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 18
- Published Oct 22MI
West Michigan Task Force Helps Residents Navigate Medicaid Changes
A West Michigan task force is working to raise awareness about Medicaid coverage changes affecting roughly one in four Michigan residents enrolled in state healthcare. The group is helping residents understand new eligibility and coverage modifications so they can take steps to retain their Medicaid benefits. The effort targets confusion among enrollees facing procedural or eligibility changes that could otherwise lead to coverage loss. Local outreach aims to reduce unnecessary disenrollment by connecting residents with resources to complete required paperwork or renewals.
Why it mattersCommunity outreach like this directly affects Medicaid retention rates, and states and health plans depend on local navigator efforts to minimize coverage loss and reduce churn-driven administrative costs.
- Published Oct 22CA
CHA, Hospitals Urge Newsom to Reverse Prop 35 Fund Reallocation
The California Hospital Association joined dozens of hospital organizations in a letter to Gov. Newsom opposing the Department of Health Care Services' reallocation of Proposition 35 funding originally designated for Behavioral Health Facilities Throughput. CHA also issued a news release on the matter. The hospitals, which deliver behavioral health, psychiatric, emergency and other crisis care, are asking DHCS to direct at least $275 million of the $600 million at stake to Medi-Cal inpatient psychiatric services rather than spreading it across projects they say won't relieve capacity constraints. The letter signals a brewing dispute over how the state administers voter-approved behavioral health funding.
Why it mattersCalifornia hospitals stand to lose dedicated funding for Medi-Cal inpatient psychiatric capacity if DHCS proceeds with the reallocation, directly affecting their ability to address behavioral health crisis throughput.
- Published Oct 22MO
Missouri Launches Joint State-Federal Fraud Crackdown on Benefit Programs
Governor Mike Kehoe announced Operation Show-Me the Money, a new partnership between Missouri and the U.S. Department of Justice to investigate and prosecute fraud in taxpayer-funded benefit programs. The initiative pairs staff from the Missouri Attorney General's Medicaid Fraud Control Unit with DOJ investigators and uses a three-pronged approach: agency referrals and tips, targeted program reviews starting with SNAP, and cross-agency data analysis to spot fraud patterns. The effort launched October 22, 2026, and findings may lead to administrative, program, or legislative changes. It builds on Kehoe's earlier signing of a federal pledge to combat benefit fraud.
Why it mattersMedicaid providers and managed care plans in Missouri face heightened audit and investigative scrutiny as the state's Medicaid Fraud Control Unit gains expanded federal data-sharing and prosecutorial support.
- Published Oct 22
- Published Oct 22
- Published Oct 22FL
Sunshine Health Awards $100,000 in Grants to Florida Caregiver Groups
Sunshine Health, Centene's Florida Medicaid managed care subsidiary, is distributing $100,000 in grants to four nonprofit organizations supporting foster, adoptive, and kinship caregivers of children with behavioral health needs. Each of the four recipients, Citrus Family Care Network, Family Initiative, Florida 1.27, and Kids First of Florida, will receive $25,000. The funding aims to build caregiver skills for creating stable, healing-centered homes and to expand early mental health intervention access for children and families across the state. The grants were announced October 22, 2026.
Why it mattersThe grants signal Sunshine Health's continued community investment strategy around child welfare and behavioral health, areas directly tied to its Florida Medicaid managed care contract performance on member outcomes.
- Published Oct 22CA
California Auditor Finds Millions in Improper Medi-Cal Transportation Payments
In an opinion piece, the author argues that California should fix Medi-Cal's documented financial controls before asking voters to approve Proposition 40, a new tax on billionaires pitched as an emergency response to federal Medicaid cuts. The author cites a California State Auditor report released October 15 finding that more than 130 medical transportation providers received nearly $31 million in excessive reimbursements in fiscal year 2024-25, including billing taxi and wheelchair van rides at higher nonemergency ambulance rates. The piece also cites a May NBC Bay Area investigation alleging taxi drivers paid Medi-Cal beneficiaries to take long rides to a Menlo Park methadone clinic, and an April DHCS announcement of a hospice fraud scheme involving stolen identities. The author contends these findings, plus already-enacted state and local Medi-Cal revenue sources like SB 125's managed care tax, undercut the case for Proposition 40.
Why it mattersState Medicaid officials and taxpayers face renewed scrutiny over DHCS's provider oversight and transportation reimbursement controls just as California debates new Medi-Cal revenue measures.
- Published Oct 22
- Published Oct 22
- Published Oct 22
- Published Oct 22
- Published Oct 22
- Published Oct 22
- Published Oct 22
- Published Oct 22
- Published Oct 22IL
Illinois Doula Coverage Law Falters Amid Insurer Network Gaps
A WBEZ/Chicago Sun-Times investigation finds Illinois's Birth Equity Initiative, which requires private insurers to cover postpartum doula care with no cost-sharing, is failing families despite taking effect this year. Families report insurers like Blue Cross and Blue Shield of Illinois have too few in-network doulas, demand families pay thousands up front for reimbursement, and sometimes claw back payments already made. The law lacks a network adequacy standard for doulas, and only an estimated 30% of privately insured Illinoisans have plans the state can even regulate. State Rep. Robyn Gabel, a lead sponsor, says she plans to introduce a fix in January requiring insurers to maintain adequate doula networks; the state's Medicaid program already covers doulas separately.
Why it mattersState regulators and legislators face pressure to add network adequacy and reporting requirements before insurer non-compliance becomes widespread and costly for families and providers.
- Published Oct 22PA
Broad + Liberty Editors Argue Medicaid Home Care Oversight Is Failing
In an editorial, Broad + Liberty's editors argue that weak government oversight, not just individual criminals, is to blame for a wave of Medicaid home health care fraud. They cite reporting on Delco official Mohammed "Danny" Sayduzzaman's company, which collected $84.8 million in Medicaid payments despite spotty paperwork and liens against its owners, alongside other recent cases including a Montgomery County prison sentence, a $5.76 million Philadelphia fraud charge, Minnesota's $90 million scandal, and a New York guilty plea over $65 million in fraud. The editors contend that pandemic-era federal spending expanded without adequate verification, and argue government should be able to confirm who receives payments, whether they comply with law, and whether services are actually delivered, not just prosecute fraud after funds are gone.
Why it mattersState Medicaid agencies and program integrity units face mounting pressure to tighten upfront verification and enrollment screening for home health providers as fraud cases accumulate nationally.
- Published Oct 22LA
Reopened New Orleans Planned Parenthood Still Can't Bill Medicaid
Planned Parenthood's New Orleans Health Center reopened on October 14 but still cannot accept most health insurance, including Medicaid, for patient visits. To cover the gap, the organization spent the past year fundraising to subsidize sexual health care costs for patients who would otherwise rely on Medicaid or other coverage. The clinic's reopening comes amid an ongoing exclusion from Medicaid reimbursement affecting Planned Parenthood sites, a situation tied to broader federal and state efforts to defund the organization. No timeline is given for when Medicaid billing might resume.
Why it mattersLouisiana Medicaid beneficiaries who relied on Planned Parenthood for sexual and reproductive health services now face reduced access unless they can pay out of pocket or qualify for the clinic's subsidized care.
- Published Oct 22
- Published Oct 22
- Published Oct 22
- Published Oct 21CA
Commentary Blames Newsom for California Medicaid Fraud, Funding Cuts
In an opinion piece, the author argues that California's own mismanagement and tolerance of fraud within its Medicaid program are responsible for resulting federal funding cuts, placing blame on Governor Gavin Newsom and his party. The piece frames fraud in the state's Medicaid system as a self-inflicted problem rather than the result of external federal policy changes. No specific fraud case, audit finding, or funding action is detailed in the piece; it is presented as a political argument rather than a report of a new enforcement action or policy change.
Why it mattersFor California Medicaid stakeholders, continued political attention to program integrity failures raises the risk of tighter federal oversight and future funding conditions tied to fraud prevention.
- Published Oct 21
- Published Oct 21
- Published Oct 21
- Published Oct 21NY
NY Post Opinion Mocks Hochul's Claimed Fraud Crackdown
In a New York Post commentary, the author argues that Governor Kathy Hochul's self-presentation as a "fraud warrior" is itself disingenuous, suggesting her fraud-fighting posture is overstated or hypocritical. The piece does not detail specific Medicaid program actions, data, or policy changes, instead using sarcasm to question the governor's credibility on fraud enforcement. No specific legislation, audit, or enforcement action is described in the excerpt provided.
Why it mattersFor New York Medicaid stakeholders, public skepticism about the sincerity of state fraud-enforcement claims can shape political pressure on program integrity funding and oversight priorities.
- Published Oct 21FL
Simply Healthcare Funds Preeclampsia Awareness Campaign in Florida
Simply Healthcare Plans, a Florida Medicaid managed care plan, is funding a Preeclampsia Foundation campaign to teach mothers how to recognize warning signs of the pregnancy-related hypertension disorder. The dollar amount was not disclosed. The work begins in Brevard County with education built into community baby showers for single mothers, focus groups, tailored materials, and a toolkit other community groups statewide can use. Simply covers more than 825,000 Floridians across Medicaid, Medicare Advantage and Florida Healthy Kids, and frames the effort as aligned with the state's Medicaid-managed maternal health initiative, From the Start. Preeclampsia affected 10.1% of Florida births in 2024, and Medicaid paid for 39.2% of the state's births that year.
Why it mattersFor Florida's Medicaid managed care plans, the investment signals growing MCO spending on community-based maternal health initiatives tied to state quality programs, which could shape future plan performance metrics and procurement evaluations.
- Published Oct 21NY
Staten Island Adult Daycare Operators Charged in $530K Medicaid Fraud
New York prosecutors charged two Staten Island adult daycare operators, Yangsim Oum and her daughter Juyone Choe, with defrauding Medicaid of more than $530,000 in a scheme dubbed "Operation Golden Grift." The pair allegedly billed Medicaid for services to hundreds of seniors who were never actually served, including beneficiaries who had died or were out of the country at the time billed. The charges were announced Wednesday by the district attorney's office. The case targets fraudulent billing for adult day services covered under New York's Medicaid program.
Why it mattersThe case underscores Medicaid program integrity risks in adult day health services and signals continued state prosecutorial focus on provider billing fraud affecting LTSS spending.
- Published Oct 21
- Published Oct 21