Latest
-
Medicaid Managed Care: The Big Five in Q4 2025
Andy Schneider and Nancy Kaneb The Q4 2025 results for the “Big Five” Medicaid managed care companies are now available. These publicly-held companies—Centene, CVSHealth/Aetna, Elevance, Molina, and UnitedHealth Group—together control about half of the Medicaid managed care market, so their performance matters to tens of millions of Medicaid beneficiaries. (The results for prior quarters in…
-
Implementing Costly Medicaid Work Reporting Requirements: Who Will Foot the Bill?
Introduction The budget reconciliation bill enacted in July 2025 (H.R. 1) includes two major changes to federal Medicaid law that will impose large implementation costs on most states. One mandates the states that extend Medicaid coverage to low-income (“expansion”) adults require those adults to report 80 hours of work or community service per month. The other…
-
CMS Quietly Releases Medicaid State Improper Payment Rates for 2025: How Did Minnesota Do?
With little fanfare, CMS earlier this month released a Fact Sheet on improper payments in Medicare, Medicaid, CHIP, and the Marketplaces in 2025. With even less fanfare, CMS this week posted Medicaid improper payment rates for 17 states, including Minnesota. To its credit, CMS did not conflate Medicaid improper payments with fraud against Medicaid. In the…
-
CMS Weaponizes Fraud Against Medicaid in Minnesota
On January 6, 2026, the Centers for Medicare & Medicaid Services (CMS) Administrator, Dr. Mehmet Oz, sent a letter to the Governor of Minnesota, Tim Walz, notifying him that his state’s Medicaid agency was “operating its program in substantial noncompliance” with federal requirements to “ensure sufficient controls to prevent, detect, and address fraud, waste, and…
-
Medicaid Managed Care in 2025: The Year That Was
The lead story of 2025 is the enactment of H.R. 1, which will dramatically alter the Medicaid coverage and financing landscape over at least the next three years. The primary target of the law’s Medicaid cuts were the 41 states (including DC) that have elected to cover the expansion adults; of these, 34 contract with…
