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.
Medicaid
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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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Missouri to Pause New Medicaid Enrollment for Two Provider Groups Aug. 1
Missouri will pause initial MO HealthNet enrollment applications for DMEPOS and consumer-directed services or personal-care providers statewide starting Aug. 1, 2026. Existing active providers and applications received before that date are excluded.
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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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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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Michigan’s FY 2026-27 Budget Is Law: What Changes for Roads, Schools and Medicaid
Gov. Gretchen Whitmer signed Michigan’s FY 2026-27 budget on July 21. Most spending changes begin with the fiscal year on October 1, including money for roads, free school meals, tax provisions and Medicaid and SNAP administration.
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Beshear Plans to Use More Than $781 Million to Block Kentucky Medicaid Rate Cut
Gov. Andy Beshear says unexpected state revenue will prevent a scheduled 4% Medicaid provider-rate cut on August 1, fund additional Michelle P. waiver costs and address other state funding gaps.
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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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Texas leaders set 3% lower baseline for 2028-29 agency budget requests
Texas leaders are requiring agencies, appellate courts and universities to build 2028-29 budget requests around a 3% lower baseline, with major exemptions.
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Oklahoma Medicaid fraud case widens as AG probes thousands of enrollments
Oklahoma’s Medicaid agency says thousands of residents may have been fraudulently enrolled as the attorney general examines oversight and fraud referrals.
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Medicaid Fraud Referrals Vary Widely Across States, HHS Watchdog Says
A new HHS-OIG evaluation found Medicaid managed-care fraud-referral deadlines range from one day to 270 days, with uneven training, enforcement and feedback.
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HHS Defers $1.07 Billion in Medicaid Payments to California, Minnesota
HHS is temporarily withholding $1.07 billion in Medicaid payments to California and Minnesota while states document claims federal officials labeled high risk.
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HHS-OIG denies New York Medicaid fraud unit’s recertification
HHS-OIG denied recertification of New York’s Medicaid Fraud Control Unit and suspended federal funding through Sept. 30 after saying the unit lagged similar states in criminal fraud cases. ([oig.hhs.gov](https://oig.hhs.gov/documents/medicaid-fraud-control-units/11727/NY_MFCU.pdf))
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Dallas division at center of North Texas health-care fraud sweep
Federal prosecutors charged 13 North Texas defendants in seven cases, with most in the Dallas division, as part of a June 23 fraud sweep.
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CMS Medicaid work rule faces lawsuit over medical-frailty exemption
A multistate lawsuit says CMS’s new Medicaid work-requirement framework could make exemption checks harder before the Jan. 1, 2027 rollout.
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DOJ health-care fraud sweep: 455 charged, $6.5B in alleged false claims
DOJ says its 2026 National Health Care Fraud Takedown charged 455 defendants tied to more than $6.5B in alleged false claims. The rollout is continuing.
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States and D.C. sue CMS over Medicaid work/community-engagement limits
On June 29, 2026, states and D.C. sued CMS over Medicaid work and community-engagement rules, saying CMS will narrow the “medically frail” exemption before Jan. 1, 2027.
