Medicaid - Health Care Quality Digest

House passes reconciliation bill with massive Medicaid cuts

Health Care Dive

MAY 22, 2025

Speaker Mike Johnson negotiated a number of last-minute changes to the megabill to ensure passage, including moving up the start date for Medicaid work requirements. The House passed the bill 215-214 on Thursday morning.

Medicaid

RFK Jr. calls GOP Medicaid plans ‘not true cuts’

Health Care Dive

MAY 15, 2025

Republicans’ plan to reduce spending on Medicaid would eliminate waste, fraud and abuse, the HHS secretary said in hearings Wednesday. Millions could become uninsured under the proposal.

Medicaid

Medicaid cuts could have ‘drastic impact’ on providers

Health Care Dive

MAY 9, 2025

Some providers may need to reduce services, lay off staff or close their doors if Congress enacts major cuts to the safety-net insurance program, experts say.

Medicaid

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Medicaid cuts could threaten healthcare access for young adults: report

Health Care Dive

MAY 27, 2025

Young adults could struggle to navigate government bureaucracy and face other challenges managing work requirements or increased eligibility checks in the safety-net insurance program, the Urban Institute found.

Medicaid

Medicaid Healthcare

Democrats urge Republicans to focus on Medicare Advantage upcoding instead of Medicaid cuts

Health Care Dive

MAY 9, 2025

Stopping MA insurers from inflating their reimbursement is a better strategy to save federal dollars than restricting benefits or cutting eligibility in Medicaid, the Democrat lawmakers wrote to GOP leadership this week.

Medicaid

Medicaid Medicare

House Republicans unveil Medicaid cuts including work requirement, provider tax freeze

Health Care Dive

MAY 12, 2025

The House Energy and Commerce Committee is backing more moderate reforms to Medicaid. But Republicans’ policy proposals would still result in millions of Americans losing health insurance.

Medicaid

Millions could lose coverage under potential GOP Medicaid policies: CBO

Health Care Dive

MAY 9, 2025

The Congressional Budget Office expects states will replace about half of the reduced federal support with their own resources, and then reduce spending by cutting provider payment rates, optional benefits and enrollment.

Medicaid

CMS sets Medicaid renewal compliance deadlines

Fierce Healthcare

SEPTEMBER 24, 2024

The feds have set new deadlines for compliance with Medicaid renewal requirements given widespread enrollment concerns during the unwinding. | The feds have set new deadlines for compliance with Medicaid renewal requirements given widespread enrollment concerns during the unwinding.

Medicaid

Biden proposes Medicare, Medicaid cover anti-obesity drugs

Fierce Healthcare

NOVEMBER 26, 2024

The Centers for Medicare & Medicaid Services (CMS) is attempting to cover anti-obesity medications under Medicare Part D and Medicaid, the agency announced Nov.

Medicaid

Medicaid Medicare

House Republicans pass budget blueprint that could spell Medicaid cuts

Health Care Dive

FEBRUARY 26, 2025

Although the budget resolution does not mention Medicaid specifically, lawmakers would be hard pressed to find enough cuts to meet an $880 billion target without touching federal healthcare programs.

Medicaid

Medicaid Federal Healthcare Healthcare

Medicaid work requirements could cut coverage for 5.2M

Health Care Dive

MARCH 20, 2025

A new report found that millions could lose access to care, even though most Medicaid beneficiaries are working or should be eligible for exemptions from work requirements.

Medicaid

RFK Jr. appears confused about Medicaid, Medicare during confirmation hearing

Health Care Dive

JANUARY 29, 2025

incorrectly said that Medicaid was fully funded by the federal government and that Medicare is a fee-for-service program during a hearing in front of the Senate Finance Committee on Wednesday. Kennedy Jr.

Medicaid

Medicaid Medicare

Indiana insurers, hospitals accused of Medicaid fraud in giant whistleblower lawsuit

Fierce Healthcare

SEPTEMBER 19, 2024

Major Indiana managed care organizations and health systems are blamed for defrauding the state Medicaid system by tens, if not hundreds, of millions of dollars, says a newly unsealed whistleblower | A newly unsealed lawsuit alleges major health insurers and health systems defrauded Indiana Medicaid by hundreds of millions of dollars, with the government (..)

Medicaid

Medicaid Hospitals

UnitedHealth projects shaky Medicaid redetermination aftermath

Fierce Healthcare

MAY 30, 2024

UnitedHealth is predicting an upcoming “disturbance” among its Medicaid programs as members continue to disenroll after the COVID-19 public health emergency. UnitedHealth gave an overview of areas in which the insurer can improve upon, how Medicaid redeterminations will affect the company and thoughts on OptumRx.

Medicaid

CMS Cuts Medicaid Funding For Some Non-Medical In-Home Services

Home Health Care

APRIL 11, 2025

The Centers for Medicare & Medicaid Services (CMS) announced Thursday that it would no longer approve funding for some services previously covered by state section 1115 demonstrations, including some in-home non-medical services. These programs do not tie directly to services provided to Medicaid beneficiaries.

Medicaid

Medicaid Medicare Medical Services Nursing

Medicaid redeterminations still affecting Centene as stock plunges

Fierce Healthcare

SEPTEMBER 4, 2024

Centene’s business is still impacted by Medicaid redeterminations, a process that began in early 2023, the company said during the Wells Fargo Healthcare Conference. Centene's stock sunk Wednesday after the company highlighted issues it faces surrounding Medicaid redeterminations.

Medicaid

Medicaid Healthcare

Centene beats investor expectations despite Medicaid headwinds

Health Care Dive

OCTOBER 26, 2024

Like other payers, Centene flagged a mismatch between patient acuity and payment rates in Medicaid. But the insurer said a diversified portfolio helped it navigate challenges in the third quarter.

Medicaid

TennCare violated healthcare rights of Tennessee Medicaid beneficiaries, judge rules

Fierce Healthcare

AUGUST 27, 2024

TennCare, the state of Tennessee’s Medicaid program, intentionally prevented families from receiving healthcare coverage and benefits, a federal district judge determined Aug.

Medicaid

Medicaid Healthcare Prevention

Medicaid, SNAP cuts could lead to 1 million jobs lost in 2026: report

Health Care Dive

MARCH 25, 2025

Reducing spending on Medicaid and the food assistance program could batter state economies and lead to job cuts — including 477,000 roles in in the healthcare sector alone, according to the Commonwealth Fund.

Medicaid

Medicaid Healthcare

Centene looks beyond Medicaid redeterminations

Health Care Dive

APRIL 26, 2024

The nation's largest Medicaid insurer expects to return to normal operations this year, though redeterminations continue to dog Centene through a mismatch between rates and acuity.

Medicaid

Public health scholars ask HHS to reject Georgia Medicaid work requirement extension

Health Care Dive

JUNE 6, 2025

The American Public Health Association and dozens of other experts had harsh words for Georgia’s request to continue its controversial “Pathways to Coverage,” saying it enrolls fewer beneficiaries at a higher cost.

Medicaid

CMS sets Medicaid payments to home care workers at 80%

Fierce Healthcare

APRIL 22, 2024

The Centers for Medicare & Medicaid Services is hoping to improve Medicaid enrollees’ access to care through a final rule that better compensates caregiving roles. | CMS released a series of final rules Monday, including Medicaid access regulations that some groups worry will cause providers to close.

Medicaid

Medicaid Home Care Regulations Medicare

Medicaid cuts could worsen home care worker shortage: KFF

Health Care Dive

FEBRUARY 20, 2025

States have increased provider payment rates to address workforce shortages, but they may have to cut back if spending cuts hit Medicaid, according to the health policy researcher.

Medicaid

Medicaid Home Care

Federal Medicaid cuts could shift $44.3B in costs to expansion states

Health Care Dive

FEBRUARY 27, 2025

The 41 states that expanded Medicaid could be asked to spend 25% more to cover care costs if planned cuts are approved by Congress. Some states may cut the expansion program instead.

Medicaid

HHS OIG finds gaps in opioid treatment for Medicare, Medicaid enrollees

Fierce Healthcare

SEPTEMBER 27, 2024

Many counties do not have medication for opioid use disorder (MOUD) services available through providers and treatment programs, and even in counties that do, Medicare and Medicaid beneficiaries of | A new report from HHS OIG looked at access to medication for opioid use disorder services and found many high need counties do not have specialized providers. (..)

Medicaid

Medicaid Medicare

State Medicaid directors concerned about program’s stability: KFF

Health Care Dive

OCTOBER 24, 2024

The presidential election, loss of higher federal funding, inflationary pressures and other challenges are leaving state regulators uncertain about Medicaid’s “new normal.”

Medicaid

Medicaid Regulations

1 in 8 enrollees exited Medicaid during redeterminations in 4 Southern states: study

Health Care Dive

JULY 3, 2024

The survey, which included low-income people in Arkansas, Kentucky, Louisiana and Texas, found about half of those who were no longer enrolled in Medicaid became uninsured.

Medicaid

Medicaid overtakes Medicare Advantage as health insurers’ bogeyman in Q2

Health Care Dive

AUGUST 15, 2024

Despite challenges in Medicaid and MA, major insurers still posted large earnings in the second quarter — many helped by growing health services divisions.

Medicaid

Medicaid Medicare

MACPAC calls for greater transparency amid steep rise in Medicaid directed payments

Health Care Dive

NOVEMBER 5, 2024

Dramatic growth in an opaque Medicaid funding mechanism is exacerbating concerns about the program’s fiscal integrity — while spurring financial gains for the hospital industry.

Medicaid

Medicaid Integration Hospitals

Colorado dropped Medicaid enrollees as red states have, alarming advocates for the poor

Fierce Healthcare

JULY 12, 2024

Colorado stands out among the 10 states that have disenrolled the highest share of Medicaid beneficiaries since the U.S. Colorado stands out among the 10 states that have disenrolled the highest share of Medicaid beneficiaries since the U.S.

Medicaid

CMS to end some federal Medicaid spending for state health programs

Health Care Dive

APRIL 14, 2025

The decision represents “the end of an era of being open to a broader conception of health within the Medicaid program,” one expert said.

Medicaid

Medicaid, MA headwinds pressure payers in Q2. Here's a look at how major companies fared

Fierce Healthcare

AUGUST 9, 2024

Medicare Advantage and Medicaid woes continued to plague some major payers in the second quarter, with UnitedHealth Group regaining its crown as the most profitable company in the industry for Q2.<

Medicaid

Medicaid Medicare

Mississippi Medicaid awarding contracts to Centene, Molina, TrueCare after 2-year delay

Fierce Healthcare

SEPTEMBER 6, 2024

Two years after Mississippi awarded Medicaid contracts to three insurers, the state is finally moving forward with its decision following challenges from UnitedHealthcare and Elevance Health.

Medicaid

Fierce Healthcare - Untitled Article

Fierce Healthcare

MAY 20, 2025

With most eyes on Medicaid cuts in Congress, keep a close eye on ACA enrollment over the next six months, warn health policy experts.

Medicaid

Medicaid Expansion Cuts Threaten $80B Loss for Healthcare Providers

HIT Consultant

MARCH 11, 2025

Image by freepik What You Should Know: – A new analysis by the Urban Institute, supported by the Robert Wood Johnson Foundation , reveals that healthcare providers in 41 states that expanded Medicaid eligibility would face significant financial losses if federal funding for Medicaid expansion programs is cut.

Healthcare Providers

Healthcare Providers Medicaid Healthcare Hospitals

CES 2024: Elevance Health launches program to provide digital health-enabled smartphones to Medicaid members

Fierce Healthcare

JANUARY 10, 2024

Elevance Health is launching a new initiative that aims to put smartphones in the hands of Medicaid members who otherwise cannot connect to virtual services. In the wake of the COVID-19 pandemic, virtual care and digital health tools are more popular than ever.

Medicaid

Nearly two-thirds of Medicaid beneficiaries already work: KFF

Health Care Dive

FEBRUARY 7, 2025

Most adults on Medicaid are already employed, suggesting few beneficiaries wouldn’t meet a work requirement policy being considered by Republicans in Congress.

Medicaid

CMS puts forward meager offering for digital health in final Medicare physician fee schedule rule

Fierce Healthcare

NOVEMBER 4, 2024

Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs all got updates in the final 2025 Medicare physician fee schedule rule, (..)

Medicare

Medicare Medicaid

Exclusive: Medicaid insurers can do more to improve maternal health access, HHS report says

Fierce Healthcare

OCTOBER 1, 2024

States are missing opportunities to require Medicaid managed care organizations (MCOs) to improve maternal health access, a new report from the Department of Health and Human Services Office of Ins | With the country facing a maternal health crisis, HHS OIG's latest report argues states could be doing more to ensure Medicaid managed care organizations (..)

Medicaid

CMS finalizes 2.9% pay increase for outpatient facilities, ASCs, with new maternal health mandates

Fierce Healthcare

NOVEMBER 3, 2024

Under a final rule issued by the Centers for Medicare and Medicaid Services, outpatient hospital facilities and ambulatory surgical centers will get a 2.9% Medicare pay increase next year, up from | Under a final rule issued by CMS, outpatient hospital facilities and ambulatory surgical centers will get a 2.9%

Medicare

Medicare Medicaid Hospitals

Fierce Healthcare - Untitled Article

Fierce Healthcare

MAY 22, 2025

As Republicans in Congress push through a tax and immigration package that includes provisions that would cut Medicaid eligibility, Providence CEO Erik Wexler has a stark warning to lawmakers: the challenges facing healthcare amount to a national security issue.

Medicaid

Medicaid Healthcare

More than half of adults worry Medicaid cuts could hurt healthcare access: KFF

Health Care Dive

JUNE 10, 2025

Concerns about the policies are split along party lines. Still, more than 30% of Republicans said they were concerned the cuts could negatively impact their ability to get and pay for healthcare.

Medicaid

Medicaid Healthcare

Nearly 11M would become uninsured under GOP reconciliation bill: CBO

Health Care Dive

JUNE 5, 2025

million would lose coverage due to Medicaid cuts. The analysis from the nonpartisan budget scorekeeper found 7.8

Medicaid

Uninsured rate jumps to 8.2% amid Medicaid unwinding: CDC

Health Care Dive

AUGUST 7, 2024

The slide in the nation’s uninsured rate could become steeper if subsidies in the Affordable Care Act exchanges expire on schedule next year, according to health policy experts.

Medicaid

House passes reconciliation bill with massive Medicaid cuts

RFK Jr. calls GOP Medicaid plans ‘not true cuts’

Webinars

Trending Sources

Medicaid cuts could have ‘drastic impact’ on providers

Webinars

Medicaid cuts could threaten healthcare access for young adults: report

Democrats urge Republicans to focus on Medicare Advantage upcoding instead of Medicaid cuts

House Republicans unveil Medicaid cuts including work requirement, provider tax freeze

Millions could lose coverage under potential GOP Medicaid policies: CBO

CMS sets Medicaid renewal compliance deadlines

Biden proposes Medicare, Medicaid cover anti-obesity drugs

House Republicans pass budget blueprint that could spell Medicaid cuts

Medicaid work requirements could cut coverage for 5.2M

RFK Jr. appears confused about Medicaid, Medicare during confirmation hearing

Indiana insurers, hospitals accused of Medicaid fraud in giant whistleblower lawsuit

UnitedHealth projects shaky Medicaid redetermination aftermath

CMS Cuts Medicaid Funding For Some Non-Medical In-Home Services

Medicaid redeterminations still affecting Centene as stock plunges

Centene beats investor expectations despite Medicaid headwinds

TennCare violated healthcare rights of Tennessee Medicaid beneficiaries, judge rules

Medicaid, SNAP cuts could lead to 1 million jobs lost in 2026: report

Centene looks beyond Medicaid redeterminations

Public health scholars ask HHS to reject Georgia Medicaid work requirement extension

CMS sets Medicaid payments to home care workers at 80%

Medicaid cuts could worsen home care worker shortage: KFF

Federal Medicaid cuts could shift $44.3B in costs to expansion states

HHS OIG finds gaps in opioid treatment for Medicare, Medicaid enrollees

State Medicaid directors concerned about program’s stability: KFF

1 in 8 enrollees exited Medicaid during redeterminations in 4 Southern states: study

Medicaid overtakes Medicare Advantage as health insurers’ bogeyman in Q2

MACPAC calls for greater transparency amid steep rise in Medicaid directed payments

Colorado dropped Medicaid enrollees as red states have, alarming advocates for the poor

CMS to end some federal Medicaid spending for state health programs

Medicaid, MA headwinds pressure payers in Q2. Here's a look at how major companies fared

Mississippi Medicaid awarding contracts to Centene, Molina, TrueCare after 2-year delay

Fierce Healthcare - Untitled Article

Medicaid Expansion Cuts Threaten $80B Loss for Healthcare Providers

CES 2024: Elevance Health launches program to provide digital health-enabled smartphones to Medicaid members

Nearly two-thirds of Medicaid beneficiaries already work: KFF

CMS puts forward meager offering for digital health in final Medicare physician fee schedule rule

Exclusive: Medicaid insurers can do more to improve maternal health access, HHS report says

CMS finalizes 2.9% pay increase for outpatient facilities, ASCs, with new maternal health mandates

Fierce Healthcare - Untitled Article

More than half of adults worry Medicaid cuts could hurt healthcare access: KFF

Nearly 11M would become uninsured under GOP reconciliation bill: CBO

Uninsured rate jumps to 8.2% amid Medicaid unwinding: CDC

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