Daily Briefing, 2026-06-19 | Medicaid Monitor

The complete record

6 stories, Friday, June 19, 2026

Federal Policy

Federal Grant Delays Threaten Disability Research Institutions and Services

Federal agencies have delayed issuing grants to disability research institutions nationwide, creating uncertainty about program continuity and employment. The delays affect research centers that study and support services for people with disabilities, including those enrolled in Medicaid long-term services and supports. No timeline has been provided for when grant awards will resume. The disruption threatens institutional stability and could interrupt data collection and technical assistance that state Medicaid programs rely on for LTSS policy development.

Why it mattersGrant-funded disability research centers provide technical assistance and evidence that state Medicaid agencies use to design and evaluate LTSS programs, home and community-based services waivers, and managed LTSS contracts.

USSTAT News7:31 AM MT

LTSS · Managed Care

Managed Care

1 storyManaged Care section →

Half of U.S. Counties Lack OB-GYN Despite Declining Birth Rates

Nearly half of U.S. counties have no practicing obstetrician or gynecologist, creating maternity care deserts despite declining fertility rates. The shortage stems from systemic workforce and reimbursement issues rather than demand pressures. Many rural and underserved areas lack adequate prenatal and delivery services, forcing pregnant beneficiaries to travel long distances for care. The gap affects Medicaid managed care organizations' ability to meet network adequacy standards and HEDIS measures for prenatal and postpartum care.

Why it mattersMedicaid MCOs face network adequacy compliance risks and quality metric penalties in areas without sufficient OB-GYN providers, particularly as maternal health becomes a regulatory and contractual focus.

USSTAT News1:30 PM MT

Maternal · Managed Care

State Policy

1 storyState Policy section →

Indiana Proposes Major Revisions to Residential Care Facility Rights and Eviction Rules

The Indiana Department of Health published proposed amendments to regulations governing residential care facilities, addressing resident rights, residency agreements, and involuntary evictions under 410 IAC 16.2-5. The proposal represents one of the most significant updates to Indiana's assisted living regulatory framework in recent years. The changes are intended to align Indiana's rules with current standards, though the effective date and comment period are not specified in the available excerpt. The revisions will affect assisted living providers and may impact Medicaid managed care organizations that contract with residential care facilities for long-term services and supports.

Why it mattersMedicaid MCOs contracting with Indiana residential care facilities for LTSS may need to update provider agreements, grievance processes, and discharge protocols to reflect revised resident protections and eviction requirements.

INHall Render7:31 AM MT

LTSS

Legal

1 storyLegal section →

California Court Issues Evidentiary Ruling in EKRA Criminal Prosecution

A federal district court in California ruled on evidentiary and testimonial issues in United States v. Simons, a criminal prosecution under the Eliminating Kickbacks in Recovery Act (EKRA). The May 1, 2026 decision provides early judicial guidance on how courts will handle evidence in EKRA cases as enforcement expands beyond substance use disorder treatment facilities. EKRA prohibits kickbacks for patient referrals to recovery homes and clinical treatment facilities. The ruling affects Medicaid managed care organizations that contract with behavioral health providers, substance use disorder treatment networks, and recovery services, as EKRA enforcement increasingly targets referral arrangements in these settings.

Why it mattersMCOs contracting with behavioral health and substance use disorder providers face heightened scrutiny of patient referral arrangements and compensation structures under expanding EKRA enforcement, requiring review of network provider agreements and compliance protocols.

USHall Render7:31 AM MT

Behavioral Health · Managed Care

Industry

2 storiesIndustry section →

Freedom Senior Services Names New CEO Following Gemspring Capital Acquisition

Freedom Senior Services has appointed Dr. Brian Holzer as CEO following the company's acquisition by private equity firm Gemspring Capital. Holzer, a home-based care veteran, stated he plans to pursue aggressive mergers and acquisitions while expanding the company's service lines and client demographics. The leadership change follows the ownership transition to Gemspring Capital. This move signals continued consolidation in the home health sector, which increasingly serves Medicaid managed long-term services and supports (LTSS) beneficiaries.

Why it mattersConsolidation among home health providers affects network adequacy, provider rates, and service delivery for managed care organizations contracting for LTSS and home-based care services.

USHome Health Care News1:30 PM MT

LTSS · Managed Care

Eli Lilly Denies 340B Discounts to Hospitals Without Claims Data

Eli Lilly has begun denying 340B drug discounts to hospitals that have not submitted claims-level data under its reporting requirements, according to the American Hospital Association. The AHA confirmed the action in a June 18 statement, calling it "extraordinary." The move affects hospitals participating in the 340B Drug Pricing Program, which provides discounted outpatient drugs to eligible safety-net providers. This follows ongoing disputes between drug manufacturers and covered entities over data-sharing requirements that manufacturers have imposed despite regulatory uncertainty.

Why it mattersMedicaid managed care organizations with hospital contracts or pharmacy carve-ins may see cost-shifting if hospitals lose 340B discounts and seek higher reimbursement rates or rebate protections in their MCO agreements.

USBecker's7:30 AM MT

Pharmacy · Managed Care