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 35
- Published Oct 2
- Published Oct 2
- Published Oct 2GA
GBPI Urges Georgia to Revise Pathways Waiver Amendment
In a comment submitted to Georgia's Department of Community Health, GBPI responds to the state's proposed amendment to the Georgia Pathways to Coverage Section 1115 demonstration waiver. The advocacy group asks the department to add more detailed projections of cost and enrollment impacts to the amendment request. GBPI also calls for removal of any language that would allow discontinuing coverage for low-income Georgians under the waiver. The comment was submitted September 14, 2026, during the public notice and comment period for the proposed amendment.
Why it mattersState officials and advocates tracking Georgia Pathways will need to watch whether DCH revises the amendment's cost projections and coverage-termination provisions before CMS review.
- Published Oct 2
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- Published Oct 1
- Published Oct 1MN
Fraud Expert Warns of Rising Medicaid Identity Theft Schemes
In a WDIO segment, fraud prevention consultant Jeff Leston of Castlestone LLC discusses why healthcare fraud, including Medicaid fraud, continues to rise. The piece notes Minnesota Attorney General Keith Ellison's recent announcement that nine people were federally charged for Medicaid program fraud totaling over $3 million, including a Duluth provider responsible for $2.2 million. Leston attributes much of the fraud to "zero-factor authentication" at the point of care, data breaches exposing insurance numbers across multiple systems, foreign actors who can quickly move stolen funds overseas, and AI-enabled creation of synthetic identities used to submit fraudulent claims. He urges consumers to report suspicious Medicaid or Medicare claims and calls on Congress and state legislators to strengthen post-breach identity protections.
Why it mattersState Medicaid agencies and MCOs face growing exposure to identity-based billing fraud and synthetic identity claims that existing point-of-care verification systems fail to catch.
- Published Oct 1
- Published Oct 1
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- Published Oct 1CA
Report: Medicaid Cuts, ACA Premium Hikes Threaten Rural Hospitals
American Community Media reports that hundreds of rural hospitals across the country face closure as a combination of Medicaid funding cuts and rising ACA marketplace premiums pushes more Americans into the ranks of the uninsured. Rural hospitals, which rely heavily on Medicaid reimbursement and already operate on thin margins, are described as especially vulnerable to reduced federal support and declining coverage. The piece frames the risk as part of a broader healthcare affordability crisis affecting low-income and rural populations. No specific federal action, legislation, or timeline is detailed in the source beyond the general trend.
Why it mattersState Medicaid agencies and rural providers face mounting financial exposure as reduced Medicaid funding and coverage losses threaten the viability of safety-net hospitals serving Medicaid beneficiaries.
- Published Oct 1
- Published Oct 1
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- Published Oct 1CA
CANHR Issues Fact Sheet as Health Net Ends ALFT Services
CANHR has released a consumer fact sheet responding to Health Net's plan to terminate its Assisted Living Facility Transitions (ALFT) program by December 31, 2026. ALFT helps high-needs, low-income Medi-Cal beneficiaries cover additional costs of residing in assisted living facilities instead of more expensive skilled nursing care. Health Net has not reversed its decision despite pushback, leaving affected members needing to plan alternative placement and services before funding ends. The fact sheet outlines service options, considerations, and consumer rights for those impacted.
Why it mattersMedi-Cal beneficiaries relying on ALFT face a hard funding cutoff that could force transitions to costlier or less appropriate care settings if alternatives aren't secured before year-end.
- Published Oct 1
- Published Oct 1
- Published Oct 1MN
Two Minnesota Men Plead Guilty in $500,000 Medicaid Housing Fraud
Ahmed Abdirashid Mohamed pleaded guilty in federal court in St. Paul to charges tied to a $500,000 Medicaid fraud scheme involving Minnesota's now-discontinued Housing Stabilization Services (HSS) program, becoming the 89th federal welfare fraud conviction in the state over the past four years. His co-defendant, Hassan Ahmed Hussein, pleaded guilty the prior week in the same case. The Department of Justice confirmed both pleas in a press release; sentencing for both men will be scheduled later. Separately, another defendant, Sharmaine Meadows, is currently on trial for an alleged $4 million fraud scheme also run through the HSS program.
Why it mattersThe convictions underscore sustained federal prosecution of Medicaid provider fraud in Minnesota's HSS program, signaling continued scrutiny that state agencies and managed care plans overseeing home and community-based service billing should anticipate.
- Published Oct 1
- Published Oct 1