CMS opens comment period on permanent Medicare drug-negotiation framework
CMS proposed long-term rules for negotiating and renegotiating prices for high-cost, single-source Medicare drugs beginning in 2029. Comments are due Aug. 17, 2026.
Health Policy
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CMS Sets Nationwide Medicaid Work-Requirement Framework for 2027
An interim final rule from CMS will require certain adult Medicaid applicants and enrollees to document 80 hours of work, education, training or community service each month.
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CMS Plans Stricter Medicaid Waiver Spending Tests for 2027
CMS plans tougher financial reviews for Medicaid Section 1115 demonstrations beginning January 1, 2027, potentially limiting states’ waiver flexibility.
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CMS Proposes Medicare Oversight and Home-Health Payment Changes
CMS proposes broader Medicare enrollment enforcement and a projected 2.4% aggregate home-health payment increase for 2027. Comments are due August 31.
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Federal Medicaid deferrals pressure California and Minnesota
HHS is holding more than $1 billion in Medicaid payments while California and Minnesota document claims flagged for review, with providers facing added scrutiny.
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States face a January deadline as Medicaid work-rule systems move into implementation
CMS is helping states build Medicaid work-rule systems before January 1, 2027, including data checks, notices and exemption reviews for affected adults.
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New York Medicaid officials seek public input on proposed five-year waiver extension
New York is asking CMS to extend a major Medicaid demonstration for five years. Residents can speak Aug. 11 or submit written comments by Aug. 21, 2026.
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Nebraska Medicaid Work-Requirement Reviews Begin for First Renewal Group
Nebraska began Medicaid expansion work requirements May 1. Existing members are reviewed during their regular renewal, with the first affected eligibility periods ending July 31, 2026.
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Arkansas Medicaid Work-Requirement Checks Begin, With Penalties Delayed Until 2027
Arkansas DHS is checking records for many ARHOME enrollees during a six-month soft implementation. Notices may arrive now, but penalties under the new requirement begin no earlier than January 1, 2027.
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Ohio Medicaid Work Requirements: What Enrollees Need to Know Before 2027
Ohio Medicaid’s new 80-hour monthly community-engagement requirement begins January 1, 2027. Here is who may be affected, how Ohio plans to verify eligibility and what enrollees should do before notices arrive.
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New Hampshire Medicaid Members Should Prepare for 2027 Work-Requirement Changes
New Hampshire is preparing Granite Advantage members for federal Medicaid changes beginning January 1, 2027, including an 80-hour monthly community-engagement standard for applicable adults.
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Nevada Medicaid prepares for 2027 work requirements and six-month renewals
Nevada plans September notices to about 280,000 Medicaid expansion members before a January 1, 2027 federal work requirement, while exemptions and a lawsuit could change implementation.
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California Faces $867.5 Million Medicaid Deferral as IHSS Review Reaches Deadline
CMS is withholding $867.5 million in federal Medicaid funds from California while reviewing in-home-care claims. The state says IHSS services continue.
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Ohio Medicaid Audit Flags Weak Oversight and Billions in Potentially Improper Payments
An Ohio Auditor of State review found gaps in Medicaid claims monitoring, reporting, deposits, rebates and system access. A separate audit projected up to $4.4 billion in potentially unallowable costs, but the figure is based on sampled transactions and is not a confirmed loss.
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About 450,000 New Yorkers Must Shop for New Health Coverage After Essential Plan Change
New York narrowed Essential Plan eligibility on July 1, affecting about 450,000 enrollees. Residents have until August 30 to seek coverage retroactive to July 1 and until September 1 to use the special-enrollment period.
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Kentucky Medicaid Members Begin Getting Notices About 2027 Community-Engagement Rules
Kentucky Medicaid’s first notices are informational, but some adults may need to document work, education, training, volunteering or qualifying income before applying or renewing coverage in 2027.
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CMS Will End Part D Premium Stabilization After 2026
CMS will end a temporary premium stabilization program for stand-alone Medicare Part D plans after 2026. Final 2027 plan premiums are expected in September.
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Montana Medicaid Work Rules Are in Effect. What Enrollees Need to Do Before October
Montana Medicaid Expansion adults ages 19 to 64 generally must document 80 hours of monthly activity, but coverage denials or disenrollment for noncompliance are not scheduled until October 2026.
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Iowa Opens Rural Residency Funding Program With Up to $10.5 Million Available
Iowa HHS is seeking applications for up to 14 rural residency programs, with awards capped at $750,000 and applications due August 24.
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Idaho Medicaid Expansion Reporting Rules Begin Jan. 1, 2027. What Residents Need to Know
Idaho will begin applying federal Medicaid expansion reporting requirements on January 1, 2027. Applicants and current enrollees should understand the activity standards, exemptions, review periods and steps to take now.
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HHS begins phased wind-down of COVID emergency authorizations for drugs, devices
United States Public Health Safety and Legal Rules – HHS is ending COVID-era emergency use declarations on different timelines, with medical-device authority expiring first.
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DOJ memo questions disability integration mandate, drawing alarm from advocates
United States Rights and Public Policy – DOJ’s June 18 OLC opinion says the ADA and Rehabilitation Act do not require states to use the most integrated setting.