Medicaid news from every state
Medicaid reporting from more than 400 local newsrooms, public radio stations, advocates, attorneys general and state agencies, sorted into one feed per state and updated every four hours.
Medicaid stories from local newsrooms in every state, updated every four hours.
Latest from every state, page 10
- Published Oct 30
- Published Oct 30
- Published Oct 30PA
PA Senate Passes Resolution Studying Home Nursing Medicaid Rates
The Pennsylvania Senate unanimously passed Senate Resolution 238, sponsored by Sen. Frank Farry, directing the Legislative Budget and Finance Committee to study how Medicaid reimbursement rates and nursing workforce shortages affect access to pediatric and adult shift nursing services. Shift nursing allows medically complex patients, including those needing ventilator care, feeding tubes or seizure management, to receive care at home rather than in facilities, but staffing shortages leave shifts unfilled, forcing parents to miss work or delaying hospital discharges. Home care providers including BAYADA Hearts for Home Care, Aveanna Healthcare and the Pennsylvania Homecare Association backed the measure, framing it as a step toward reimbursement reform. The resolution does not change rates itself but sets up an independent legislative review intended to inform future policy action.
Why it mattersHome nursing providers and families relying on Medicaid-funded private duty nursing gain a formal legislative review that could lead to future rate increases addressing chronic workforce shortages.
- Published Oct 30
- Published Oct 30FL
Florida Health Justice Publishes Guide to Medicaid LTC HCBS Waiver
Florida Health Justice has published a guide explaining how to navigate Florida's Medicaid Long-Term Care Waiver, which covers home and community-based services (HCBS) as an alternative to nursing home placement. The guide is aimed at beneficiaries, families, and advocates seeking to understand eligibility, enrollment, and program navigation for HCBS services. No new policy change is reported; the piece is an explanatory resource on an existing waiver program. It matters for Floridians with long-term care needs who want to access home-based supports instead of institutional care.
Why it mattersBeneficiaries and advocates need clear guidance on waiver navigation since HCBS slots are limited and enrollment processes are complex, directly affecting access to home-based long-term care alternatives.
- Published Oct 30
- Published Oct 30
- Published Oct 30AR
Arkansas Maternal Health Center Expands Postpartum Outreach With New Funding
The Arkansas Center for Women and Infants' Health at UAMS received an additional $8 million in federal funding, championed by Sen. John Boozman, to expand its statewide postpartum support system. The center's nurse-led call program contacted 5,492 postpartum women between May 2025 and April 2026, finding that 1 in 5 reported a warning sign of a serious complication and 1 in 10 screened positive for postpartum depression. The report also found 61% of contacted women were enrolled in Medicaid through pregnancy, and 20% of those on Medicaid did not know coverage ends 60 days after delivery. The center is now working with the state Health Department and additional hospitals to reach all postpartum women statewide and extend follow-up contact through the full postpartum year.
Why it mattersState Medicaid officials and managed care plans face direct exposure to gaps in postpartum coverage awareness, since most women reached were Medicaid enrollees who often didn't know their pregnancy-related coverage expires 60 days after delivery.
- Published Oct 30PA
CMS Clarifies Rules for Reviewing Critical Access Hospital Eligibility
CMS issued updated guidance clarifying when it will review whether Critical Access Hospitals (CAHs) still meet Medicare rural status and distance requirements. Effective September 20, 2026, reviews will be triggered when a new acute care hospital seeks certification near an existing CAH, when CMS identifies a previously unconsidered nearby hospital, or when a facility seeks new CAH certification or conversion. Starting in 2033, CMS will also review all existing CAHs on a 10-year cycle, though it may review eligibility at any time. CAHs found ineligible generally get a set period to reclassify as rural, convert to an acute care hospital or Rural Emergency Hospital, or face Medicare termination; the guidance also recommends CAHs seek advance CMS review before adding provider-based locations and clarifies that recertification surveys can proceed without prior CMS confirmation of rural and distance eligibility.
Why it mattersRural hospitals that lose CAH status face significant Medicare reimbursement cuts and must quickly pursue reclassification or conversion to avoid termination from the program, which also affects their standing as Medicaid-serving rural providers.
- Published Oct 30CT
CT Health Foundation Roundup Covers Affordability, Disability Lawsuit, AAPI Care Gaps
In its weekly health news roundup, the Connecticut Health Foundation compiles five stories: state-run public insurance options like Colorado's as a possible model amid rising costs and upcoming Medicaid cuts; nationwide struggles with medical affordability highlighted through a Connecticut family's experience; a study finding one in five Connecticut medical trainees face food insecurity; a lawsuit by four Connecticut residents challenging the state's sole reliance on IQ scores to determine eligibility for intellectual disability services; and a survey showing nearly half of Asian American, Native Hawaiian and Pacific Islander women lack a reproductive health provider, with immigration-status fears deterring some from seeking care.
Why it mattersThe IQ-score lawsuit and state public-option trend both carry direct implications for how Connecticut and other states structure eligibility and coverage for Medicaid-funded disability and affordability programs.
- Published Oct 30
- Published Oct 30
- Published Oct 30
- Published Oct 30
- Published Oct 30
- Published Oct 30SD
South Dakota Poll Finds Voters Split on Medicaid Ballot Measure
South Dakota News Watch and the Chiesman Center for Democracy at the University of South Dakota released the final installment of their fall 2026 South Dakota Poll, conducted by Mason-Dixon Polling and Strategy among 500 likely voters on Oct. 12-14. Among the findings, about one-third of respondents remained undecided on a ballot measure to change Medicaid coverage, a margin similar to uncertainty seen on a separate measure to set up an unclaimed property fund. The poll also covered the governor's race, U.S. Senate and Attorney General races, and other ballot measures including voter eligibility and a constitutional amendment threshold. Full methodology, demographics and cross-tabs were released alongside the results ahead of the Nov. 3 election.
Why it mattersThe large undecided share on the Medicaid ballot measure signals the outcome is unsettled heading into Election Day, which matters for state officials and advocates planning for potential changes to Medicaid coverage rules in South Dakota.
- Published Oct 30OK
Oklahoma to Hold Hearing on Medicaid Work Requirement Rules
The Oklahoma Health Care Authority will hold a public hearing on Monday, Nov. 2, at 1 p.m. to take comment on proposed permanent rules implementing Medicaid work requirements and more frequent eligibility redeterminations required under the federal reconciliation law known as the One Big Beautiful Bill Act. The rules would affect Oklahoma Medicaid enrollees subject to new community engagement requirements and more frequent eligibility checks. Stakeholders including beneficiaries, advocates, and providers can weigh in before the rules are finalized.
Why it mattersState Medicaid agencies and providers need to track how Oklahoma translates federal work requirement mandates into enforceable state rules, since the design of redetermination and verification processes will directly affect coverage retention and administrative burden.
- Published Oct 30
- Published Oct 29MN
Minnesota Provider Indicted Over $3.2 Million Medicaid Fraud
A federal grand jury indicted Jama Mohamod, operator of American Home Health Care, on eight counts of defrauding Minnesota Medicaid of more than $3.2 million. Prosecutors allege that over three years he submitted false claims inflating hours billed under the state's Individualized Community Supports program and used the proceeds for personal expenses. The charges follow a Minnesota Department of Human Services fraud review and payment withhold prompted by client complaints, including from a client who said he wasn't receiving entitled care. Mohamod has pleaded not guilty; no trial date has been confirmed.
Why it mattersThe case underscores state Medicaid agencies' exposure to home- and community-based services fraud and the role of provider payment withholds as an enforcement tool during active investigations.
- Published Oct 29MN
Three Minnesotans Indicted on Medicaid Fraud Charges in Federal Court
Three defendants made initial federal court appearances in Minneapolis on Medicaid fraud indictments tied to home health and autism therapy businesses. Feisal Mohamed Elmi faces eleven counts connected to his autism clinic, Aspen Associates LLC, with alleged fraud continuing until January 2026; a separate hearing was set after prosecutors raised concerns about his planned one-way flight to the United Kingdom and a prior $500,000 overseas wire transfer. Faiza Osman Ahmed was indicted on six counts tied to Home Sweet Home Health Care LLC, with alleged fraud through March 2026, and Jama Yusuf Mohamod was indicted on eight counts tied to American Home Health Care LLC, with alleged fraud through September 2026. The cases are ongoing and developing.
Why it mattersThe indictments signal continued federal enforcement scrutiny of Minnesota autism and home health providers billing Medicaid, a sector already under heightened program-integrity review in the state.
- Published Oct 29
- Published Oct 29
- Published Oct 29CA
Critics Target CalAIM Medically Tailored Meals for Undocumented Enrollees
A commentary piece criticizes California's CalAIM program for providing medically tailored meals, funded as part of the state's Medi-Cal managed care reform, to enrollees who are undocumented immigrants. The author frames this as taxpayer-funded benefits going to people in the country illegally, citing California's expansion of Medi-Cal eligibility regardless of immigration status. CalAIM uses "community supports" benefits, including medically tailored meals, as an alternative to higher-cost medical services for enrollees with chronic conditions. The piece argues this represents misuse of Medicaid managed care dollars under Governor Newsom's reform package.
Why it mattersCalifornia Medicaid officials and MCOs face political pressure over state-funded coverage of undocumented immigrants, which could affect state budget negotiations and future CalAIM funding decisions.
- Published Oct 29
- Published Oct 29
- Published Oct 29
- Published Oct 29
- Published Oct 29NM
New Mexico Recruits Ombudsman Volunteers for Long-Term Care Residents
New Mexico's Aging and Long-Term Services Department (ALTSD) is recruiting volunteers for its Long-Term Care Ombudsman Program, which advocates for more than 12,000 people living in nursing homes, assisted living and other long-term care facilities statewide. The recruitment push coincides with National Residents' Rights Month, themed "Join Us at the Table," and asks New Mexicans to help amplify residents' voices on issues like care plans, food, belongings and living arrangements. The program offers free, confidential advocacy and mediation, and volunteers receive training and ongoing support from ALTSD. There is no specific deadline; residents and prospective volunteers can contact ALTSD via aging.nm.gov or a toll-free number.
Why it mattersLong-term care providers and state regulators rely on ombudsman oversight to surface and resolve resident complaints, making volunteer capacity directly relevant to facility compliance and quality-of-care monitoring for Medicaid-funded LTC residents.
- Published Oct 29MN
Minnesota DHS Report Finds Housing Support Rates Lag Inflation
A new Minnesota Department of Human Services report finds that the state's Housing Support Supplementary Services program, which serves about 7,100 people monthly, pays providers a standard rate of $494.91 per client per month that has risen just 16% since 1993 while inflation climbed 121% over the same period. The report, commissioned after lawmakers directed DHS to review whether rates cover actual service costs, also found rates aren't tied to documented staffing, provider costs or service expectations. Housing Support helps older adults and people with disabilities at risk of homelessness or institutional placement, with about 24,000 Minnesotans receiving room-and-board assistance monthly. Providers like Missions Inc. and Avivo say they operate housing programs at a deficit as residents present more complex health and behavioral health needs, and advocates note the report itself arrives nearly a year late with some underlying cost data already outdated.
Why it mattersMinnesota lawmakers and DHS now face pressure to revise Housing Support reimbursement rates or risk continued provider deficits that threaten capacity for a state-funded program serving thousands of disabled and older adults at risk of homelessness.
- Published Oct 29