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 19
- Published Oct 21
- Published Oct 21
- Published Oct 21
- Published Oct 21OH
Ohio Health Plans Group Defends Medicaid Managed Care Model
In a post from the Ohio Association of Health Plans, the trade group argues that Ohio's Medicaid managed care program protects taxpayers, combats fraud, and improves care delivery for enrollees. The piece appears to be an advocacy statement defending the managed care model rather than reporting a specific new policy action or event. No new rule, contract, or enforcement action is described in the available content. The framing suggests a response to ongoing scrutiny or debate over managed care's value and oversight in the state.
Why it mattersOhio managed care plans and state policymakers should note the industry's public positioning as debates over managed care oversight and fraud prevention continue to shape Medicaid policy discussions.
- Published Oct 21
- Published Oct 21GA
GA Senator to Press Amerigroup Over ABA Therapy Payment Cuts
Georgia state Sen. Brian Strickland will hold a press conference on October 22 to address a 30% cut in payments for Applied Behavior Analysis (ABA) therapy made by Amerigroup, Georgia's Medicaid contractor for children in foster care. The payment reduction took effect September 1, 2026, and affects ABA providers serving foster children with autism and related behavioral health needs. Strickland's event signals legislative scrutiny of the contractor's rate decision and its impact on access to care for a vulnerable Medicaid population.
Why it mattersProviders serving foster children through Amerigroup face reduced reimbursement that could curtail ABA therapy access, while state lawmakers signal possible pressure on the contract or rate-setting process.
- Published Oct 21IL
Illinois Opens Marketplace Enrollment for 9,300 Who Lost Medicaid
Get Covered Illinois, the state's health insurance marketplace, is offering a special enrollment opportunity to roughly 9,300 residents who lost Medicaid coverage because of the One Big Beautiful Bill Act. Affected individuals can sign up for marketplace plans through December 31, 2026. The move gives those disenrolled from Medicaid a pathway to alternative coverage rather than becoming uninsured. The extended window gives residents nearly a full year to transition to subsidized marketplace plans.
Why it mattersState officials are using marketplace enrollment to limit coverage losses and uninsurance spikes stemming from federal Medicaid eligibility changes.
- Published Oct 21
- Published Oct 21MO
Missouri Mandates HCBS Settings Rule Training for Adult Day Providers
Missouri's MMAC Contracts Unit is requiring adult day care, Doorways, and Pathways providers to attend one of two mandatory virtual training sessions, on November 4 or November 19, 2026, to maintain MO HealthNet enrollment and DHSS licensure. The 45-minute WebEx sessions cover the federal HCBS Settings Final Rule, and attendance cannot be substituted with an attestation. After attending, agencies must submit their annual HCBS Settings Self-Assessment and HCBS Assurances forms, which MMAC asks providers to hold until after the training. Failure to have an owner or associated staff member attend will trigger adverse action from MMAC.
Why it mattersAdult day, Doorways, and Pathways providers that skip both sessions risk MO HealthNet enrollment termination and DHSS license adverse action, directly threatening their Medicaid billing eligibility.
- Published Oct 21
- Published Oct 21GA
Georgia Budget and Policy Institute: Pathways Enrolls Just 13% of Eligible Adults
Three years into Georgia's Pathways to Coverage program, the state's Medicaid work requirement demonstration has enrolled only 18,527 people, roughly 13% of uninsured, low-income working Georgians who potentially qualify. The report finds 43% of everyone ever enrolled since July 2023 later lost coverage, largely due to paperwork problems and income fluctuations rather than failure to meet work hours. Two new qualifying activities added in October 2025 for parents of young children and SNAP work-program participants remain severely under-enrolled compared to similar populations in SNAP. Georgia still has the nation's second-highest rate of uninsured non-elderly adults, and the brief flags potential program changes coming in January 2027.
Why it mattersState Medicaid officials and advocates face mounting evidence that administrative burden, not work-requirement noncompliance, is driving coverage churn and suppressing enrollment in a program other states may look to as a model.
- Published Oct 21
- Published Oct 21CA
Justice in Aging Explains SMAC Reporting Requirements for Medicaid Oversight
In a resource post, Justice in Aging explains reporting and transparency requirements that apply to State Medicaid Agency Contracts (SMACs), the arrangements states use to delegate functions such as Medicaid managed care administration to contracted entities. The piece describes how existing oversight and disclosure rules are intended to hold these contracts accountable and protect beneficiaries from gaps in service or improper denials. It is framed as an explainer rather than a report on a new rule or enforcement action, aimed at helping advocates and stakeholders understand existing accountability mechanisms.
Why it mattersAdvocates and beneficiary representatives can use SMAC reporting and transparency rules to monitor whether states and their contracted entities are meeting Medicaid oversight obligations.
- Published Oct 21
- Published Oct 21GA
Physician Commentary: Georgia's Medicaid Gap Limits Patient Care
In a blog post, Georgia primary care physician Kreena Patel, MD, MPH argues that the lack of Medicaid expansion in Georgia, compared with her prior experience in expanded-Medicaid Arizona, directly worsens patient access and health outcomes. She describes patients skipping visits or stretching medication refills due to cost after ACA marketplace tax credits expired, and contrasts the robust wraparound support staff at her Arizona FQHC with the thin staffing at her Georgia FQHC. She cites a visit cap of 12 Medicaid visits per year as a specific barrier preventing timely management of chronic conditions like hypertension. The piece frames these firsthand clinical experiences as evidence for expanding Medicaid coverage in Georgia.
Why it mattersGeorgia providers and FQHCs face compounding financial and staffing strain as non-expansion status and reduced marketplace subsidies push more cost-sharing burden directly onto low-income patients, driving care delays and worse chronic disease control.
- Published Oct 21
- Published Oct 21
- Published Oct 21
- Published Oct 21
- Published Oct 21
- Published Oct 21
- Published Oct 21NY
Federal Agents Raid Brooklyn Adult Day Cares Over Medicaid Fraud
Homeland Security Investigations agents raided at least two adult day care centers in Brooklyn on Tuesday as part of a federal operation targeting alleged Medicaid fraud, including money-laundering and kickback schemes. Officials said the raids are part of a monthslong crackdown involving some of New York's most vulnerable Medicaid beneficiaries. Gov. Kathy Hochul described the effort as a "massive effort to combat fraud and abuse." No charges or defendants were detailed in the initial report.
Why it mattersAdult day care providers and their referral partners face heightened federal scrutiny of billing and kickback arrangements, with potential exclusion, clawback, and criminal exposure for those implicated.
- Published Oct 21
- Published Oct 21WV
Harrison County Group Hosts Free Medicaid Information Event
The Harrison County Family Resource Network held a free community event on Medicaid information at Christ Episcopal Church in Clarksburg on Tuesday evening. The event was open to the public and aimed at helping local residents learn about Medicaid. No specific policy changes, eligibility updates, or program details were reported beyond the event's occurrence.
Why it mattersCommunity outreach events like this help local residents navigate Medicaid enrollment and benefits, supporting state efforts to maintain coverage access.
- Published Oct 21
- Published Oct 21
- Published Oct 21
- Published Oct 21CT
Blumenthal, Murphy Push to Reverse Federal Medicaid Cuts in Connecticut
U.S. Sens. Richard Blumenthal and Chris Murphy are leading an effort to reverse federal Medicaid cuts and new mandates that officials say could cause more than 100,000 Connecticut residents to lose health coverage. The senators are pushing back against changes enacted at the federal level, framing the fight as protecting access for low-income residents who rely on Medicaid. No specific legislative vehicle or timeline for reversal is detailed in available reporting. The push signals continued congressional friction over recent federal Medicaid funding and eligibility policy changes.
Why it mattersState Medicaid agencies and health plans in Connecticut face significant enrollment and revenue uncertainty if the underlying federal cuts and mandates take effect as projected.
- Published Oct 21
- Published Oct 21