Centers for Medicare and Medicaid Services

Florida spent $6.57 billion between 2023 and 2025 providing applied behavior analysis services, significantly more than any other state. Consequently, a blue ribbon task force has been convened to review Florida’s Medicaid program and ABA service delivery by December 31st. This review is happening amid policy changes requiring managed care plans and increased scrutiny over healthcare fraud.

House Republicans hope that efforts to crack down on alleged abuse in safety-net programs will revive talks of tackling fraud before year's end. However, skepticism remains about whether any such bill will reach the president’s desk due to impending midterms and lack of immediate success. The article notes that achieving legislative goals requires intervention from Vice President Vance or President Trump.

The article asserts that despite its importance in crises, government services are often designed around bureaucracy rather than the people they serve, making access difficult and eroding public trust. To propose a solution, it offers a blueprint suggesting a new Cabinet-level Department of Services and giving implementation authority to a Deputy Chief of Staff for better delivery across all government levels.

Governor Kathy Hochul condemned the end of a Medicare subsidy program designed to keep prescription drug premiums lower for seniors in New York. The Centers for Medicare and Medicaid Services announced the conclusion of this program, which had started in 2024 under the Biden Administration.

Federal health officials from the FDA and CMS met with 10 technology companies, including Microsoft AI and Amazon One Medical, to discuss clinical artificial intelligence adoption and regulation. The July 8 'clinical AI demo day' aimed to provide regulators firsthand experience with AI doctor technology and shape policy on health AI.

The article highlights bipartisan support for healthcare price transparency, citing a 2025 poll showing 96% public approval. It argues that transparency empowers patients to shop for non-emergent care, drives competition, and addresses opaque billing practices contributing to healthcare debt. Legislative progress in Congress aims to formalize transparency laws.

Sen. Don Gaetz advises Florida’s next governor to reassess ongoing legal challenges against federal Medicaid eligibility requirements for the KidCare program. Gov. Ron DeSantis rejected a 2023 law expanding KidCare due to a federal mandate requiring continuous eligibility, leading to a court dispute and removal of thousands of children from the program over missed premium payments.

Medicare is eliminating alternative pathways that allowed FDA-designated 'breakthrough' medical devices to qualify for supplemental payments without proving clinical improvement. The Centers for Medicare and Medicaid Services finalized a rule requiring such devices to demonstrate substantial clinical improvement starting in fiscal year 2028.

A coalition of states, including California, sued federal health agencies over new Affordable Care Act provisions, arguing they unlawfully increase costs and reduce enrollment. The states claim the 2027 Notice of Benefit and Payment Parameters shifts costs to enrollees and states while expanding access to low-coverage catastrophic plans.

North Carolina Attorney General Jeff Jackson and 23 other states sued the federal government over revised Medicaid work requirement guidelines, arguing the Centers for Medicare and Medicaid Services (CMS) imposed an overly strict definition of 'medically frail.' The lawsuit claims the new rules, effective June 1, add unnecessary hurdles for Medicaid beneficiaries with serious health conditions, risking coverage loss and increased administrative burdens.

Georgia officials excluded HIV from a list of conditions exempting low-income residents from Medicaid work requirements, raising concerns from health advocates. The state's proposed policy aligns with federal Medicaid changes requiring work or community service for coverage, but advocates argue excluding HIV could worsen health outcomes and increase costs. A decision on the policy is pending a state board meeting.

The Trump administration announced a $1 billion deferral in Medicaid payments to California and Minnesota due to suspected fraud and noncompliance, part of a broader effort to prevent fraudulent spending. Minnesota received a $199 million deferral for services paid in March 2026, with state officials criticizing the move as punitive and politically motivated.

The article discusses the SEC's proposal to eliminate quarterly financial reports, which has received over 200,000 public comments, and Medicare's recent outpatient rule that includes cuts to drugs under the 340B discount program. The Centers for Medicare and Medicaid Services also reinforced a policy hospitals oppose.

Medicaid officials improperly shared data about millions of people with ICE, which then shared it with Palantir, according to court filings. A U.S. District Judge temporarily paused data sharing after ICE admitted to multiple improper transfers, including a dataset containing millions of names, and struggled to delete all copies. The issue was highlighted in a motion filed by Democratic attorneys general challenging the data-sharing agreement.

Medicare is proposing a 19% increase in reimbursement for physicians who provide smoking cessation counseling and address alcohol and substance misuse during patient visits. The Centers for Medicare and Medicaid Services (CMS) released the proposal, which includes a comment deadline of Sept. 14. The American Lung Association praised the change as overdue.

The Centers for Medicare and Medicaid Services (CMS) has proposed changes to its 2027 payment rules for clinical software and AI, aiming to establish a consistent payment structure based on patient outcomes. This marks the first time CMS has outlined a new policy direction for funding AI and software-based clinical tools, according to the AI Healthcare Coalition.

Minnesota state officials have taken control of The Terrace nursing home in Crystal after a judge approved emergency receivership due to resident safety concerns and 63 citations since December. The ruling allows the state to transfer residents and cover operating costs following the facility's Medicare certification termination by CMS.

Medicare regulators proposed banning vendors from providing remote patient monitoring services on behalf of doctors, citing concerns over low-value services and payments exceeding $500 million in 2024. The policy shift aligns with efforts to reduce fraud and wasteful spending under the Trump administration and introduces an alternative model for digital health services.

Two Democratic senators are questioning the credentials and conflicts of interest of members in a health care advisory committee led by Robert F. Kennedy Jr. and Mehmet Oz. The committee includes figures like motivational coach Tony Robbins and health care executives.

Dr. Mehmet Oz, CMS Administrator under President Trump, accused blue states like California of exploiting Medicaid fraud as a 'feature' to fund state programs and pay unemployed individuals. He criticized California Governor Gavin Newsom for not addressing widespread fraud, leading to a $1.3 billion cut in the state's Medicaid reimbursements by the Trump administration.

Dr. Mehmet Oz, CMS Administrator under President Donald Trump, accused blue states like California of exploiting Medicaid fraud as a 'feature' to fund state programs and create economic incentives. He criticized California Gov. Gavin Newsom for not addressing widespread fraud despite internal warnings and cited a $1.3 billion cut in Medicaid reimbursements to the state.

Obamacare premiums are projected to rise by a median of 14% in 2027, with 77 insurers across 16 states and Washington, D.C., proposing increases. The hikes follow the expiration of enhanced subsidies and rising healthcare costs, leading to fewer healthier enrollees and higher costs for those with incomes above 400% of the federal poverty level.

Obamacare premiums are projected to rise by 14% in 2027, with insurers citing rising healthcare costs and expired subsidies as key factors. The analysis of 77 insurers across 16 states and Washington, D.C., shows most proposing increases between 10-20%, while 20 insurers seek hikes above 20%. Marketplace enrollments have dropped by 2.6 million since February 2023.

Health insurance premiums for Affordable Care Act Marketplace plans are projected to rise by a median of 14% in 2027, marking the second consecutive year of double-digit increases. Insurers attribute the hikes to expired subsidies, rising healthcare costs, and federal regulatory changes, while enrollments in Marketplace plans have dropped by 2.6 million since February 2023.

Health insurance premiums for Affordable Care Act Marketplace plans are projected to rise by a median of 14% in 2027, with no proposed decreases. Insurers attribute the increases to rising healthcare costs, expired subsidies, and regulatory changes. The analysis by the Peterson Center on Healthcare and KFF reviewed 77 insurers across 16 states and Washington, D.C.

Obamacare premiums are projected to rise by 14% in 2027, with insurers citing rising healthcare costs and expired subsidies as key factors. A report by the Peterson Center on Healthcare and KFF found 77 insurers across 16 states propose median increases between 10% and 20%, marking the second consecutive year of double-digit hikes. Marketplace enrollments dropped by 2.6 million in February compared to the prior year.

Ohio University will receive $10 million from the federal Rural Health Transformation Program to address healthcare workforce needs in rural communities. The funding, part of Ohio's total $202 million allocation, will support programs like summer camps, career fairs, and apprenticeships for students.

Elected leaders in Lincoln Parish, Louisiana, are responding to an 87-page report identifying 24 alleged violations at Northern Louisiana Medical Center (NLMC). The report from the U.S. Department of Health and Human Services and CMS could lead to the hospital's Medicare provider agreement termination in 2026 if deficiencies are not corrected, with the operator, Allegiance Health Management, facing financial challenges.

President Donald Trump signed the Big Beautiful Bill Act one year ago, which the Trump administration claims has reduced Medicaid costs and prevented $42 billion in fraudulent health care spending. Democrats argue the law weakens health care programs for low-income Americans, while Dr. Mehmet Oz, administrator of Medicare and Medicaid, defends stricter work requirements and enrollment changes. Estimates suggest over $1 trillion was cut from federal health care spending, with 4.8 million Americans losing Medicaid coverage.

Minnesota's Department of Human Services reviewed nearly 5,500 social service providers in high-risk areas like autism and elderly care over five months, leading to widespread disruptions. Nearly two-thirds of providers received disenrollment notices due to paperwork issues, site visit failures, or background checks, causing payment interruptions and uncertainty for families relying on these services.

Medicare will start covering weight-loss drugs via a temporary pilot program on July 1, allowing millions of enrollees access to medications like Wegovy and Zepbound at significantly reduced costs under a deal with Eli Lilly and Novo Nordisk. The program aims to address obesity as a treatable disease, offering seniors like Mary and Jeff Abrahamson affordable options that improve health outcomes.

25 Democratic-led states and the District of Columbia have sued the Trump administration over new Medicaid work requirements, arguing the federal guidance narrows the 'medically frail' exemption, making it harder for disabled or ill individuals to remain on Medicaid. The lawsuit challenges the administration's interpretation of the One Big Beautiful Bill Act, which mandates monthly work or community service for Medicaid recipients in expanded eligibility states.

The Rural Health Transformation Program, a $50 billion federal initiative from 2026 to 2030, aims to address rural healthcare crises by funding state-led efforts to stabilize hospitals and build sustainable health systems. Education and workforce development are key priorities, with a focus on creating pathways for rural students into nursing careers through cross-sector partnerships like Indiana's RAZ-32 model.

25 Democratic-led states and the District of Columbia have sued the Trump administration over Medicaid work requirements, challenging new federal guidance that narrows the 'medically frail' exemption. The lawsuit argues the guidance makes it difficult for disabled and ill individuals to remain on Medicaid.

Twenty-five Democratic-led states and the District of Columbia sued the Trump administration over new Medicaid work requirements, arguing the federal guidance narrows the 'medically frail' exemption, making it harder for disabled and ill individuals to retain coverage. The lawsuit challenges the implementation of work requirements under the One Big Beautiful Bill Act, which mandates 80 hours of monthly work or community service for Medicaid eligibility in 40 states.

25 Democratic-led states and the District of Columbia have sued the Trump administration over new Medicaid work requirements, arguing the 'medically frail' exemption is too narrow. The lawsuit challenges federal guidance that narrows who qualifies for exemptions from the 80-hour monthly work requirement under the One Big Beautiful Bill Act.

25 Democratic-led states and the District of Columbia have sued the Trump administration over new Medicaid work requirements, arguing the federal guidance narrows the definition of 'medically frail' and makes it harder for disabled or ill individuals to remain on Medicaid. The lawsuit challenges the implementation of work rules under the One Big Beautiful Bill Act, which requires Medicaid recipients in 40 states to work or engage in community service for 80 hours monthly.

The Trump administration's revised definition of 'medical frailty' for Medicaid work requirements in Minnesota imposes stricter criteria, requiring individuals to demonstrate both a medical condition and an inability to work. This change complicates state implementation and expands administrative challenges for Minnesota and other states adapting to federal Medicaid mandates under the One Big Beautiful Bill.

25 Democratic-led states and the District of Columbia have sued the Trump administration over Medicaid work requirements, arguing the new federal guidance narrows the definition of 'medically frail' and makes it harder for disabled and ill individuals to remain on Medicaid. The lawsuit challenges the administration's implementation of work requirements under the One Big Beautiful Bill Act, which mandates 80 hours of monthly work or community service for Medicaid eligibility in expanded programs.

Pennsylvania has joined a multi-state lawsuit challenging the Trump administration's Medicaid work requirement rules under the One Big Beautiful Bill Act. The lawsuit argues the new requirements, which mandate community engagement and work hours for Medicaid benefits, will cause harm and complexity for states to implement.