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 23
- Published Oct 16CA
California Auditor Finds Department Skipped 26,000 Fraud Probes
California's state auditor, Grant Parks, released a report finding the Department of Health Care Services has failed to investigate 26,000 of the 28,000 Medi-Cal providers flagged as highest-risk for fraud, waste and abuse. The report cites examples including two ineligible providers that billed nearly $1.6 million in 2024-25 and a transportation provider that claimed implausible mileage while collecting over $11 million in the same period. The Department disputes the findings, saying the report omits context and relies on isolated anecdotes rather than system-wide data showing effective controls. The report renews scrutiny of oversight at an agency serving about 14 million Medi-Cal beneficiaries and paying out $200 billion annually, and it was first flagged as high-risk by the state in 2007.
Why it mattersThe findings signal heightened program-integrity scrutiny that could trigger new provider screening requirements, audits, or legislative oversight affecting Medi-Cal providers and managed care plans statewide.
- Published Oct 16
- Published Oct 16WI
WiAHC Honors Lawmakers Who Backed Home Health Medicaid Rate Hike
The Wisconsin Association for Home Health Care (WiAHC) named state Senator Rachael Cabral-Guevara and state Representative Clint Moses as "Champions of Home Health Care" for the 2025-2026 legislative session, citing their formal request that the Joint Finance Committee raise the home health skilled nursing Medicaid reimbursement rate from $96.96 to approximately $117.86 per visit, equal to 70 percent of the Medicare home health rate. That increase was included in the final FY2025-2027 state budget signed into law. WiAHC also designated Governor Tony Evers and state Senator Patrick Testin as "Friends of Home Health Care" for their roles in securing the rate increase, with Testin supporting it on the Joint Finance Committee and Evers signing the budget. WiAHC presented award plaques to Cabral-Guevara and Moses.
Why it mattersWisconsin home health providers could see higher per-visit Medicaid reimbursement under the newly enacted state budget rate increase.
- Published Oct 16GA
Georgia Watch Names Lawmakers, Advocates 2026 Consumer Champions
Georgia Watch, a statewide consumer advocacy nonprofit, presented its 2026 Consumer Champion Awards to six individuals and organizations for consumer protection work. Honorees include state legislators who sponsored healthcare-related bills, such as Sen. Kay Kirkpatrick's legislation limiting AI-only coverage denials and reducing prior authorization requirements, and Rep. Darlene Taylor's work on Community Health Worker certification, higher Medicaid reimbursement rates, and maternal home visiting program expansion. Other awards recognized work on financial fraud protection and civil justice access. The awards were presented October 1, 2026, in Atlanta.
Why it mattersState Medicaid stakeholders should track these legislators' continued influence, since their past bills touch Medicaid reimbursement rates, prior authorization rules, and community health worker programs that affect provider payment and managed care utilization review in Georgia.
- Published Oct 16
- Published Oct 16WI
Wisconsin DHS Recruits Members for Medicaid, IRIS, LTC Councils
The Wisconsin Department of Health Services announced in mid-October that it is seeking applicants for four state Medicaid-related boards, committees, and councils. Openings include Medicaid members or caregivers, a long-term care direct care worker, a community outreach expert, three to four IRIS (Include, Respect, I Self-Direct) Program participants or their decision makers, three long-term care self-advocates, a long-term care expert, and two long-term care providers. Applications are available on the DHS Medicaid Boards, Committees, and Councils page, with a deadline of November 6.
Why it mattersWisconsin Medicaid members, caregivers, long-term care providers, and IRIS program participants interested in shaping state policy may want to apply before the November 6 deadline.
- Published Oct 16MN
Minnesota Budget Project: MNsure Enrollment Fell 28% as Tax Credits Lapsed
In a Minnesota Budget Project analysis, the organization reports that after Congress allowed enhanced premium tax credits to expire at the end of 2025, MNsure premiums rose 30 percent and enrollment dropped 28 percent, about 41,000 fewer Minnesotans, in 2026. Nationally, marketplace enrollment fell by 3 million, and a KFF poll found roughly 1 in 10 2025 marketplace enrollees became uninsured in 2026. Affected groups include farmers, independent contractors, early retirees, and others without employer coverage; in 2025 about 92,000 Minnesotans used the credits to cut costs by about $360 a month. The piece also links the credit expiration to Medicaid eligibility and funding cuts enacted under H.R. 1, arguing both changes compound coverage losses and uncompensated care costs for hospitals.
Why it mattersHospitals and safety-net providers face rising uncompensated care costs as marketplace coverage losses compound with separate federal Medicaid eligibility and funding cuts.
- Published Oct 16
- Published Oct 16
- Published Oct 16
- Published Oct 16
- Published Oct 16OH
Ohio Auditor Finds Poor Management Practices at State Medicaid Agency
Ohio Auditor Keith Faber released a performance audit finding widespread management failures at the state Medicaid department following a multi-year system update. Auditors identified nonexistent strategic and operational plans, minimal program evaluation, inconsistent contract management, and inadequate use of data to drive improvements. The audit also found a lack of institutional knowledge among staff, with employees expected to serve as subject matter experts unable to answer questions about programs, and program managers unable to discuss evaluation and outcome measurement. The findings raise questions about the agency's operational capacity and oversight of its programs.
Why it mattersThe findings signal operational and oversight gaps at the state Medicaid agency that could affect program accountability, contract oversight of MCOs and vendors, and the state's ability to measure outcomes across its Medicaid programs.
- Published Oct 16CT
Weekly Roundup: Maternity Ward Closures, ICE Detention, Medical Debt
In its weekly health news roundup, the Connecticut Health Foundation compiles reporting on several maternal and health equity issues. The Marshall Project documents dangerous conditions for pregnant women in ICE detention, including inconsistent prenatal vitamins and poor nutrition. The Guardian reports 52 maternity wards have closed since federal Medicaid funding cuts under HR 1 took effect in 2025, with about 40% of U.S. births paid by Medicaid. Other stories cover cash-payment pilots aimed at improving Black maternal health outcomes, immigration policy effects on foreign-trained physicians, and new data showing more than a quarter of Americans carry medical debt.
Why it mattersState Medicaid agencies and hospitals must plan for continued maternity service losses as federal financing cuts under HR 1 reduce the revenue base supporting obstetric units nationwide.
- Published Oct 16
- Published Oct 16
- Published Oct 16
- Published Oct 16
- Published Oct 16MO
St. Louis Refugees Report Health Crisis After Medicaid Cuts Take Effect
Federal healthcare benefit cuts for certain immigrants, refugees, asylum seekers and humanitarian parolees took effect October 1 under H.R. 1. St. Louis-area advocacy organizations report dozens of affected individuals have complained of going without needed healthcare services since the cutoff. The change strips Medicaid-related coverage eligibility from groups who previously qualified, leaving many without a path to care. Advocates say the impact is already visible on the ground, with humanitarian immigrants describing suffering due to lost access.
Why it mattersSafety-net clinics and community organizations serving immigrant populations face surging uncompensated care demand as newly ineligible refugees and parolees lose Medicaid coverage.
- Published Oct 16PA
PA Poll Finds Broad Support for Medicaid Work Requirements
In its roundup "Elephant in the Room," Broad + Liberty covers several Pennsylvania election-season developments, including a Commonwealth Foundation-commissioned poll of 800 Pennsylvania voters conducted by Public Opinion Strategies. The poll found 77 percent of respondents support Medicaid and SNAP work requirements, including those set to take effect at the end of the year. The roundup also covers gubernatorial candidate Stacy Garrity's NFIB endorsement, new campaign ads, and a Meta social-media settlement, none of which involve Medicaid. The poll results arrive as Pennsylvania's political campaigns intensify ahead of the Nov. 3 election.
Why it mattersPublic polling showing strong voter support for Medicaid work requirements could shape Pennsylvania legislative and gubernatorial positioning on implementation as the federal requirement deadline approaches.
- Published Oct 16
- Published Oct 16
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- Published Oct 15
- Published Oct 15MN
CMS Ends Marketplace Subsidies for 189,000 Dual Enrollees, Deceased
In a commentary piece, American Experiment reports on CMS's October 14, 2026 announcement ending Advance Premium Tax Credits for roughly 189,000 people enrolled in subsidized Federal Marketplace plans who also had Medicare, Medicaid, or CHIP coverage, or who had died. CMS estimates the action saves approximately $1.5 billion over the next year, building on a 2025 effort that ended duplicate subsidies for 551,000 Medicaid enrollees, for nearly $6 billion in combined savings. Flagged individuals get 30 days to dispute the match before subsidies stop, with appeals available afterward. The author argues this reflects restored Medicaid/CHIP Periodic Data Matching after a multi-year pause, and calls for states to apply similar verification to their own Medicaid rolls, citing Minnesota-specific findings of enrollees unaware they had coverage.
Why it mattersState Medicaid agencies and marketplaces must reconcile eligibility files against this federal data-matching action to avoid continued duplicate payments and exposure to program integrity audits.
- Published Oct 15
- Published Oct 15
- Published Oct 15
- Published Oct 15
- Published Oct 15