HHS Defers More Than $1 Billion in Medicaid Payments to California and Minnesota
The Department of Health and Human Services said the payments will remain deferred while it reviews claims classified as high risk in a Medicaid fraud crackdown.
Medicaid
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Three Companies and Executives Agree to Pay $36.4 Million Over Genetic-Testing Billing Allegations
Access DX Laboratory, former CEO Michael Stewart and Florida businessman Harold Shatz reached settlements with the United States over alleged kickbacks and medically unnecessary genetic testing billed to Medicare and Medicaid.
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UVM Health cuts 76 jobs and restructures 66 more positions amid pressure to reduce costs
The University of Vermont Health Network says it will eliminate about 76 positions and require 66 employees to reapply for restructured jobs as it seeks to reduce expenses.
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New York sues over Medicaid work rules that state says could affect 475,000 recipients
New York Attorney General Letitia James joined 24 states and Washington, D.C., in challenging federal Medicaid work requirements scheduled to begin Jan. 1, 2027.
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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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GAO Flags Fraud Risks in 20 State-Administered Federal Programs With $1.2 Trillion in FY 2025 Funding
A new Government Accountability Office report examines fraud risks and oversight practices in 20 large federally funded programs administered by states and other government entities, including Medicaid, SNAP and disaster assistance.
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GAO warns states lack adequate safeguards for major federally funded benefit programs
A new Government Accountability Office report examines fraud risks in 20 state-administered federal programs that received an estimated $1.2 trillion in fiscal year 2025.
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HHS pauses more than $1 billion in Medicaid payments to California and Minnesota during fraud reviews
Federal health officials paused more than $1 billion in Medicaid payments to California and Minnesota while reviewing high-risk claims, including California in-home-care claims.
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HHS proposes changing Medicaid health-care tax rules
The Department of Health and Human Services published a proposed rule on July 23, 2026, to amend Medicaid’s indirect hold-harmless threshold for health-care-related taxes.
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New Hampshire Medicaid changes begin as premiums and work-rule preparations affect more than 180,000 residents
New Hampshire began implementing Medicaid changes in July, including premiums for some enrollees, while work requirements and eligibility checks remain under preparation.
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Nebraska begins enforcing Medicaid work requirements for expansion members
Nebraska began implementing Medicaid work requirements on May 1, 2026, making it the first state to put the new federal rules into effect as renewal reviews reach more expansion enrollees.
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Kentucky Medicaid provider payments cut 4% beginning Aug. 1
Kentucky Medicaid has notified participating providers that reimbursement rates will be reduced 4% starting Aug. 1 because the state budget does not provide enough funding to maintain current payment levels.
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CMS proposes changing Medicaid health-care-tax financing rules used by states
A new CMS proposal would amend the indirect hold-harmless threshold for health-care-related taxes and could require states to reassess Medicaid financing arrangements.
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GAO says programs handling $1.2 trillion face persistent fraud-management gaps
A new Government Accountability Office review finds continuing weaknesses in fraud-risk controls across 20 federally funded programs administered by states and local governments.
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D.C. Medicaid members in Wellpoint automatically moved to AmeriHealth Caritas
The District says Wellpoint DC members were automatically assigned to AmeriHealth Caritas DC effective Aug. 1, with beneficiaries urged to review care details.
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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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Beshear uses $255 million to block Kentucky Medicaid cut, but long-term funding remains unresolved
Kentucky will use unexpected surplus and corporate-tax revenue to prevent a scheduled 4% Medicaid reimbursement reduction for affected fee-for-service providers. The move protects services through the current fiscal-year period, while lawmakers still face a recurring-funding question.
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Indiana’s Medicaid provider freeze is now in effect. What HCBS providers and families should know
Indiana’s six-month moratorium on new certification and enrollment for many home- and community-based Medicaid providers took effect August 1, following an FSSA audit that reported $198,031,230.18 in extrapolated improper payments.
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Florida Medicaid open enrollment begins Oct. 1: What beneficiaries should watch now
Florida Medicaid open enrollment runs Oct. 1-Nov. 30, 2026. Beneficiaries can keep their plan or request a change effective Dec. 1, while some adults with intellectual and developmental disabilities have a separate voluntary ICMC option.
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CBO Projects $33.6 Trillion in Health Insurance Subsidies by 2036
CBO projects $33.6 trillion in federal health insurance subsidies through 2036, while the uninsured population rises from 30 million to 37 million.
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Medicaid work rules move to state systems. What enrollees should watch
The Medicaid work rule is effective, but states will decide how to verify hours, exemptions and notices before most systems must be ready by Jan. 1.
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New Hampshire approved $1.64 billion more Medicaid contract authority
The state raised the combined ceiling for three Medicaid managed-care contracts to $4.41 billion through August 2029. The approval does not show that the full increase has been spent or will be spent immediately.
