Medicaid

Federal Health Policy Update for April 30

The following is the latest health policy news from the federal government for April 24-30. Some of the language used below is taken directly from government documents. Congress Yesterday, House Republicans adopted the Senate’s budget resolution, clearing the way for the party-line reconciliation process to move into the drafting phase. The limited budget resolution for Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection instructs the Senate Judiciary and Homeland Security committees to write legislation by May 15. Today, the House passed the Senate’s spending bill to fund the rest of the Department of Homeland Security, including FEMA. [...]

joe2026-04-30T14:21:14-04:00April 30, 2026|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Some States Seek to Expand Medicaid Work Requirements

While last year’s H.R. 1, often referred to as the “One Big Beautiful Act Bill,” introduced a requirement that Medicaid applicants document that they have worked, attended school, or participated in some form of community engagement for one month as a condition of eligibility for the program, a few states are looking to make that requirement more rigorous. Indiana, for example, has turned that one-month requirement into three months and Missouri, Arizona, and Kentucky are considering increasing the requirement as well. Missouri officials are even proposing a constitutional amendment that would ban the state from expanding the scope of current [...]

joe2026-04-29T10:33:23-04:00April 30, 2026|Medicaid|

Federal Health Policy Update for April 23

The following is the latest health policy news from the federal government for April 17-23. Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order calling for accelerated access to medical treatments for patients with serious mental illness, with an emphasis on greater access to psychedelic drugs. Learn more from this executive order and an accompanying White House fact sheet. Shortly after the White House issued this executive order, HHS’s Advanced Research Projects Agency for Health (ARPA-H) announced the first set of research teams for its Evidence-Based Validation [...]

joe2026-04-23T16:43:24-04:00April 23, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicare, Medicare reimbursement policy|

CMS Introduces Next Step in Fighting Medicaid Fraud, Waste, and Abuse

In his agency’s latest attempt to identify and address Medicaid fraud, Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz has announced that states will have 30 days to submit to CMS a plan for revalidating all providers enrolled in their Medicaid programs. In explaining his rationale for this approach, Oz told participants at a recent event that "The basic thing you'd want to do, if you actually cared about the program, is to make sure that legitimate providers are providing services that you're paying for and doing it the right way… So we're asking the states to own [...]

joe2026-04-21T15:42:28-04:00April 22, 2026|Centers for Medicare & Medicaid Services, Medicaid|

Federal Health Policy Update for April 16

The following is the latest health policy news from the federal government for April 11-16. Some of the language used below is taken directly from government documents. CMS – New Proposed Regulations FY 2027 Medicare Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Proposed Rule CMS has published its proposed FY 2027 Medicare hospital inpatient and long-term-care hospital prospective payment system rule. The highlights of the proposed rule are: A 2.4 percent rate increase for both acute-care hospital inpatient and long-term care hospital services. A $564 million reduction in Medicare disproportionate share hospital (Medicare DSH) and [...]

joe2026-04-16T16:21:07-04:00April 16, 2026|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met last week in Washington, D.C. During the course of the deliberations, MACPAC’s staff made the following presentations to the commissioners: Implementing Community Engagement Requirements in Medicaid State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Plans: Draft Chapter Children and Youth with Special Health Care Needs (CYSHCN) Transitions to Adult Coverage: Draft Chapter and Recommendations Automation in the Prior Authorization Process: Draft Recommendations Exploring the Role of the State Medicaid Agency in the Program of All-Inclusive Care for the Elderly: Policy Options Health and Welfare in Self-Directed [...]

joe2026-04-15T12:51:27-04:00April 16, 2026|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care|

Is CON on the Way OUT in Rural States?

The federal Rural Health Transformation Program may sound the death knell for certificate-of-need laws in some states. The rural funding program, created last year as part of H.R. 1, often referred to as the One Big Beautiful Bill Act, is a five-year, $50 billion program intended to offset some of the damage anticipated as a result of that law’s 10-year reduction in federal health care spending, and especially its Medicaid cuts, on rural health care. While every state that applied for funding through the program was awarded grants, the Centers for Medicare & Medicaid Services has indicated that approval of [...]

joe2026-04-10T14:27:33-04:00April 13, 2026|Centers for Medicare & Medicaid Services, Medicaid|

Federal Health Policy Update for April 10

The following is the latest health policy news from the federal government for April 4-10. Some of the language used below is taken directly from government documents. Congress The House and Senate were in recess this week and are scheduled to be back in session on April 14. House Speaker Mike Johnson (R-LA) has indicated that the House will not vote on the Senate‑passed Department of Homeland Security continuing resolution until there is meaningful progress on a reconciliation package to fund U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection. In an effort to narrow the scope [...]

joe2026-04-10T13:43:20-04:00April 10, 2026|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|

Search for Undocumented Medicaid Participants Not Yielding Major Results

An administration effort to identify undocumented U.S. residents illegally enrolled in Medicaid is not turning up many undocumented residents illegally enrolled in Medicaid. At least not so far. Last fall, the administration sent the names of hundreds of thousands of suspected illegal Medicaid participants to the states and directed them to review the eligibility of those individuals. Data from five states, however, has not turned up many such individuals. Between them, Colorado and Pennsylvania reviewed 79,000 names and found none illegally enrolled in their state Medicaid programs. Texas reviewed 28,000 records and terminated 77 people from the program. Ohio checked [...]

joe2026-04-07T16:53:00-04:00April 9, 2026|Medicaid|

States Looking to Swap Medicaid Taxes

With Medicaid provider taxes on the road to oblivion as a result of passage of last year’s H.R. 1, often referred to as “The One Big Beautiful Act Law,” a number of states are looking to Medicaid managed care plan taxes to replace at least some of the tax revenue they will lose from the demise of Medicaid provider taxes. Iowa has already adopted such a tax, more than tripling its Medicaid managed care plan tax in the middle of its fiscal year. The state even increased taxes on managed care plans that do not serve Medicaid patients. Elsewhere, lawmakers [...]

joe2026-04-07T14:42:09-04:00April 8, 2026|Medicaid|