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 31
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7NH
State Settles Class Action Over Medicaid Home Care Shortfalls
A class action lawsuit alleging that a state health department failed to provide all required services under a Medicaid home care program has reached a settlement. The suit claimed the state's home and community-based services program did not deliver services as mandated, affecting enrollees who depend on home-based care instead of institutional placement. Details on the settlement terms, remedies, and implementation timeline were not specified in the source material. The case underscores ongoing pressure on states to meet federal and state obligations for home care access under Medicaid.
Why it mattersState Medicaid agencies face compliance and operational obligations to ensure home and community-based services are actually delivered as promised, and this settlement signals litigation risk when service gaps persist.
- Published Oct 7
- Published Oct 7
- Published Oct 7KS
NACRHHS Webinar Reviews Rural EMS and Behavioral Health Integration
The National Advisory Committee on Rural Health and Human Services (NACRHHS) held a webinar with the Rural Health Information Hub covering two rural health topics: access to emergency medical services and integration of behavioral health with primary care. Kansas Health Institute President and CEO Kari Bruffett, a NACRHHS member, participated in the discussion. A recording and additional details are posted on the Rural Health Information Hub's event page. The Kansas Health Institute published a summary pointing readers to the webinar as a technical assistance resource.
Why it mattersState rural health offices and Medicaid-serving rural providers can use this technical assistance resource to inform EMS access strategies and behavioral health-primary care integration efforts.
- Published Oct 7KS
KHI Offers Support to Kansas Groups Seeking Rural Health Grants
Kansas Health Institute (KHI) announced it will support Kansas organizations applying for newly announced rural health transformation grants. The post also notes that KHI President and CEO Kari Bruffett, who serves on the National Advisory Committee on Rural Health and Human Services, participated in a recent NACRHHS webinar held with the Rural Health Information Hub covering rural emergency medical services access and integration of behavioral health with primary care. A recording of the webinar is available through RHIhub. The underlying grant program and its funding mechanism are not detailed in this source.
Why it mattersRural Kansas providers and health systems, many serving Medicaid populations, may gain access to technical assistance improving their odds of securing new rural health funding.
- Published Oct 7NY
Northwestern Mutual Study Finds Few Plan Long-Term Care Finances
A Northwestern Mutual study finds that 73% of Americans want to age in their own homes, but 54% have not financially planned for long-term care costs. The findings highlight a gap between consumer preference for home-based aging and preparedness to pay for the services needed to achieve it. The study does not describe a policy change or new program, but underscores the financing challenge many families face as they consider long-term services and supports. No effective date or regulatory action is referenced in the findings.
Why it mattersUnmet private long-term care planning often pushes families toward Medicaid as the payer of last resort once savings are exhausted, increasing pressure on state LTSS budgets.
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 7
- Published Oct 6
- Published Oct 6
- Published Oct 6
- Published Oct 6CA
California's Prop. 40 Billionaire Tax Would Backfill Medi-Cal Cuts
California's Proposition 40, on the November ballot, would impose a one-time 5 percent wealth tax on billionaires to help backfill federal cuts to Medi-Cal. The measure splits the Democratic Party: Gov. Gavin Newsom, gubernatorial nominee Xavier Becerra, and major labor unions oppose it, while the state Democratic Party, Bernie Sanders, and Rep. Ro Khanna back it. Early voting is underway, and the measure currently leads 52 percent to 46 percent among likely voters in a PPIC poll. The state's nonpartisan Legislative Analyst's Office projects the tax could raise tens of billions over several years but warns it may also shrink ongoing income tax revenue if billionaires relocate, raising sustainability questions for funding an ongoing program like Medi-Cal.
Why it mattersA one-time wealth tax proposed to offset federal Medicaid funding cuts raises direct questions for California's Medicaid agency and managed care plans about the durability and predictability of state financing for Medi-Cal.
- Published Oct 6
- Published Oct 6
- Published Oct 6CT
Connecticut Woman Pleads Guilty to $1.3M Health Care Fraud
Jacqueline Pelphrey, formerly of Manchester, Connecticut, pleaded guilty to health care fraud after waiving indictment, according to the U.S. Attorney for the District of Connecticut. Pelphrey owned and operated Women's Health Resources Inc., doing business as Essentials for the Special Woman, and is accused of defrauding health insurance programs of nearly $1.3 million. The case was brought by federal prosecutors; sentencing details were not specified in the available report. The matter underscores continued federal enforcement focus on fraud schemes involving durable medical equipment and specialty health product suppliers billing insurance programs.
Why it mattersThe case signals continued federal prosecutorial attention on provider-side billing fraud that drains Medicaid and other health insurance program funds, reinforcing compliance risk for durable medical equipment and specialty suppliers.
- Published Oct 6
- Published Oct 6CA
CenCal Health Tells Hospitals to Adopt Updated Medicare MOON Form
CenCal Health notified its CareConnect hospital partners that the Office of Management and Budget has approved a revised Medicare Outpatient Observation Notice (MOON), with updated readability and design and available in English and Spanish. The revised notice is effective immediately and valid through February 28, 2029. Hospitals may exhaust existing stock of the prior version but must fully transition to the updated MOON by April 20, 2026. The notice requirement applies to all Medicare beneficiaries, including health plan enrollees, receiving outpatient observation services, informing them they have not been admitted as inpatients.
Why it mattersHospitals and health plan partners must update forms and workflows by the April 2026 deadline or risk noncompliance with federal beneficiary notice requirements.
- Published Oct 6CA
CenCal Health Compiles Immigration Know-Your-Rights Resources for Members
CenCal Health, the Medi-Cal managed care plan serving Santa Barbara and San Luis Obispo counties, published a resource roundup directing providers and patients to immigration-related know-your-rights and legal aid materials. The list includes National Immigration Law Center guidance on health care access for immigrants, a California Attorney General reminder of immigrant rights and protections, mental health resources for undocumented people, a factsheet on protecting community spaces from immigration enforcement, and directories for free or low-cost legal assistance. No new CenCal policy or eligibility change is announced; the post simply aggregates existing external resources for use by the plan's network and enrollees.
Why it mattersProviders and care coordinators serving immigrant Medi-Cal populations can use these consolidated resources to help patients understand their rights and maintain access to care without fear of immigration enforcement.
- Published Oct 6CA
DHCS Updates Guidance on CMS-DHS Medi-Cal Data Sharing, Injunction
California's Department of Health Care Services (DHCS) issued a statement, first released June 13 and updated August 13, addressing reports that CMS shared Medi-Cal member data with the Department of Homeland Security. The update informs members about a federal court injunction that temporarily blocks further data sharing. DHCS and CenCal Health point individuals with unsatisfactory immigration status, or others concerned about their data, to resources including the California Department of Social Services' list of qualified nonprofits, the Immigration and California Families webpage, and local embassy or consulate contacts for legal assistance.
Why it mattersMedi-Cal members and enrollment assister organizations need current guidance on data privacy protections and available legal resources amid ongoing federal litigation over CMS-DHS data sharing.