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Friday, July 24 · 5 stories
- State Policy
NASHP Examines State Use of Community Health Workers for Oral Health Access
The National Academy for State Health Policy published an analysis of how states are deploying community health workers to expand oral health access in rural areas. The publication explores state-level strategies for integrating these workers into care delivery models where dental provider shortages limit access. The approach is particularly relevant for states addressing dental health disparities through Medicaid program design, as community health workers can connect beneficiaries to preventive services and coordinate care in underserved regions.
- State Policy
Political Dispute Over Medicaid Payment Deferrals Threatens Home Care Provider Stability
Political tensions are escalating around states' use of Medicaid payment deferrals, with home care providers caught in the crossfire. The dispute centers on whether states can delay payments to manage budget cycles, a practice that disproportionately affects home- and community-based services providers operating on thin margins. Home care advocates warn that payment timing conflicts threaten provider solvency and beneficiary access to HCBS. The controversy reflects broader partisan divisions over Medicaid financing and state flexibility in program administration.
Thursday, July 23 · 2 stories
- State Policy
Rhode Island and Hawaii Enact Healthcare AI Laws; Arizona Governor Vetoes Chatbot Bill
Rhode Island and Hawaii enacted healthcare AI legislation in June and July 2026, while Arizona's governor vetoed a similar chatbot disclosure bill. Rhode Island Governor Dan McKee signed two AI-related healthcare bills into law. The measures reflect divergent state approaches to regulating artificial intelligence in healthcare settings. These laws may affect how Medicaid managed care organizations deploy AI tools for utilization management, care coordination, or member services in these states.
- State Policy · KY
Kentucky Governor Reverses 4% Medicaid Provider Rate Cuts
Kentucky Governor Andy Beshear announced a reversal of the state's previously enacted 4% Medicaid provider rate cuts. The move follows criticism of the original cuts' impact on disability services and other providers. Beshear cautioned that the reversal would not immediately resolve all provider concerns, saying the change is not "a magic wand" or "a magic bullet." Managed care organizations operating in Kentucky should expect updated rate schedules reflecting the restored funding levels.
Wednesday, July 22 · 1 story
- State Policy · CO
Colorado Medicaid Owes $8 Million in Federal Funds for HCBS Claims
An Office of Inspector General audit found Colorado Medicaid improperly claimed at least $8 million in federal funds for in-home disability care services. The OIG identified an additional $45 million in federal payments requiring further review. State officials acknowledged billing errors but stated no fraud occurred. The audit examined home and community-based services claims, a program area where improper billing has drawn increased federal scrutiny. Colorado must repay the federal share of identified improper payments.
Tuesday, July 21 · 4 stories
- State Policy · NM
New Mexico Lawmakers Criticize Slow Rollout of Behavioral Health System Reforms
Bipartisan New Mexico legislators voiced frustration over delays in implementing the state's behavioral health system overhaul during a Monday legislative session. The criticism focuses on the pace of program deployment intended to rebuild behavioral health infrastructure and service delivery. The concerns come amid ongoing challenges in the state's behavioral health network, which affects Medicaid managed care organizations responsible for coordinating behavioral health services for enrollees. The delays may impact MCO network adequacy requirements and care coordination for members with behavioral health needs.
- State Policy · DE
Delaware Enacts Hospital Price Caps, Charity Care Expansion, PE Acquisition Moratorium
Delaware Governor Matt Meyer signed three healthcare bills on July 20, 2026, that will phase in hospital price caps, expand charity care eligibility, and temporarily block private equity acquisitions of nonprofit hospitals. The legislation aims to improve healthcare affordability and access in Delaware. The price cap implementation will be delayed to allow a phased approach. These changes affect hospital reimbursement structures and access requirements that impact Medicaid managed care organizations contracting with Delaware hospitals.
- State Policy · NY
New York Struggles to Establish Oversight for Opioid Settlement Spending
New York state agencies face challenges establishing clear oversight for multibillion-dollar opioid settlement funds, which come with loose spending guidelines rather than strict requirements. Advocates for individuals affected by the opioid crisis are calling for stronger fiscal guardrails and accountability mechanisms. The situation in New York reflects broader challenges states face in managing settlement dollars intended for substance use disorder treatment and prevention. The lack of centralized oversight raises concerns about whether funds will reach evidence-based programs that serve Medicaid populations most affected by opioid use disorder.
- State Policy · OH
Ohio Legislature Debates Bill to End Medicaid Managed Care for 3 Million Enrollees
Ohio lawmakers are considering Senate Bill 386 and a House companion bill, the Medicaid Savings Act, which would dismantle the state's Medicaid managed care system currently serving approximately three million enrollees. The bipartisan legislation would shift Ohio away from its managed care delivery model. The bill is under active debate in Statehouse committee rooms. If enacted, this would represent one of the largest managed care program terminations in recent state Medicaid history, affecting every MCO operating in Ohio.
Monday, July 20 · 7 stories
- State Policy
Georgia and Maine Evaluate Respite Care Programs to Improve Caregiver Outcomes
Georgia and Maine conducted evaluations of their respite care programs to assess effectiveness in supporting family caregivers and inform future state investments. The evaluations examined how respite services affect caregiver burden, health outcomes, and care continuity for individuals receiving long-term services and supports. Results are being used to guide state policy decisions on respite service design, reimbursement levels, and eligibility criteria. This work reflects growing state focus on caregiver support as a cost-effective strategy to maintain community-based care and reduce institutional placement.
- State Policy · MS
Mississippi Exchange Premiums Rise as State Remains Without Medicaid Expansion
Health insurance premiums on Mississippi's federally-facilitated marketplace continue to increase while the state has not expanded Medicaid eligibility under the Affordable Care Act. Low-income workers above the poverty line face higher out-of-pocket costs for exchange coverage, while those below 100% of the federal poverty level remain ineligible for both exchange subsidies and Medicaid. The coverage gap affects Mississippi residents who would qualify for Medicaid in expansion states but have no affordable coverage option in Mississippi. Mississippi is one of ten states that have not adopted Medicaid expansion as of 2026.
- State Policy · FL
Florida Counties Face $420M Medicaid Bill as Property Tax Revenue Declines
Florida's 67 counties will pay nearly $420 million toward state Medicaid spending this fiscal year, according to state economists. Miami-Dade County faces the largest share at $69.4 million, followed by Broward at $34.7 million and Hillsborough County. The county obligation comes as Florida counties anticipate declining property tax revenue. This county-level Medicaid cost-sharing arrangement represents mandatory local government contributions to the state's Medicaid program budget.
- State Policy · NE
Nebraska Secures Temporary Medicaid Work Requirement Waiver for Dawson County After Plant Closure
Federal officials approved a temporary hardship exemption from Nebraska's Medicaid work requirements for Dawson County following the closure of a Tyson Foods plant that eliminated approximately 3,000 jobs. Governor Jim Pillen directed the state Department of Health and Human Services to request the exemption last month. The waiver temporarily suspends work requirement compliance for affected Medicaid enrollees in the county. This represents a significant operational accommodation for managed care organizations serving the region, as they will need to adjust eligibility tracking and member communications during the exemption period.
- State Policy
KFF Examines State Strategies to Protect Pregnant Women from Medicaid Work Requirements
KFF published an analysis examining how states may structure Medicaid work reporting requirements to protect coverage for pregnant and postpartum women. The analysis reviews state options for exemptions, verification processes, and coverage continuity mechanisms as states implement work and community engagement requirements. States must balance federal compliance with maternal health access as work requirements return to consideration. For managed care organizations, the analysis highlights operational challenges in identifying exempt populations, managing enrollment disruptions, and maintaining continuity of prenatal and postpartum care under varying state policies.
- State Policy · KY
Kentucky to Cut Medicaid Rates 4% Affecting Disability Services
Kentucky is implementing a 4% Medicaid rate cut that will affect services for individuals with disabilities. Families and advocates are calling the reduction a threat to care access and urging state leaders to reverse the decision. The cut affects provider reimbursement rates across Medicaid services, with particular concern about impacts on disability and long-term services. Advocates are pressing the legislature and administration to identify alternative budget solutions before the reduction takes effect.
- State Policy
States Consider Publicly Naming Large Employers With Medicaid-Enrolled Workers
State legislators are proposing measures to publicly identify major companies whose employees rely on Medicaid coverage, a response to impending federal work requirements scheduled for January implementation. The proposals aim to highlight employer wage and benefit practices that result in government-subsidized healthcare coverage for low-income workers. These legislative efforts emerge as states face federal pressure to enforce work requirements while managing program costs. The focus on employer practices represents a shift in state Medicaid policy debates toward workforce participation and private sector responsibility.
Friday, July 17 · 4 stories
- State Policy
Restrictive APRN Regulations Drive Nurse Migration Across State Lines
Advanced practice registered nurses (APRNs) are relocating from states with restrictive scope-of-practice regulations to states with more permissive practice authority. These nurses provide critical access to care in underserved areas where physician shortages exist. State-level variations in APRN regulations affect workforce availability and access to services. The migration patterns may exacerbate provider shortages in states with stricter regulations while benefiting states that grant APRNs greater practice independence.
- State Policy · WI
Wisconsin APRN Modernization Act Removes Physician Collaboration Requirement September 1
Wisconsin's APRN Modernization Act takes effect September 1, 2026, eliminating the requirement that advanced practice registered nurses maintain collaborative arrangements with physicians or dentists to practice. The law modifies state licensure requirements for qualified APRNs. This change affects network adequacy and provider access strategies for Medicaid managed care organizations operating in Wisconsin, as APRNs gain independent practice authority. MCOs may need to update credentialing policies, provider contracts, and network composition to reflect the expanded scope of practice.
- State Policy · NY
Report Outlines Strategies to Expand New York Medicaid CHW Benefit
A new report from the Center for Health Care Strategies provides recommendations for expanding community health worker services under New York's Medicaid program. The analysis addresses opportunities for state policymakers, managed care organizations, and CHW stakeholders to strengthen implementation of the state's CHW benefit. Recommendations focus on enhancing access, improving reimbursement structures, and scaling CHW integration within Medicaid managed care networks. The report is published in July 2026.
- State Policy
KFF Tracker Compiles Section 1115 Medicaid Waiver Activity Across States
The Kaiser Family Foundation maintains an ongoing tracker of Section 1115 Medicaid waiver activity, cataloging approved and pending waiver provisions across states. The tracker covers waiver provisions affecting eligibility, benefits, social determinants of health initiatives, and other delivery system reforms. It provides a reference tool for monitoring state flexibility requests and approved demonstrations that deviate from standard Medicaid requirements. The resource is continuously updated as states submit new waiver applications and CMS issues approval decisions.