Latest
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Revalidation of ‘High-Risk’ Medicaid Providers: Early Lessons from Minnesota
On April 23, the CMS Administrator, Dr. Mehmet Oz, issued a letter to State Medicaid Directors “formally asking that your state develop and submit a comprehensive two-year provider revalidation (PR) strategy….” This SMD is not posted on Medicaid.gov with all the other SMDs, but you can view it on the Fox News website. The state…
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Medicaid Work Reporting Requirements: States Ask a Federal Court to Protect Medically Frail Individuals from CMS Overreach
On June 3, CMS issued an Interim Final Rule (IFR) misinterpreting the work reporting requirements enacted last July in H.R. 1. The H.R. 1 provisions were bad enough, but as my colleague Leo Cuello has explained, the IFR imposes policies on states and individuals that the Congress did not enact. Most notably, the IFR makes…
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The Administration Weaponizes Fraud Against Medicaid: HHS OIG Hammers Hawaii
On May 13, Vice President Vance, the chair of the White House Task Force to Eliminate Fraud, held a press conference. He announced the deferral of $1.3 billion in federal Medicaid matching payments owed to California, which received considerable attention. He also announced that the HHS Inspector General had by letter that day warned state…
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Medicaid Managed Care: The Big Five in Q1 2026
The “Big Five” have reported their financial and enrollment results for the first calendar quarter of 2026. The “Big Five” are the five largest publicly-traded insurers, measured by enrollment, in the Medicaid managed care market. Four of them—United Health Group, Elevance, CVSHealth/Aetna, and Centene, in that order—were also the four largest commercial health insurers by…
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CMS Weaponizes Fraud Against Medicaid in California
For the second time in the 60-year history of the Medicaid program, a CMS deferral of federal matching funds has been announced by the Vice President of the United States at a White House press conference. The first time was on February 25, when Vice President J.D. Vance told the press that CMS was delaying…
