State Policy
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- State Policy · AZ
Arizona Audit Finds AHCCCS Failed to Implement Parent Caregiver Payment Limits
A state audit found that Arizona's Medicaid agency (AHCCCS) has not implemented legally required payment limits for parents who serve as paid caregivers for their developmentally disabled children, more than a year after the regulations became law. Auditors estimate the delay has cost the state hundreds of millions of dollars as program costs continue to escalate. The audit flags ongoing failure to enforce standardized payment guardrails designed to control expenditures in the state's long-term services and supports program for individuals with developmental disabilities.
- State Policy · NE
Nebraska Medicaid Director Resigns Amid Work Requirement Implementation
Drew Gonshorowski has resigned as director of Nebraska's Division of Medicaid and Long-Term Care after less than two years, as the state became the first to implement more aggressive Medicaid work requirements. The leadership change comes at a critical juncture for Nebraska's program. The timing and circumstances of the resignation were not detailed in available reporting. A new director will need to oversee ongoing implementation of the work requirement policy and address any operational challenges in the state's Medicaid program.
- State Policy · PA
Pennsylvania Budget Excludes Home Health Nurse Rate Increase Despite Workforce Shortages
Pennsylvania's enacted budget does not include funding increases for home health nursing services, despite workforce shortages in the sector. Industry representatives report that current Medicaid reimbursement rates make it difficult to recruit and retain home health nurses. The budget outcome means existing rate structures will continue, affecting access to home-based nursing care for Medicaid beneficiaries. Home health agencies serving Medicaid populations face ongoing challenges competing for nursing staff without enhanced reimbursement.
- State Policy
Cato Institute Report Finds Certificate of Need Laws Restrict Healthcare Access
The Cato Institute released a report analyzing nearly 130 studies on certificate of need (CON) laws, which require healthcare providers to obtain state approval before constructing new facilities or adding services. The report concludes that CON laws restrict healthcare access and competition. CON laws remain in effect in approximately 35 states and directly affect Medicaid beneficiaries' access to nursing homes, dialysis centers, home health agencies, and other services that require state approval before expansion. The analysis adds to ongoing state-level debates over repealing or reforming CON requirements.
- State Policy · IA
Iowa Medicaid Fraud Task Force Explores Public Tip Collection Strategies
Iowa's Medicaid Fraud Elimination Task Force, convened by Governor Kim Reynolds in July, held its second meeting on August 12, 2026, to discuss strategies for soliciting fraud tips from the public. Attorney General Brenna Bird emphasized the need for more proactive collection and response to fraud reports. The 11-member task force will draft recommendations for the state on fraud prevention and detection approaches. This initiative signals Iowa's focus on strengthening program integrity mechanisms through public engagement.
- State Policy · NV
Nevada Cuts Out-of-State Behavioral Health Placements for Children by Over Half
Nevada has reduced out-of-state institutional placements for children with behavioral health needs by more than 50% over four years, following federal findings that the state was overrelying on such placements. The state achieved this through expanded community-based services and in-state treatment capacity. The changes address federal requirements under the Americans with Disabilities Act and Medicaid's integration mandate. This matters for state Medicaid agencies and managed care plans managing behavioral health benefits, as it demonstrates a viable pathway to comply with federal home and community-based services requirements while reducing high-cost institutional care.
- State Policy · CA
California Immigrants Drop Medi-Cal Coverage Despite Eligibility Under New Enrollment Rules
California's Medi-Cal program is experiencing enrollment declines among immigrant populations following implementation of new eligibility rules, despite many immigrants remaining eligible for full coverage. Program data show eligible immigrants are not reenrolling due to information gaps and lack of trusted communication channels about continuing coverage. The enrollment drop affects access to care for immigrant Medi-Cal beneficiaries. State agencies and managed care plans face challenges communicating eligibility rules and maintaining enrollment continuity during the transition.
- State Policy · IA
Iowa Gubernatorial Candidate Proposes Ending Medicaid Privatization
Democratic gubernatorial candidate Rob Sand announced policy priorities Wednesday that include ending Iowa's privatized Medicaid managed care program, along with raising the state minimum wage to $12 per hour and investing in farm economy diversification. The proposal represents a campaign platform position rather than pending legislation. If Sand were elected and the proposal advanced, it would fundamentally restructure Iowa's Medicaid delivery system, which has operated under managed care contracts since 2016. The timing and feasibility would depend on the 2027 legislative session and gubernatorial transition.
- State Policy · IA
Iowa Advocates Push to Remove Medicaid Earnings and Asset Limits for Working Disabled Beneficiaries
Advocates in Iowa are urging state lawmakers to eliminate income and asset limits in Medicaid programs that allow people with disabilities to work while receiving benefits. Currently, most states impose earnings caps and asset restrictions on these programs, which advocates argue discourage career advancement and higher-paying employment. The advocacy effort targets state-level policy changes to expand economic opportunity for disabled Medicaid enrollees without risking benefit loss. If enacted, such changes would affect eligibility and enrollment administration for Iowa's Medicaid program serving working individuals with disabilities.
- State Policy · IN
Indiana Lawmakers Seek Audit After Medicaid Disability Waiver Denials Jump to 6%
Democratic lawmakers in Indiana are demanding an independent audit of interRAI, an assessment tool the state's Family and Social Services Administration began using in January 2026. Disability waiver denials spiked to 6% this year from under 1% previously. The timing and scale of the increase has raised questions about the tool's calibration and impact on beneficiaries who need long-term services and supports. This matters for states using or considering similar standardized assessment tools for LTSS eligibility determination.
- State Policy · KS
Kansas Faces $20.6M Federal Penalty Despite Lower SNAP Error Rate
Kansas reduced its Supplemental Nutrition Assistance Program (SNAP) error rate below 12% following passage of the One Big Beautiful Bill Act in 2025, but the state still faces a potential $20.6 million federal penalty. The penalty relates to error rate thresholds established under federal law. State officials have not indicated when the penalty determination will be finalized or whether Kansas plans to contest it. The development affects state budget planning and SNAP administrative operations.
- State Policy · WV
West Virginia Medicaid Work Requirements Launch January 1, 33,000 Beneficiaries Not Meeting Criteria
West Virginia's Medicaid work and volunteer requirements will take effect January 1, 2027, according to a briefing to state lawmakers by the Department of Human Services. An initial analysis found approximately 33,000 current Medicaid beneficiaries are neither meeting the federal work or volunteer requirements nor automatically exempt from them. The requirements were authorized under federal law and will require affected beneficiaries to demonstrate compliance to maintain coverage. This implementation affects a substantial segment of West Virginia's Medicaid population and follows years of legal challenges to work requirements nationwide.
- State Policy · NC
North Carolina Hospitals Deploy Postpartum Wristbands as Medicaid Coverage Cuts Loom
North Carolina hospitals are implementing "I Gave Birth" wristbands to identify recent mothers and encourage emergency care-seeking when postpartum complications arise. The initiative is expanding across multiple states as the Trump administration pursues Medicaid cuts that threaten to reduce postpartum coverage. The wristbands aim to address maternal mortality by prompting clinical staff to recognize and treat postpartum complications. The timing coincides with growing concerns about access to postpartum care under proposed federal Medicaid reductions.
- State Policy · NV
Nevada Lawmakers Consider Maternal Health Protections, Medicaid Fraud Enforcement for 2027 Session
Nevada legislators discussed health policy priorities for the 2027 legislative session at an interim Health and Human Services committee meeting on August 12, 2026. The agenda includes a maternal health "momnibus" bill with multiple pregnancy and postpartum protections, enhanced Medicaid fraud investigation capacity, and streamlined state health agency reporting requirements. Child welfare funding reforms were deferred despite prior discussion. These proposals would affect Nevada Medicaid operations, managed care oversight, and provider compliance once the 2027 session convenes.
- State Policy · NY
New York Gets CMS Approval to Overhaul Medicaid Provider Enrollment and Revalidation
New York's Department of Health received CMS approval to implement a plan revamping the state's Medicaid provider enrollment and revalidation processes. The changes aim to improve oversight of New York's Medicaid program. The announcement follows a McDermott Will & Emery client alert from August 4, 2026, addressing Medicaid moratorium and ownership change issues in the state. The timing and scope of implementation will affect providers seeking enrollment or ownership changes in New York's Medicaid program.
- State Policy · IN
Indiana Medicaid Work Requirement Affects 300,000 Enrollees Starting January 2027
Indiana's Medicaid work requirement takes effect January 1, 2027, affecting an estimated 300,000 low-income enrollees. State officials confirmed the mandate applies to new applicants and existing members renewing coverage in January, but compliance systems and exemption procedures remain incomplete with the first deadline less than two months away. The requirement will impact non-exempt adults enrolled in Indiana's Medicaid expansion population. State agencies and managed care plans must finalize tracking, verification, and disenrollment protocols before implementation.
- State Policy · MD
Maryland Awards $80M to Expand Rural Primary Care, Behavioral Health, Dental Access
Maryland's Department of Health awarded $80 million to 41 grantees under the first round of the Rural Health Transformation Program on August 10, 2026. The funds will expand primary care, behavioral health, and dental services across Maryland's 18 designated rural areas. The program addresses workforce shortages and access gaps in underserved regions. For Maryland Medicaid managed care plans and providers, this represents new capacity and potential network expansion opportunities in rural markets where provider networks are historically thin.
- State Policy · IN
Indiana Plans Federal Waiver to Restore HIP Cost-Sharing for Adult Enrollees
The Indiana Family and Social Services Administration will seek a five-year CMS waiver to reinstate cost-sharing requirements for able-bodied adults enrolled in the Healthy Indiana Plan under a new HIP 3.0 iteration. The waiver would revive a modified version of Indiana's previous copayment model for this population. The timing of the waiver submission and CMS review process has not been specified. This represents a return to Indiana's earlier HIP approach requiring enrollee contributions, which had been modified or suspended under previous waiver terms.
- State Policy
NASHP Webinar to Cover State Multisector Aging Plans and Caregiver Support
The National Academy for State Health Policy will host a webinar on September 17, 2026, at 2:00 p.m. ET examining how states are using multisector plans on aging to advance caregiver support initiatives. The session will explore state strategies for integrating caregiver support across health and social service systems. States are increasingly using Medicaid waiver authorities and state plan options to fund and coordinate caregiver respite, training, and support services as part of broader efforts to sustain home- and community-based services delivery.
- State Policy
NHeLP Intern Advocates for Medicaid Coverage of Climate-Informed Doula Services
A National Health Law Program intern argues that Medicaid should cover doula care tailored to climate-related pregnancy risks, including extreme heat, flooding, and natural disasters. The piece focuses on how environmental hazards affect maternal health outcomes and birth experiences. While doula coverage is expanding in many state Medicaid programs, the article addresses the intersection of climate impacts and maternal health services. The advocacy positions climate-conscious doula care as a health equity priority for pregnant Medicaid beneficiaries in vulnerable communities.