Medicaid policy
Trump MFN Drug Pricing Deals Enter the Implementation Test
Nine more drugmakers have joined Trump’s MFN pricing push. Here’s how Medicaid participation, rebates, tariffs, and onshoring conditions shape the implementation test.
Medicaid policy
Medicaid policy
CMS ABA Toolkit: What States, Plans, and Providers Need to Know
CMS’s ABA toolkit gives states a nonbinding framework for treatment intensity, authorization, documentation, payment, and program integrity. It creates no national treatment-hour cap; implementation will depend on state or program action.
Medicaid policy
Medicaid Work Requirements: What the Court Ruling Changes—and What It Doesn’t
A federal court declined to block three CMS provisions governing Medicaid work requirements. The ruling leaves the implementation timeline in place for now without resolving the legal merits.
Medicaid policy
CMS Medicaid Provider Tax Proposal: What Changes in 2026
CMS’s proposed Medicaid provider-tax rule changes more than the cap. See how the July 4, 2025 baseline, class-level calculations, reporting rules and phase-down could affect state and provider reviews.
Medicaid policy
Medicaid Managed Care's Encounter Data Problem Is Bigger Than the Fraud Debate
Medicaid managed care covers more than three-quarters of beneficiaries, but the encounter data states use for rate-setting, fraud detection, and MCO oversight has no systematic independent validation at scale. What that structural gap means for enforcement, H.R. 1 compliance, and FWA tools.
Medicaid policy
Nebraska Medicaid Work Requirements Start May 1, 2026
Nebraska will begin enforcing Medicaid work requirements on May 1, 2026 for adults covered through Medicaid expansion. The early signal is operational: how the state handles verification, exemptions, and renewals ahead of the January 1, 2027 federal start date.