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Pressley, Warren, Booker, Moore, Dingell, Adams, Underwood, Colleagues Renew Push to Combat Maternal Health Crisis
Mamas First Act would expand Medicaid coverage to include prenatal, delivery, and postpartum care provided by doulas, midwives, tribal midwives,...
US Health Secretary Kennedy says CMS is pausing Medicaid payments to California and Minnesota
The Trump administration is pausing over $1 billion in Medicaid payments to California and Minnesota "because of suspected fraud and noncompliance," U.S. Health Secretary Robert F. Kennedy, Jr. said on Tuesday.
US Health Secretary Kennedy Says CMS Is Pausing Medicaid Payments to California and Minnesota
July 21 (Reuters) - The Trump administration is pausing over $1 billion in Medicaid payments to California and Minnesota "because of suspected fraud and noncompliance," U.S. Health Secretary Robert F. Kennedy, Jr. said on Tuesday. "If those states want that money they need to ...
Defense lawyers in demand amidst health care fraud crackdown
The U.S. Department of Justice is expanding AI-powered health care fraud enforcement as prosecutors target Medicare and Medicaid fraud with advanced analytics nationwide.
Netflix actress, model plead guilty to $3.4M Medicaid fraud scheme
The unusual defendants were swept up as part of a larger investigation into healthcare fraud in the Minnesota housing services program. An alleged third co-conspirator has pleaded not guilty and will take her chances at a jury trial.
'I just wanted to give up': Disabled patients face Medicaid denials from IT errors
Complex computer systems that decide whether people get Medicaid benefits have a history of errors. Now changes to comply with Trump's tax and domestic policy law are inundating those systems.
Rising health insurance costs slam Mississippi
Mississippi's working poor have been hit with rising health insurance exchange costs and no Medicaid expansion, meaning they have less access to healthcare than most Americans.
CEO: Medicaid work requirements will hurt Iowa healthcare
The Gazette spoke with Joe Lock, president and CEO of the Eastern Iowa Health Center, to understand how the new rule will impact the clinic and its patients.
Kansas City health and faith leaders team up to help minimize Medicaid coverage loss
New work requirements and twice-yearly eligibility checks are expected to cause millions of adults to lose Medicaid coverage. But community religious leaders and health advocates have been meeting every other week to plan and strategize about how to mitigate the damage.
Trump’s deep public health cuts hinder response to record US cyclosporiasis outbreak
Experts say layoffs, reduced disease surveillance and Medicaid cuts have made the foodborne parasite more difficult to track and contain
ACA and Medicaid changes hang over health earnings
Insurers and health systems already are feeling the effects of significant enrollment drops and changes in who's paying for care.
Doctors fear Medicaid changes will force them to decide who’s too sick to work
Physicians say new Medicaid rules starting Jan. 1 regarding employment will undermine their relationships with patients.
CT Congressman Wants Legal Support For Patients Denied Health Coverage
The act would establish a grant program through the Department of Labor to help law schools set up consumer advocate programs where patients can receive no-cost legal assistance with their insurance claim appeal.
Oral health advocates try to unravel mystery of two NC budget paragraphs
A budget provision about dental Medicaid services, ambulatory surgical centers confounds oral health organizations, advocates.
Medicare wants to shake up how it pays for clinical AI
In this edition of STAT Health Tech: Centers for Medicare and Medicaid Services proposes major changes to RPM, clinical AI payment models.
Two more insurers sue CMS over Medicare Advantage star rating methodology
The lawsuits come days after Elevance Health filed a complaint of its own, asking a court to compel the Centers for Medicare & Medicaid Services to remain consistent in how it doles out stars.
KFF Health Tracking Poll: Public Views on Fraud in Government Health Programs
As the 2026 midterms approach, health care costs remain voters' top health priority, but fraud in government health programs, including Medicaid and Medicare, is resonating with Republican voters, 55% of whom say it's extremely important for candidates to address. Most voters say there is at least “some” fraud in government health programs, but larger shares say there is fraud in the tax system, defense, and foreign aid, while the smallest share sees fraud in the ACA Marketplaces.
AHA responds to CMS on potential modifications to ACA’s Essential Health Benefits
The AHA July 15 responded to a request for information from the Centers for Medicare & Medicaid Services on the Affordable Care Act’s Essential Health Benefits framework, which creates the guardrails for defining comprehensive insurance coverage.
Elevance shuts down D.C. Medicaid business, eyes additional exits after passable Q2
Elevance will leave D.C. this summer and is considering other markets to depart, executives said. The company outperformed Wall Street expectations in the second quarter — but not by much, and its stock fell accordingly.
Trump administration claims healthcare fraud crackdown has saved taxpayers $5.56B in six months
A new report from the U.S. Department of Health and Human Services’ Office of Inspector General shows most of the money comes from a small number of huge cases, where the federal government was able to reclaim hundreds of millions of dollars in Medicare and Medicaid funds being abused by criminal defendants.
They harvest the nation’s food, but a new rule may strip them of health insurance
Seasonal work. Inconsistent hours. Frequent moves. Cash payments and informal jobs. For farmworkers who rely on Medicaid, these common employment patterns could put their health coverage at risk. It’s a heightened concern for the estimated million-plus farmworkers who are U.S. citizens or legal permanent residents, as new work requirements kick in for the federal-state healthcare […]
Facing funding losses, states call out big businesses with employees on Medicaid
The policy gaps in behavioral health coverage — and what it’ll take to close them, per 1 exec
Nearly four years after the 988 Suicide & Crisis Lifeline launched, states, payers and county systems still define behavioral health crisis care inconsistently, and Medicare offers limited coverage for community-based crisis stabilization services — leaving safety-net funding, Medicaid, federal block grants, and state and local dollars to carry the cost for nearly 200 million Americans. […]
Trump's HHS abandons threat to withhold Medicare and Medicaid funding over trans care
NPR has learned that the Department of Health and Human Services will not be finalizing its most aggressive attempt to end gender affirming care for youth nationally.
They harvest the nation’s food, but a new rule may strip them of health insurance
Seasonal work. Inconsistent hours. Frequent moves. Cash payments and informal jobs. For farmworkers who rely on Medicaid, these common employment patterns could put their health coverage at risk. It’s a heightened concern for the estimated million-plus farmworkers who are U.S. citizens or legal permanent residents, as new work requirements kick in for the federal-state healthcare […]
New Medicaid work requirements in Nebraska prompt ‘extreme mass confusion’
In the first state to implement the Trump administration mandate, Medicaid participants are anxious for information — and are struggling to get it.
They harvest the nation’s food — and a new rule may strip them of health insurance
For farmworkers who rely on Medicaid, common employment patterns could put their health coverage at risk under new rules.
NC’s first full budget since 2023 reflects transformed health policy landscape
It’s been more than 1,000 days since the legislature passed a state budget, but sweeping federal health care changes may force North Carolina to rethink how it funds Medicaid, food assistance and other health programs.
CMS Releases Medicare Home Health Payment Proposed Rule for 2027
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule updating the Home Health (HH) Prospective Payment System (PPS) for calendar year (CY) 2027.
HHSC Names New Chief Counsel, Texas Medicaid Director | Texas Health and Human Services
HHSC names key leadership appointments to lead the agency’s Chief Counsel Division, and guide Texas Medicaid and CHIP Services.
CMS Approach to Work Reporting Requirement Won’t Work for People with Substance Use Disorders or Mental Health Conditions
By Deborah Steinberg, Senior Health Policy Attorney, Legal Action Center A few weeks ago, CCF explained how the Centers for Medicare & Medicaid Services (CMS) issued a new interim final rule with comment period (IFR) that went far beyond its authority to implement the new work reporting requirements. H.R. 1 – the budget reconciliation law […]
CENTENE SUBSIDIARY MERIDIAN HEALTH PLAN OF ILLINOIS AWARDED ILLINOIS MEDICAID CONTRACT
/PRNewswire/ -- Centene Corporation (Centene) (NYSE: CNC), a leading healthcare enterprise committed to helping people live healthier lives, announced today...
Pelosi, Rowe-Finkbeiner: We can fix health care, but Trump chooses Iran
Republicans triggered this health care crisis by slashing $1 trillion from Medicaid and failing to extend the Affordable Care Act premium tax credits.
Pa. advocates fear Medicaid cuts, work requirements could impact those with serious illnesses, mental health issues
Changes to Medicaid under H.R. 1 include new work requirements and restrictions on who is eligible for the safety net insurance program.
Oregon eyes $421 million in Medicaid cuts, including fewer benefits and limits on prescription drugs
Major cuts are coming to the Oregon Health Plan, the state’s free healthcare program covering 1.4 million children and low-income adults. But the group of experts Gov. Tina Kotek charged with minimizing the harm of those cuts has given her no definitive recommendations.
CMS Proposes Home Health Prospective Payment System Rate Update
What: On July 6, 2026, the Centers for Medicare & Medicaid Services (CMS) proposed a rule to update the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. Why: The proposed rule i
Digital Health Tools and Technologies: An Overview of CMS’ Recent Efforts to Expand Their Use in Medicare
As an increasing share of older adults have adopted digital health technologies over the past several years, and with most expressing interest in using them to manage their health care, the Centers for Medicare & Medicaid Services (CMS) has introduced several initiatives to expand the use of digital health technologies in Medicare. This brief summarizes these initiatives and draws on data from various surveys, including KFF Tracking Polls from September 2025 and March 2026, to highlight facts about recent experiences with and use of digital health tools among Medicare beneficiaries and older adults more generally.
Elevance Health sues CMS in latest challenge to Medicare Advantage star rating methodology
The complaint accuses the Centers for Medicare & Medicaid Services of failing to properly recalculate its grades for Medicare Part C plans, something it promised to do in June.
Medicaid funding is resuming for Planned Parenthood, Maine provider
Planned Parenthood and two smaller regional abortion providers are resuming billing Medicaid for services other than abortion after being cut off for most of a year.
New Iowa Medicaid fraud task force draws questions from retired health administrator
A retired health care administrator is questioning Gov. Kim Reynolds’ decision to form a new task force aimed at fighting Medicaid fraud, saying the state’s focus overlooks what she sees as a larger problem: health care becoming less affordable.
Health insurer Centene to stop participating in Arkansas’ Medicaid expansion
DHS will transfer enrollees in the three Centene plans to other plans for which they are eligible, an agency spokesperson said.
'Yes, this does suck': NYC health officials brace for new Medicaid work rules
The new city budget includes $3M for hiring community health workers to help people navigate the changes.
New Medicaid Work Rule Means More Opportunities To Lose Coverage
A work requirement is coming to Medicaid. Sam Whitehead tells WAMU’s “Health Hub” how to keep your coverage — and who’s exempt from the new rule.
Protect Medicaid to Protect Children's Health
Medicaid is the largest source of health coverage for children in the United States. Cuts to the program would put kids' health — and their futures — at risk.
Secure the Future of Children's Health Care Coverage
Nearly half of America's children rely on Medicaid and CHIP for their health coverage. This fact sheet lays out the steps Congress must take to secure children's health care coverage for the future.
Months after Mayo Clinic left, some rural towns adjust to a ‘completely different health continuum’
With impending federal changes to Medicaid, workforce issues and the increasing cost of American healthcare, many rural healthcare providers are in a period of uncertainty.
Conservatives rage over re-funding of Planned Parenthood
Despite the restoration of Medicaid funding for health care services -- but not abortions -- dozens of closed clinics are not likely to reopen.
Universal Health Services (UHS) Is Up 8.7% After CMS Proposes Hospital Payment Increase and Analyst Support
In recent days, Universal Health Services received a boost after the Centers for Medicare & Medicaid Services proposed a 2.4% payment rate increase for hospitals, alongside supportive analyst commentary on its operating performance and upcoming second-quarter results. This regulatory tailwind for hospital reimbursement comes as UHS continues to expand its behavioral health footprint and prepare for its next earnings update, potentially influencing how investors assess its longer-term growth...
For one small business, AI was key to a quick start and expansion
Here Now Health isn't an AI-based company, but its quick path from an idea in founder Michelle Turner's mind to an operating mental health platform for foster children relied deeply on the technology now restructuring the U.S. economy. Working from her Virginia Beach home, she used AI tools to school herself in startup culture, create a business plan and fine-tune a presentation for early-stage investors. Funding began to flow, and the company, launched in January 2025, now has 16 employees and is certified in three states to provide Medicaid-funded mental health counseling for children entering the foster system, a gap in care she identified through her own experience as a foster parent.
One year after passage, Trump health care law remains politically divisive
After the Big Beautiful Bill Act passed, Dr. Mehmet Oz says the law reduced fraud and stabilized Medicaid programs.
How does Maryland stack up in preventing and prosecuting Medicaid fraud?
High-profile federal Medicaid fraud prosecutions, including the indictment of a Dundalk pharmacist, raised questions about how Maryland works to prevent and prosecute fraud.
Oregon Health Authority director Sejal Hathi announces resignation
Hathi’s departure is a surprise and comes as OHA is preparing to cut $421 million from medicaid after years of expanding the program.
A Medicaid fee in New Jersey is now in place for some businesses. More states may follow
The new legislation signed by Governor Sherrill will charge companies that have at least 50 employees covered by Medicaid.
New Jersey will charge fees to employers with low-income workers on Medicaid, and other states could follow suit
New Jersey is set to charge companies whose workers have Medicaid health coverage.
State health officials celebrate extended Medicaid coverage after pregnancy
Eligible pregnant people can now qualify for one year of Medicaid coverage postpartum instead of only 60 days, thanks to a state law passed earlier this year.
With DeGette’s loss, Raul Ruiz eyes her job on a powerful health panel - Live Updates
The Energy and Commerce Health Subcommittee has jurisdiction over HHS, Obamacare, Medicare and Medicaid.
With DeGette’s loss, Raul Ruiz eyes her job on a powerful health panel - Live Updates
The Energy and Commerce Health Subcommittee has jurisdiction over HHS, Obamacare, Medicare and Medicaid.
CMS proposes updates to home health payments for CY 2027, updates to provider enrollment and quality and value-based purchasing programs
The Centers for Medicare & Medicaid Services July 1 issued its calendar year 2027 proposed rule for the home health prospective payment system. The rule proposes a 2.4% update, which includes a 3.1% market basket update, reduced by a 1.0 percentage point cut for productivity, as well as an 0.3 percentage point increase related to outlier payments. In addition, the agency proposes a temporary cut of 3.0% that it states is necessary to achieve budget-neutral implementation of the Patient-driven Groupings Model.
Affordable Healthcare Emerges as a Voter Priority in Purple Nevada
The Trump administration’s cuts to Medicaid and SNAP may complicate Republican Gov. Joe Lombardo’s reelection chances.
NC’s first full budget since 2023 reflects transformed health policy landscape
North Carolina's first full budget since 2023 reflects Medicaid expansion, Healthy Opportunities Pilot funding, SNAP changes and new federal health policies.
Medicaid work requirements challenged by coalition of 26 states
Led by Massachusetts and California, the plaintiffs say CMS ignored the will of Congress by strictly defining a “medically frail” exemption that would allow a person access to safety net medical coverage.
Richmond mental health agency operator charged in $49.6M Medicaid fraud scheme
The operator of a Richmond mental health agency faces federal charges after prosecutors say she ran a years-long Medicaid fraud scheme that targeted low-income and homeless Virginians.
Trump administration suspends funding for New York's Medicaid fraud unit over low performance
The funding suspension is part of the Republican administration's broader anti-fraud actions in the healthcare sector.
Trump administration suspends funding for New York's Medicaid fraud unit
The move is the second suspension of a state Medicaid fraud unit this year by the Republican Trump administration.
Oklahoma Health Care Authority board approves balanced budget despite funding gaps
Budget cuts and modifications are leaving the state Medicaid agency with "razor-thin margins" as it enters the 2027 fiscal year.
Strengthening Collaboration between Workforce, Health, and Human Services to Meet New Federal Requirements
Human Services Policy Advisors Institute | June 24th, 2026 H.R. 1, or “The One Big Beautiful Bill”, introduced significant changes to work requirements across major health and human services programs. including expanding the populations subject to SNAP time limits, reducing state/territory SNAP waiver flexibility, and creating new work requirements in Medicaid. These changes accelerate the […]
Half of states sue over Medicaid work requirements
FDA peptide panelists, a new study on Covid and flu shots, and more health news from Morning Rounds
Unredacted comments from California hospital lawsuits show stunning admissions and a 'forced' McKinsey collaboration
Who controls the Medicaid market, GLP-1 usage and pizza household costs, and more from Health Care Inc.
Wisconsin moms on Medicaid now get 12 months of coverage
Wisconsin’s new law extends mothers’ Medicaid coverage for a full year after birth. Medical experts say it will save lives.
12 arrested in South Florida in nationwide investigation into $6.5B health care fraud
Investigators say Medicaid and Medicare thieves in South Florida bilked taxpayers for $27 million for everything from fake therapy to medical equipment patients never received. Officials seized the stolen taxpayer money from Key West to Fort Pierce.
5 states targeting Medicaid behavioral health enrollment amid fraud concerns
At least five states have taken steps in 2026 to restrict new Medicaid behavioral health provider enrollments as stakeholders seek to curb fraud, waste and abuse while strengthening oversight of high-risk services. The developments come as the Trump administration aims to crack down on healthcare fraud. On June 25, the Justice Department charged 455 people, […]
CMS projects national health spending grew to $5.7 trillion in 2025
National health spending is projected to have reached $5.7 trillion in 2025, up 7.3% from 2024, according to an analysis by the Centers for Medicare & Medicaid Services published yesterday by Health Affairs. It marks the third consecutive year of growth greater than 7%. CMS projects growth to continue in 2026 due to continued demand for high-cost retail prescription drugs, mostly from individuals with Medicare and private insurance.
4 charged in Nebraska as part of DOJ national health care fraud takedown
Criminal charges announced today are tied to alleged schemes to defraud Medicare and Medicaid, according to the U.S. Attorney’s Office for the District of Nebraska.
Louisville doctor, nurse and nonprofit founder charged in federal health care fraud crackdown
Federal prosecutors in the Western District of Kentucky announced charges in four separate cases involving alleged schemes to defraud Medicare and Medicaid, misuse medical credentials and controlled substances, and submit
Medicaid-focused Cityblock acquiring MA business Homeward Health
Cityblock Health has raised $886 million and Homeward Health has raised roughly $72 million.
Medicaid-focused Cityblock acquiring MA business Homeward Health
Cityblock Health has raised $886 million and Homeward Health has raised roughly $72 million.
DOJ announces $6.5B healthcare fraud takedown with record Medicaid enforcement
The Department of Justice unveiled charges against 455 people, including 90 doctors and other licensed medical professionals, for their alleged participation in healthcare schemes that involved mor | Law enforcement unveiled charges against 455 defendants for their alleged participation in healthcare schemes, among which fraudulent amniotic wound allografts and undelivered Medicaid services were spotlighted.
Lead Maine petitions DHHS to adopt new Medicaid rules
Libby emphasized that neither initiative would cut benefits or eligibility for MaineCare, the state’s Medicaid program that spends more than $1.4 billion a year and serves 400,000 Mainers.
Bipartisan group of senators urges CMS to improve Rural Health Transformation Program implementation
A bipartisan group of senators June 18 urged the Centers for Medicare & Medicaid Services to improve implementation of the Rural Health Transformation Program.
Exclusive | Justice Department Unveils $6.5 Billion Healthcare Fraud Crackdown
Prosecutors are expected to charge around 450 defendants in alleged fraud spanning Medicaid and hospice care.
Holland & Knight Health Dose: June 23, 2026 | Insights
The Centers for Medicare & Medicaid Services CMS issued a request for information RFI seeking input on implementation of new requirements for pharmacy benefit managers PBMs.
Backed by threat of clawbacks, feds wield tight grip on $50B rural health fund
Centers for Medicare & Medicaid Services Administrator Mehmet Oz praised states’ plans when announcing the rural health program awards last year and said his agency would help states “turn their ideas into lasting improvements for rural families.” But state officials and healthcare leaders said it’s also clear the agency wants to encourage specific policy changes and hold states accountable to the promises they made and rules they agreed to follow.
Medicaid and ACA enrollment falls by more than 5 million, new report finds
The decline over the last 12 months stems in part from President Donald Trump’s Medicaid cuts and the expired enhanced Affordable Care Act subsidies.
Wisconsin’s Medicaid work requirements: Here’s what to know
An estimated 63,000 Wisconsinites could lose BadgerCare Plus as the state prepares to implement new federal Medicaid expansion work requirements next year.
The feds promised Minnesota’s rural hospitals grant money to ease massive Medicaid cuts. Hospitals are still waiting.
Rural health care providers in Minnesota and across the country are bracing for heavy Medicaid funding cuts next year.
Interwell Health delivers savings, top quality scores in Kidney Care Choices Model
Interwell Health, the largest participant in the Center for Medicare and Medicaid Innovation's Kidney Care Choices (CKCC) Model, has produced shared savings of $273 million in its first three years while also receiving top quality scores in that period, Interwell, a unit of Fresenius Medical Care, said this month.
California is getting ready to increase a health insurance tax — will it affect your premium?
Legislators this week approved a health tax bill meant to continue critical federal funding for the state’s Medicaid program.
New Listening Mothers survey: Pregnant patients struggling on Medicaid
A national maternal health survey found many mothers felt unheard during pregnancy and birth, with Medicaid patients reporting worse outcomes.
‘I literally was crying last night because I’m nervous about what I’m going to find out’: a record 51% of Americans aren’t ‘cost secure’ on health
Half of Americans couldn't reliably afford healthcare, before the Medicaid cuts even started.
Colom prioritizing lower costs, good jobs, affordable health care in state
In 2025, about 27 million people in the United States were medically uninsured, a number that is expected to increase by 10 million in the next decade due to tightened Medicaid eligibility, changes to enrollment processes and a loss of enhanced Affordable Care Act plan subsidies.
Healthcare Has Been the Job Engine. That’s About to Change.
Federal healthcare cutbacks, including Medicaid funds, are expected to result in hundreds of thousands of fewer jobs.
Medicaid Work Requirements and Access to Health Care
Scholars examine whether implementing Medicaid work requirements may limit access to health coverage.
Trump Policies Could Strip Health Coverage From 3 Million Age 50-64
Trump’s biggest health care initiatives, rolling back the 2010 Affordable Care Act and cutting Medicaid, could strip insurance from up to 3 million people aged 50-64.
Guest opinion: Rural Wisconsin workers lose health insurance twice as fast as before the pandemic
Wisconsin should expand Medicaid, invest in renewal pathways that don’t assume broadband internet access and revamp the renewal system so eligible people do not lose coverage, Jiyue Wang writes.
Private equity has no place in health care
By Miah Ntepp Of all the financial pressures placed on working people in this country, the skyrocketing costs of health care rank near the top. As families struggle under the cuts to Medicaid made by the Trump administration, they are now facing yet another barrier to affordable health care: the increasing incidence of predatory private […]
At CMS, Oz Eyes Faster Tech Approvals and a 'Power to Convene'
Top Centers for Medicare & Medicaid Services officials said Thursday they plan to increase patients’ access to new technology, including AI, but that they’re still exploring how best to regulate it and ensure patient safety. Addressing the U.S. News Healthcare of Tomorrow conference in Washington,
How Healthcare Policy Shifts Are Reshaping Care for Vulnerable Patients
The Bronx is the poorest congressional district in America and the sickest county in the state of New York. Montefiore Einstein, the academic medical center in the Bronx, serves a population that is 85% dependent on Medicaid and Medicare. As federal Medicaid rules tighten and funding shrinks, more ...
CMS Ignores the Law (Again) – This Time Taking Health Insurance Away from Individuals with Substance Use Disorders, Mental Health Conditions, and Serious Health Conditions
Just a few weeks ago, we explained how the Center for Medicare and Medicaid’s (CMS) proposed regulation on state directed payments goes far beyond the statutory authority in H.R. 1 to incredibly harmful effect. Now it has happened again. This time CMS has issued an interim final rule on work reporting requirements (the “IFR”) that […]
Justice Department sues New York over Medicaid home care ‘fraud scheme’
The Justice Department is suing the New York State Department of Health, the state’s Medicaid director and a company operating a $10 billion home health prog…
Major private payer encouraging employees to leave willingly
The largest Medicaid-specialized managed care organization in the U.S. is offering buyout packages to most of its 60,000 or so staff workers.