Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly roundup focuses on developments, research, and legislation that relate to Medicaid program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse. Below is a summary of last month’s Medicaid news.
Medicaid Enrollment and Unwinding Tracker KFF, September 30
The Medicaid Enrollment and Unwinding Tracker presents the most recent data on monthly Medicaid/CHIP enrollment reported by the Centers for Medicare & Medicaid Services (CMS) as part of the Performance Indicator Project as well as archived data on renewal outcomes reported by states during the unwinding of the Medicaid continuous enrollment provision. read more
Status of State Medicaid Expansion Decisions KFF, September 29
The Affordable Care Act’s (ACA) Medicaid expansion expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($21,597 for an individual in 2025) and provided states with an enhanced federal matching rate (FMAP) for their expansion populations. To date, 41 states (including DC) have adopted the Medicaid expansion and 10 states have not adopted the expansion. read more
Utah’s Medicaid watchdog has ‘poor governance’ and ‘lack of transparency,’ audit finds KSL.com, September 25
A new report found multiple failures within the Utah office tasked with overseeing and identifying fraud in the state’s Medicaid system and says leadership “has not made adequate effort to improve” since a similar audit in 2018. Leadership of the Office of the Inspector General of Medicaid Services, or OIG, has “been delinquent in fulfilling its duties,” the office has provided “insufficient oversight” of some care organizations and had “inconsistent” practices and “some low performance outcomes,” according to a 46-page audit presented to state lawmakers Thursday. read more
Changes coming to Nevada Medicaid enrollment in 2026 KOLO 8, September 25
Changes will be coming to Nevada Medicaid enrollment in 2026. Starting Jan. 1, 2026, all 17 counties in Nevada will utilize Medicaid Managed Care as opposed to a fee for service model. Prior to this, only Clark and Washoe Counties had access to managed care. People applying online through the Division of Welfare will see CareSource listed as an option during plan selection for 2026. read more
New Mexico’s Medicaid Costs Nearly Double While Enrollment Falls Governing, September 24
As New Mexico lawmakers prepare to convene next week in part to address the federal spending bill’s impact on Medicaid, legislative analysts say the state’s costs for the program have nearly doubled in nine years, even as enrollment has dropped. In addition, clients report ongoing issues with doctor availability. Legislative Finance Committee analysts presented their report to lawmakers during an interim committee meeting on Tuesday in Hobbs. read more
The Impact of H.R. 1 on Two Medicaid Eligibility Rules KFF, September 22
On July 4, 2025, President Trump signed into law the 2025 budget reconciliation bill, formerly known as the One Big Beautiful Bill Act, that makes significant changes to Medicaid eligibility and financing. The Congressional Budget Office estimates the law will cut federal Medicaid spending by $911 billion over 10 years and will increase the number of people who are uninsured by 10 million in 2034. One source of the law’s Medicaid cuts is a 10-year moratorium on implementation or enforcement of provisions in two rules finalized by the Biden administration that would have reduced administrative burdens to make it easier for people to enroll in and maintain Medicaid and CHIP coverage. read more
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State KFF, September 22
Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, if [in the HHS Secretary’s view] the approach is likely to “promote the objectives of the Medicaid program.” They can provide states additional flexibility in how they operate their programs, beyond the considerable flexibility that is available under current law. read more
Medicaid work requirements delayed until 2027 following federal action Indiana Capital Chronicle, September 18
Lawmakers who voted to implement work requirements for Medicaid beneficiaries next summer will have to wait another six months before they can take effect, and the state is still waiting to hear if the federal government will approve other portions of the health care plan. Meanwhile, Indiana’s financial toll under a new federal law is beginning to take shape, though final numbers are currently under review, according to comments before the State Budget Committee on Wednesday. read more
CMS issues guidance on limits for state-directed payments in Medicaid Fierce Healthcare, September 9
The Trump administration issued new guidance Tuesday outlining changes to state-directed Medicaid payments, citing these outlays as a key issue in the push to root out fraud, waste and abuse. The Centers for Medicare & Medicaid Services (CMS) said it chose to issue the guidance ahead of final rulemaking to give states additional time to adjust to changes under the One Big Beautiful Bill Act. read more
Virginia Beach braces for $2 billion cuts in Medicaid and SNAP benefits by 2034 13 News, September 5
Eastern Virginia could face “devastating losses” to Medicaid and SNAP benefits over the next decade, according to new analysis from Voices for Virginia’s Children. Using the latest U.S. Census data, the organization identified localities most vulnerable to steep reductions in federal aid, driven by policy changes under the Trump administration’s “Big Beautiful Bill.” Virginia Beach is projected to be among the hardest-hit localities, with more than $2 billion in combined SNAP and Medicaid cuts expected by 2034. read more
One Big Beautiful Bill Act: An Overview of Key Healthcare Provisions & Impacts JDSupra, September 4
The One Big Beautiful Bill Act (OBBBA) was signed into law on July 4, 2025. A sweeping piece of legislation that reshapes healthcare financing and delivery across Medicaid, Medicare, and the insurance marketplaces, the bill will have significant impacts on the healthcare sector. Much of the public commentary has focused on dire predictions that millions will lose coverage. While those headlines capture the scale of disruption, healthcare leaders should pay close attention to the regulatory details of the bill. read more
5 Key Facts about Medicaid’s Share of National Health Spending KFF, September 3
Medicaid, as the primary program providing comprehensive coverage of health care and long-term services and supports to about 80 million low-income people in the United States, accounts for one-fifth of all personal health care spending in the United States and a large share of state budgets. read more
Colorado Budget Cuts Hit Home for Medicaid Providers JDSupra, September 2
On August 28, 2025, Governor Polis signed SB25B-001 – the primary bill resulting from the special session of the Colorado legislature. The session, convened on August 21, was called for the express purpose of addressing Colorado budget shortfalls arising from the federal spending legislation signed by President Trump earlier in July. read more
