Medicaid integrity is crucial for administrators and leaders at state agencies that manage one of the nation’s largest and most vital safety-net programs. Every day, their teams process eligibility determinations, adjudicate claims, and deliver care to millions of people. With

As states begin planning their fiscal year (FY) 2027 budgets, many Medicaid programs are preparing for tougher financial conditions. State revenue growth has slowed while healthcare spending pressures continue, and recent federal policy changes under the 2025 budget reconciliation law

​As previously discussed, potential federal budget cuts pose significant threats to Medicaid, impacting millions who rely on this essential program. Recent developments across various states highlight the urgency for proactive measures to mitigate these challenges.   California's Financial Measures California

With the passing of the recent budget proposal in Congress, Medicaid remains a prime target for potential budget cuts. If funding reductions move forward, states will be left scrambling to fill gaps, likely leading to fewer benefits, stricter eligibility requirements,

Over the past three decades, Medi-Cal, California’s Medicaid program, has undergone significant changes and expansion. By 2016, the program provided coverage to more than one in three Californians, and as of January 2024, eligibility has been expanded to include all

In January 2020, DHHS declared the Coronavirus a public health emergency. Since then, the Public Health Emergency (PHE) has been renewed nine times, but it is set to expire this August unless it is extended again. Its expiration will have

Since its passage in 1965, the Medicaid program has expanded to become the single largest payer for health care in the United States, costing $671.2 billion in 2020. Due to surges in enrollment from the pandemic and the current administration's priorities,

Under the Payment Integrity Information Act of 2019, the Centers for Medicare & Medicaid Services (CMS) was required to review federal programs at risk of improper payments. The bill tasked CMS to assess what programs are at risk, estimate the number

Dependence on the Medicaid program has increased exponentially over time. Currently, it is the single largest insurer in the United States, and in FY 2019, it accounted for more than half of all federal funds distributed to states. Unfortunately, as

Over the last 56 years, Medicaid has helped provide health services to the most vulnerable populations in the United States. As member enrollment surges, Medicaid TPL and fiscal responsibility have been problematic. To resolve these issues, several legislative efforts have