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Friday, September 25 · 6 stories
- State Policy · CA
Watsonville Community Hospital Reports $10M Loss in Six Months, Considers Service Cuts
Watsonville Community Hospital in California lost $10 million in the last six months and $22.4 million in 2025, according to a hospital spokesperson. The hospital's board reviewed potential operational changes at a September 22 retreat, including growth opportunities and possible service closures, amid an $85,000 daily cash shortfall. The hospital's financial distress may affect access to care for Medicaid beneficiaries in the Watsonville area, particularly if services are reduced or eliminated.
- State Policy · AR
Arkansas Awards $54.6M in Second Rural Health Transformation Program Round
Arkansas awarded $54.6 million to dozens of recipients in the second funding round of a federal rural healthcare program, state officials announced Thursday. The Rural Health Transformation Program, established through the 2025 One Big Beautiful Bill Act, provides $50 billion to states over five years for projects supporting rural healthcare infrastructure and services. The awards support facility improvements, workforce recruitment, telehealth expansion, and care coordination initiatives across rural communities. For Medicaid managed care plans and providers operating in rural Arkansas counties, these investments may strengthen network capacity and access in historically underserved areas where network adequacy has been challenging.
- State Policy · NC
North Carolina Restores Perinatal Quality Collaborative After Medicaid Funding Dispute
North Carolina has restored funding for the Perinatal Quality Collaborative of North Carolina, enabling dozens of hospitals statewide to participate in maternal and newborn care research beginning next year. The collaborative lost funding in October 2025 due to a Medicaid funding dispute, delaying planned research projects that were originally scheduled to launch in 2025. The restoration allows the state's hospitals to resume quality improvement work targeting maternal and perinatal outcomes. This matters for North Carolina providers and state Medicaid officials managing maternal health initiatives under heightened federal scrutiny of maternal outcomes.
- State Policy · ID
Idaho Lawmakers Seek Payment, Prior Authorization Protections in Medicaid Transition
Idaho's Medicaid Review Panel heard updates on the state's transition to a new service delivery model, with legislators emphasizing the need for timely provider payments and prior authorization decisions. The article does not specify what new model Idaho is adopting, when the transition takes effect, or what triggered the legislative focus. Medicaid recipients testified on service coordination concerns. The development suggests Idaho is restructuring its delivery system with legislative oversight of operational safeguards for providers and beneficiaries.
- State Policy · NY
190,000 New York CDPAP Caregivers File for Union Election with 1199SEIU
Caregivers in New York's Consumer-Directed Personal Assistance Program (CDPAP) have filed for a union election with 1199SEIU United Healthcare Workers East. If successful, 190,000 self-directed Medicaid home care workers would join the union. The filing sets the stage for a vote that could reshape labor relations in New York's largest self-directed personal care program. For Medicaid managed care plans administering CDPAP benefits, unionization could affect caregiver wage rates, contracting terms, and administrative costs tied to CDPAP services.
- State Policy · DE
Delaware Awards $23M to Local Health Centers Ahead of Federal Medicaid Cuts
Delaware has awarded $23 million to three local medical centers as the state prepares for federal Medicaid funding reductions set to take effect later this year. The awards are part of Delaware's strategy to stabilize its healthcare infrastructure as both Medicaid cuts and rising commercial insurance rates threaten access. The investments target health centers serving Medicaid and uninsured populations, positioning safety-net providers to absorb increased demand as federal support declines. The timing reflects state anticipation of coverage losses and shifts in payer mix once federal cuts are implemented.
Thursday, September 24 · 11 stories
- State Policy
KFF Tracker Compiles Abortion Ballot Initiatives for November 2026 Election
KFF has published a tracker reviewing abortion-related ballot initiatives currently slated for November 2026 across multiple states. The brief examines how these measures may impact abortion access depending on election outcomes. While abortion ballot initiatives do not directly regulate Medicaid coverage or managed care operations, they can affect reproductive health coverage requirements for state Medicaid programs and managed care plans if measures pass that expand or restrict abortion access. State Medicaid agencies and MCOs operating in states with ballot measures may face subsequent coverage policy changes.
- State Policy
NASHP Convenes States on Children's Behavioral Health Service Delivery Models
The National Academy for State Health Policy (NASHP) reports it convened states through a policy academy focused on strengthening behavioral health services for children and youth. Participating states worked on expanding service capacity, supporting the behavioral health workforce, and improving care coordination across systems. The initiative addresses persistent challenges in children's behavioral health access and integration, particularly relevant for states expanding Medicaid-covered behavioral health benefits and managed care network adequacy requirements. Details on specific state participants, policy commitments, or timelines were not provided in the source material.
- State Policy · AR
Arkansas Launches Outreach Campaign for Medicaid Work Requirements Starting January
Arkansas Department of Human Services released an outreach toolkit Thursday including flyers, posters, text messages, and videos to inform Medicaid expansion enrollees about work requirements taking effect in January. The requirements will apply to certain expansion population members. Affected enrollees will need to meet work, education, or qualifying activity thresholds to maintain coverage. The campaign reflects Arkansas's move to implement community engagement requirements following federal approval.
- State Policy · FL
Florida ABA Task Force to Hear Managed Care Plans on Autism Therapy Delivery
A Florida task force examining applied behavior analysis service delivery for children with autism and special needs will convene Monday to hear from managed care organization representatives, including Simply Healthcare, Sunshine Health, and Humana Healthy Horizons. The task force is considering potential changes to how the state structures and delivers ABA therapy through its Medicaid program. The meeting follows earlier sessions exploring current delivery models and stakeholder concerns about access and reimbursement.
- State Policy · SD
CMS Awards South Dakota $13 Million for Mobile Crisis Response and Behavioral Health Expansion
CMS awarded South Dakota $13 million to expand behavioral health services and establish a statewide 24/7 mobile crisis response service. The funding will support crisis intervention teams, workforce development, and infrastructure to improve access to behavioral health care across the state. Implementation timing was not specified in the announcement. The investment addresses South Dakota's behavioral health access gaps and aligns with federal priorities to expand crisis services as alternatives to emergency department utilization.
- State Policy · NC
UNC Health Pardee Opens Adolescent Behavioral Health Inpatient Unit in Hendersonville
UNC Health Pardee has opened an inpatient adolescent behavioral health center in Hendersonville, North Carolina, serving teens in Henderson and surrounding counties experiencing mental health crises. The new facility addresses a regional gap in youth psychiatric services. The opening is relevant to North Carolina Medicaid given that Medicaid covers approximately half of all children in the state and is a major payer for behavioral health services, including inpatient psychiatric care for eligible adolescents.
- State Policy · RI
Rhode Island Outlines Rural Health Projects Under $156M Federal Award
Rhode Island is developing plans for its $156.17 million allocation from a nationwide rural healthcare funding program enacted in July 2026. The state is working to finalize project details ahead of an October federal deadline. The funding is part of a $50 billion national initiative targeting rural health infrastructure and services. Rhode Island Medicaid agencies and providers serving rural populations should monitor how these dollars will be deployed and whether Medicaid-funded services or facilities are included in the state's implementation plan.
- State Policy · VT
Vermont FQHC Opens Three 340B Pharmacies Amid Statewide Closures
North Star Health, a Federally Qualified Health Center, opened pharmacies in Springfield and Londonderry, Vermont, and Charlestown, New Hampshire, in September 2026, leveraging 340B drug pricing to charge patients less than commercial pharmacies. Vermont lost 28 pharmacies between 2019 and 2024, leaving pharmacy deserts in Windsor and Rutland counties where North Star operates. The Springfield pharmacy began operations in November 2025 for out-of-pocket and commercial patients and now contracts with Medicare and Medicaid. The 340B discount allows North Star to offset losses from low primary care and behavioral health reimbursement, according to CEO Josh Dufresne.
- State Policy · IN
Indiana FSSA Issues RFP for Second Short-Term Residential Facility for Disabled Adults
The Indiana Family and Social Services Administration issued a request for proposals for a provider to operate a 10-20 bed short-term residential facility for intellectually disabled adults with severe behavioral, psychiatric, or medical needs. The facility would replace a co-ed facility that closed in 2024 and address a service gap, particularly for women, as Indiana's only existing comprehensive rehabilitative management needs facility serves men only. The current per diem rate for such facilities is $703. Disability advocates have raised concerns that the new facility, combined with recent changes to Medicaid waiver assessments that have resulted in higher denial rates, could signal a shift toward institutionalization rather than community-based care.
- State Policy · NC
North Carolina Medicaid Launches Expedited Reverification for High-Risk Providers
North Carolina Medicaid has initiated an expedited, off-cycle reverification process targeting certain high-risk providers. Affected providers must complete the reverification process to maintain enrollment status, with failure potentially resulting in disenrollment from the state's Medicaid program. The initiative creates immediate due diligence considerations for providers undergoing transactions, as enrollment status could be subject to accelerated review outside the standard cycle. This action follows federal program integrity requirements that permit states to conduct targeted reverifications of providers posing elevated financial or compliance risk.
- State Policy · KY
Kentucky Planned Parenthood Vows to Continue Operations After Medicaid Termination
Planned Parenthood announced it will maintain operations in Kentucky following termination from the state's Medicaid program. The organization stated it remains committed to serving patients in Kentucky despite the ban. The termination affects Medicaid beneficiaries' ability to receive reimbursed services at Planned Parenthood locations. This development follows broader state efforts to exclude certain family planning providers from Medicaid networks, requiring affected beneficiaries to seek covered services from alternative Medicaid-enrolled providers.
Wednesday, September 23 · 9 stories
- State Policy · TN
Tennessee Hospital to Resume Labor and Delivery Services in Spring 2027
Henry County Hospital in Paris, Tennessee will restore maternity services beginning spring 2027, according to a September 22 announcement from West Tennessee Healthcare. The hospital has recruited an additional physician to its women's health team to support the resumption of deliveries. The restoration addresses a gap in local access to obstetric care in the region. For Medicaid agencies and managed care plans serving pregnant beneficiaries in rural Tennessee, this represents restoration of a delivery site that affects network adequacy and access to maternity benefits in Henry County.
- State Policy · NM
New Mexico Approves 11 of 13 Regional Behavioral Health Plans
The committee tasked with rebuilding New Mexico's behavioral healthcare infrastructure has approved 11 of 13 regional plans, with two regional plans remaining for approval. The chair provided the update to the interim Legislative Finance Committee on Tuesday. The approvals represent progress toward statewide implementation of a restructured behavioral health delivery system. This development directly affects how behavioral health services will be organized and delivered across New Mexico's Medicaid program.
- State Policy · AR
Arkansas Child Uninsured Rate Reaches Decade High at 7.7 Percent
Arkansas Advocates for Children and Families reports that 57,000 Arkansas children — 7.7% of the state's child population — were uninsured in 2024, an increase of 7,000 from the previous year and the highest level in a decade. Hispanic children face the highest uninsured rate at nearly 14%, and foreign-born children are more than seven times more likely to be uninsured than U.S.-born children. The report attributes rising uninsurance to Medicaid disenrollment following pandemic-era continuous enrollment protections and warns that federal Medicaid spending cuts under H.R. 1 will create additional instability. Arkansas' Medicaid expansion program, covering more than 200,000 low-income adults, faces an uncertain future after the Trump administration denied the state's renewal request.
