proposal To Change Medicaid Procurement Process Draws Criticism OHIO- Gift cards offered as incentive for people on Medicaid to get COVID-19 vaccine Parson says budget cuts are coming next month if deal on Medicaid tax renewal is not reached Missouri deems Medicaid expansion lawsuit an ‘attempt to circumvent’ constitutional requirements Chiquita Brooks-LaSure, CMS Head, Vows To Improve Access To Health Care DHS Working To Eliminate Medicaid Waiver Waitlist; Advocates Express Concerns Fate of Medicaid privatized managed care uncertain after Oklahoma Supreme Court ruling Vaya, Cardinal merge to take on Medicaid transformation Kemp’s Medicaid waiver plan marches on despite sharp criticism from federal review Great Circle, accused of overbilling Medicaid by nearly $2 million, settles case for less than $10,000 Three moms sue Missouri over Medicaid expansion CMS Proposes Delays to Major Regulations Affecting Medicaid Rebates CareSource adds cash to its vaccination incentives for Indiana Medicaid members Another 10 years for Texas’s 1115 waiver? Experts say it’s unlikely New Hampshire Selects Conduent to Provide Medicaid Beneficiaries with Improved Access to Healthcare Information Montana Medicaid Expansion Enrollment Hits Record During Pandemic Medicaid insurers at heart of Nevada public option plan Former state Medicaid director hired by University of Vermont Health Network Ohio Senate wants a redo of Medicaid managed care contracts State officials drop plans for 2-tier Medicaid system Gov. Stitt’s plan to privatize Medicaid lacks required legislative authorization, Oklahoma Supreme Court says Senate confirms Chiquita Brooks-LaSure as head of CMS Oklahoma Senate want framework for Stitt’s Medicaid managed care Tennessee moves to defend Medicaid waiver from legal challenge Illinois Medicaid companies made record-breaking profits during pandemic, investigation finds Guam officials eye Medicaid cliff Bill cutting procedural roadblocks for kids with Medicaid picks up steam in Texas legislature New House, Senate bills aim to make telehealth expansion permanent in Medicare, Medicaid Bipartisan group of lawmakers reintroduces bill to give inmates Medicaid access PhRMA files federal lawsuit to get rid of controversial Medicaid drug rebate rule Wisconsin Republicans to quickly kill Medicaid expansion Judge sets Medicaid expansion trial date Medicaid Enrollment Spikes During Pandemic Texas Senate passes bill extending Medicaid coverage for new moms Centene CEO: Missouri Medicaid decision an ’embarrassment’ Hospitals question fee increase to help pay for Medicaid expansion Potential seen for big financial paybacks from insurers to Medicaid The Biden Administration Greenlights $12 Billion In Federal Medicaid Home Care Money. How Will States Spend It? Group ‘reluctantly’ suspends Medicaid expansion ballot push GOP leaders reject Tony Evers’ proposal for Medicaid expansion Missouri pulls Medicaid expansion Oklahoma lawmakers seek to put ‘guardrails’ on privatized Medicaid expansion Federal Incentive Program Fails to Motivate Many Medicaid Providers Texas sues Biden admin over decision to pull Medicaid waiver State Sues Feds Over $97.57 Million In Medicaid Money This state is strongly considering a 10% Medicaid pay boost, and officials likely will dictate precisely how providers spend it Medicaid agency poised to extend contract with Centene, embattled insurer and big campaign donor NJ Targeting Medicaid Members in Vaccine Push New partnership will connect Medicaid members with free cell phones Medicaid enrollment increased 5 million during pandemic Medicaid transportation program failing by the thousands in Indiana Gambling in, Medicaid expansion out, with Alabama’s latest rural health care approach Kentucky must rebid Medicaid contracts again, judge rules Centene earnings buoyed by Medicare/Medicaid Four years after passing Medicaid buy-in, lawmakers to consider new public option proposal Medicaid covers nearly a third of RI population Democrats vow court battle if lawmakers don’t fund Missouri Medicaid expansion OK- McEntire wins passage of State-Run Medicaid Plan Paramount to appeal state’s denial of Medicaid business State official appointed to run Iowa’s Medicaid program Molina buys up Cigna’s Medicaid business in Texas for $60M King & Spalding Represents Medicaid Beneficiaries in a Suit to Challenge the Approval of the TennCare III Medicaid Demonstration Project Medicaid Expansion Effort Fails in Texas House Despite Bipartisan Momentum Revoked Texas Medicaid waiver credit negative for hospitals Anthem reports major Medicaid growth in Q1 as executives downplay concerns of pent-up care demands Missouri Senate panel votes down Medicaid expansion funding Reality sets in: Dems doubtful that FL Legislature will expand Medicaid for the vulnerable On the cusp of expanding Medicaid, Oklahoma opens enrollment June 1 The Health 202: Biden’s pick to lead Medicare and Medicaid knows the policy weeds Medicaid Under the Biden Administration: The American Rescue Plan Act – Lexology Texas Medicaid expansion picks up bipartisan support, but hurdles remain CMS pulls major Texas Medicaid waiver over concerns Trump admin hastily approved it Top Senate Republican holds up CMS nominee over Medicaid waiver Mississippi started investigating its largest Medicaid contractor 2 years ago Mississippi investigating Medicaid drug services provider Centene Out-of-state pediatric care vexes Medicaid programs Governor names former Medicaid director to lead agency again State files lawsuit, alleging company stole millions in Medicaid payments CareSource wins procurement award to keep doing business with Ohio Medicaid Open enrollment underway for NC’s new Medicaid system Medicaid expansion ballot initiative groundwork underway in Mississippi Around the nation: CMS rescinds Medicaid work requirements in 2 more states Biden administration confirms plan to end Wisconsin Medicaid work requirement Medicaid expansion campaign kicks off in South Dakota Reporters reveal diversion of Medicaid funds meant for nursing homes CareSource and other insurance companies do not yet know which will be chosen for Ohio’s overhauled Medicaid system Iowa Senate approves pilot program allowing Medicaid recipients to have direct primary care agreements Florida backs off from removing ex-foster kids from Medicaid Governor Signs School-Based Medicaid Bill Biden Proposes The Biggest Medicaid Home-Based Long-Term Care Expansion In History, But…. Drug Manufacturers Face Elimination of Medicaid Rebate Cap Beginning in 2024 Who’s Eligible For Medicaid? Rule Change Allows More Virginians to Sign Up 5 Things Hawaii: Budget testimony, Medicaid RFP awards, Optimistic economic outlook – State of Reform Georgia’s congressional Dems urge Biden to scrap state’s Medicaid plan – Georgia Recorder ‘Let voters decide’: Ballot initiative to expand Medicaid filed in Mississippi Ohio Medicaid chooses Aetna to manage care of kids with complex mental health needs Will the Missouri Senate back the House’s effort to defund Medicaid expansion? Senate leader weighs in Medicaid Fraud Control Units Performed Poorly During the Pandemic Bill aims to give marijuana revenue to tribal governments Colorado Lawmaker Takes Action After a Business Owner Loses Nearly $50,000 Over Two Emails Lost In Spam Folder: ‘This is Nuts’ Legislative Auditor finds shoddy oversight of grants at DHS Massachusetts home care company pays $1.25M for alleged Medicaid fraud Legislature pushes back on Cuomo policy to restrict Medicaid at-home care program House puts Missouri voter-approved Medicaid expansion in limbo Ga. GOP bets on limited Medicaid expansion despite fed’s push for more Lawsuit challenging Medicaid abortion restrictions in Pennsylvania dismissed House proposal would slice Medicaid reimbursements for nursing homes, hospitals Medicaid And The American Rescue Plan: How It All Fits Together AR- Medicaid bill moved to House; sponsors optimistic after committee vote backs measure Missouri Medicaid in limbo as funding bill pulled Wyoming House passes Medicaid expansion bill on 32-28 vote Oklahoma getting ‘a significant amount’ more in Medicaid money from federal relief bills Alabama reviewing Medicaid expansion incentives Tennessee could expand Medicaid and save $900M under Biden’s new offer TX- Effort to extend Medicaid coverage for new mothers emerges in Texas Legislature MS- Medicaid not expected to expand in Mississippi Florida not expanding Medicaid but extending postpartum coverage from two to 12 months Medicaid incentive so far not enough to sway holdout states PA Medicaid enrollment up 13.7% during COVID pandemic. State needs $941M to cover 13 indicted in alleged Medicaid fraud scheme Mississippi Medicaid officials investigate Centene’s pharmacy payments Waiting Lists May Be Eliminated For Disability Services Provided By Medicaid Senate confirms Xavier Becerra as HHS secretary Gov. Cox names Interim Medicaid Director Florida unlikely to expand Medicaid for 800,000 residents, despite offer of more federal money Georgia vows to continue fight if feds kill Medicaid waiver plan Feds will cover 100 percent of Medicaid vaccinations U.S. Supreme Court scraps arguments in Medicaid work case Centene’s “corporate greed” led it to allegedly overcharge Ohio’s Medicaid department Texas Judge Sides Against Planned Parenthood, Finalizing Cut From Medicaid Program | The Texan Centers for Medicare and Medicaid Services guidance expands nursing home visits Medicaid expansion amendment dies in Kansas Senate Meet Circulo, the insurtech firm on a mission to disrupt Medicaid managed care Spending bill for Medicaid expansion raises questions about intent Medicaid Work Rule Fight Threatens Push to Cover Social Needs Tennessee’s Medicaid Waiver For A Closed Drug Formulary Could Be A Trendsetter Georgia budget: House endorses behavioral health & developmental disability spend, not Medicaid Medicaid Managed Care Shows Marginal Increase in Preventative Care Medicaid, Obamacare enrollment up in SC as many lost employer health care during pandemic Texas Medicaid subcontractor dumped after data breach Medicaid-to-Medicare reimbursement ratio nears pre-Great Recession level Elimination of Medicaid Rebate Cap in the Latest COVID-19 Relief Package—The First Legislative Action on Drug Pricing Under the Biden Administration How the $1.9T COVID-19 Relief Package Impacts Medicaid, CHIP Measure on Medicaid clears state insurance panel Senate approves the reworked Medicaid expansion without the work rule – Arkansas Times The EBCI Tribal Option and what it means for Medicaid beneficiaries Biden picks Chiquita Brooks-LaSure to run Medicare, Medicaid Aetna protests Oklahoma managed Medicaid picks: 4 things to know Federal government asks court to scrap challenge to Medicaid work requirements Congress Requires New Medicaid Payment Reporting Nevada Medicaid enrolls record 810,000 residents Audit: N.C. Medicaid failed to confirm provider qualifications House Lawmakers Include 7.35% Medicaid Boost for Home- and Community-Based Services in Stimulus Proposal House Plans Medicaid, Drug Price Reforms: Stimulus Update 2 million Washingtonians rely on a Medicaid system that’s driving away doctors and dropping new mothers Gov. Stitt likely to prevail in Medicaid fight, says House Speaker Charles McCall Feds woo Georgia, other Medicaid expansion holdouts with billions Timing fluke could garner Missouri $1.7 billion in additional federal Medicaid funds Feds never replied to South Dakota’s request to join Medicaid work program, DSS secretary says Biden administration likely to cancel controversial SC Medicaid work requirements Biden’s HHS to rescind Medicaid work requirements; NH attempt thwarted by courts Feds temporarily halt approval of Georgia Medicaid overhaul backed by Gov Kemp GAO: Puerto Rico spent most of its ’18 Medicaid budget on contractors Anthem To Buy Puerto Rico Medicare And Medicaid Plans Public Charge Executive Order Met With Cheers and Jeers Department of Human Services Provides Updates on Work Supports System for Medicaid Recipients State leaders react to Medicaid bill funded by medical marijuana Judge blocks Texas effort to remove Planned Parenthood from Medicaid The Health 202: Biden narrows picks to lead Medicare and Medicaid down to two choices Governor drops proposal for Medicaid budget cut Indiana Lawmakers Propose Using Cigarette Tax For Medicaid Medicaid expansion cost-share deal would stay put in Warnock, Ossoff bill Some Illinois Medicaid patients in Chicago have limited pharmacy access Nevada Medicaid provides same-day transportation for testing and vaccines CMS Failed to Flag Medicare Fee-for-Service Healthcare Fraud, Waste 18 states back Arkansas on Medicaid work rule Humana to Begin Serving Medicaid Managed Care and Dual Eligible Residents in South Carolina Florida Medicaid website hacked for 7 years, hundreds of thousands affected Executive Order on Strengthening Medicaid and the Affordable Care Act | The White House Analyzing Recent Trends in Medicaid/CHIP Applications: What We Do and Do Not Know Oklahoma chooses vendors for $2 billion program partially privatizing Medicaid Threat of Medicaid block grants could be axed under Biden DHHS approves Legal Aid of N.C. as Medicaid transformation ombudsman services Sweeney, Greenstein Initiative to Improve Medicaid Prescription Drug Services Wins Committee Approval Medicaid, education numbers most notable in Gov. Sisolak’s proposed 2021-2023 executive budget Key MS House leader offers bill to restructure authority over Division of Medicaid Senators negotiate first steps in funding Missouri’s mandated Medicaid expansion Kentucky Medicaid bill would reduce managed care organization contracts to three Outgoing HHS Secretary Files Supreme Court Brief Supporting Medicaid Work Requirements Medicaid pays $6.6 billion for HCBS for older adults through Section 1915c waivers – News – McKnight’s Senior Living WI Submits Medicaid Demonstration Waiver, Health Savings Account Program Nevada lawmakers told Medicaid will require nearly $12 billion over 2 years State senators argue over plans to move Medicaid onto managed care contractors (Oklahoma) Amazon surpasses Walmart for most Nevada employees and dependents on Medicaid New Mexico leads nation in Medicaid health care enrollment Feds boost Florida’s Medicaid coffers by extending COVID-19 public health emergency Ohio names one pharmacy benefit manager for Medicaid to save cash Congress Delays Medicaid DSH Cuts, Makes Targeted Medicaid Policy Changes | Manatt, Phelps & Phillips, LLP – JDSupra California proposes expanding Medicaid coverage of continuous glucose monitors Bill to end Medicaid managed care advances in Illinois House CMS won’t add new Medicaid accountability rule Medicaid transformation initiative remains on pace for July 1 launch (NC) Corrado Bill Raising Reimbursement Rates for Medicaid Private Duty Nurses Advances (NJ) Info of hundreds of Wisconsin Medicaid members may have been exposed Artificial intelligence machine was able to dupe Medicaid.gov Colorado public option bill sponsor says the proposal will be reintroduced this year CMS Releases Guidance on Funding for SDH Programs CMS issues guidance for state Medicaid SDOH programs Appeals Court Upholds Trump Rule Requiring Hospitals to Show Prices Upfront The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages A-01-20-00502 12-30-2020 UnitedHealth to Purchase Change Healthcare for $8 Billion Trump Team Approves Controversial Request To Revamp Medicaid In Tennesssee Aetna drops Walgreens from its Illinois Medicaid plan Humana files new Medicaid lawsuit over membership assignment – Louisville Business First CMS officially withdraws $50B threat to Medicaid Commonwealth Provides Update on Latest Medicaid, SNAP Enrollment Data, Announces Recent Changes to SNAP Benefits and Eligibility Centene Is Climbing on Its Plans to Buy Magellan Health for $2.2 Billion Centene Is Climbing on Its Plans to Buy Magellan Health for $2.2 Billion Data Set Review- 2020 MACStats Data Book Georgia is not reporting adequate Medicaid, PeachCare data Virginia May Have to Foot the Bill for Commonwealth Center’s Mistake As relief stalls, restoring Medicaid for Dubuque’s Marshallese is hanging in the balance Tennessee Medicaid plan’s vendor mails PHI to wrong members, exposes 3,300 individuals’ info Larry Hogan announces that Medicaid reimbursement increases will go into effect January 1 State still waiting to hear word about Medicaid waiver Work Requirements Can Preserve Medicaid For Those Who Need It Most DHHS childhood reading program gains $3 million in federal Medicaid funding CMS finalizes rule for greater pricing flexibility for Medicaid drug purchases D.C. Medicaid contract awards violated procurement rules, judge says 2020 MACStats Released by MACPAC Medicaid costs, enrollment spiral in pandemic 1199SEIU pushing to repeal medicaid drug carve-out With new model, CMS opens up home care opportunities for MCOs serving dual eligibles – Home Care Daily News – McKnight’s Senior Living Medicaid and CHIP enrollment grew 5.6% since last year U.S. Supreme Court takes Medicaid work-requirement appeal with N.C. implications | Local News | journalnow.com Medicaid MCOs covering dual-eligibles to join direct contracting HHS Proposes New Prior Authorization Rules for Medicaid, CHIP and Certain Marketplace Plans – Manatt, Phelps & Phillips, LLP As pandemic tears through Louisiana’s economy, Medicaid enrollment surges by 208,000 | Legislature | theadvocate.com A year in, Idaho is paying more for new Medicaid enrollees with expensive conditions… | Eye on Boise | idahopress.com annual-report-on-certain-fraud-and-abuse-recoveries-fy-2020.pdf Nursing Home Providers Sue for Access to $153M in COVID-19 Medicaid Rate Boosts – Skilled Nursing News Opinion: Medicaid expansion states less prepared for COVID-19 Supreme Court to consider Medicaid work requirements | Healthcare Finance News Republican lawmakers ask Gov. Kevin Stitt to reconsider privatizing Medicaid – OK Governor’s health care group has tough time getting past Medicaid barrier (NC) Missouri House budget leader hopes for cost-saving Medicaid reforms, expects tough budget year Feedback on Next Medicaid Managed Care RFP Due December 29 | Department of Health | State of Louisiana Florida finds PBMs are benefiting from a lucrative profit center Magellan Rx Management Releases Fifth Annual Medicaid Pharmacy Trend Report Kentucky Medicaid court case heads to mediation with several hurdles – Louisville Business First Medicaid managed care companies take protest to court | NC Health News Health Alliance Plan Acquisition Of Trusted HP – Michigan Approved New Hampshire regulators block Partners acquisition over antitrust concerns – Boston Business Journal Blue Cross puts merger on hold amid video showing CEO sideswiping tractor trailer on I-85 Optima Health to take majority stake in Virginia Premier | Virginia Business -Feds reviewing Cuomo’s Fidelis deal : Empire Center for Public Policy Healthplex Acquired by Affiliates of MCNA Dental UnitedHealth buys Virginia Medicare Advantage plan Molina Healthcare to Expand New York Presence Through Acquisition of Certain Assets of YourCare Health Plan | Business Wire -Centene, Walgreens and RxAdvance Announce Partnership to Provide Innovative Pharmacy Management Model Insurer’s stake in firm stirs concern in Arkansas Blue Cross Blue Shield of Arizona acquires Steward Health Choice Arizona | AZ Big Media Centene and CVS Health Announce Agreement for CVS Health to Acquire IlliniCare Health | Centene Corporation WV MetroNews The Health Plan clarifies that its marriage with WVU Medicine is off – WV MetroNews -Hackensack Meridian Health to merge with Englewood Health -Community Health Systems Announces Definitive Agreements to Sell Three Virginia Hospitals | Community Health Systems, Inc. -California AG rejects Adventist-St. Joseph merger -Sanford Health, UnityPoint Health call off merger Quorum Health considering buyout offer from KKR The Stepping Stones Group Acquires New England ABA, Inc. -4 Arkansas behavioral health providers plan merger to form Arisa Health – Talk Business & Politics [Updated] Walmart Health, Amedisys Partner to Expand Home Health Access Nationwide – Home Health Care News -Addus HomeCare Completes Purchase Of Hospice Partners Of America | Addus HomeCare -Towerbrook, Ascension Health to Acquire Compassus for $1 Billion – Hospice News -Alpine Investors’ TEAM Services Group Completes Investment in AmeriBest, a Leading Home Care Agency | Business Wire -Revelstoke Completes Investment in The Care Team | Business Wire Acorn Health Acquires Behavior Therapy Specialists in O’Fallon, IL | Business Wire -Expanding Into Pennsylvania, CareFinders Total Care Doubles Down With Acquisitions of At Home Quality Care and Philadelphia Home Care, Inc. UnitedHealth buys Virginia Medicare Advantage plan Molina Healthcare to Expand New York Presence Through Acquisition of Certain Assets of YourCare Health Plan | Business Wire Health Alliance Plan Acquisition Of Trusted HP – Michigan Approved New Hampshire regulators block Partners acquisition over antitrust concerns – Boston Business Journal Blue Cross puts merger on hold amid video showing CEO sideswiping tractor trailer on I-85 Optima Health to take majority stake in Virginia Premier | Virginia Business -Centene, Walgreens and RxAdvance Announce Partnership to Provide Innovative Pharmacy Management Model Healthplex Acquired by Affiliates of MCNA Dental Feds reviewing Cuomo’s Fidelis deal : Empire Center for Public Policy MEDNAX Reaches Agreement to Sell MedData Business to Frazier Healthcare Partners (Highlighted) Data Set Review: Substance Abuse and Mental Health Data Archive (SAMHDA)
