Medicaid

• The Trump administration will require all 50 states to explain their plans to revalidate Medicaid providers as part of a national escalation of anti-fraud efforts, announced by Dr. Mehmet Oz on Tuesday. • This marks a significant expansion from previous anti-fraud initiatives that have largely focused on specific states rather than a nationwide mandate. • The move aims to strengthen program integrity and reduce fraudulent claims across the Medicaid system.

Victory for abortion rights groups as court finds state’s constitution guarantees a right to abortionA Pennsylvania court on Monday said that the state’s constitution guarantees a right to abortion while striking down a decades-long law banning the use of state Medicaid funds to cover abortion costs.The ruling by a divided seven-judge panel of the appellate-level commonwealth court is a major victory for Planned Parenthood and abortion clinic operators who first sued Pennsylvania over its Medicaid funding restrictions in 2019. Continue reading...

Experts say any short-term financial benefit will be outweighed by long-term health costs related to obesityFaced with high demand for GLP-1 drugs, some American cities and states that previously covered the cost of the weight-loss medication for low-income residents and public employees have now started to restrict or eliminate coverage.The pullback stems from the dramatic increase in public spending on drugs such as Ozempic and Wegovy in recent years. Continue reading...

• Centers for Medicare and Medicaid Services published a proposed rule on Friday requiring health insurance companies and states to resolve non-urgent prior authorization requests for prescription drugs within 24 hours. • The regulation mandates Medicaid and CHIP insurers, plus state administrators, to publicly disclose denial rates and respond faster to improve patient access. • This addresses delays in medication approvals, potentially benefiting millions enrolled in these programs amid ongoing affordability challenges.

• HHS issued a final rule on April 7, 2026, permanently extending Medicare telehealth flexibilities introduced during COVID-19, covering 85 million Medicaid enrollees. • Audio-only visits now reimbursable at $18-$40 per session, with $37 billion allocated through 2030 to rural providers. • Addresses access gaps in 20% of US counties lacking specialists; 'This bridges urban-rural divides,' said HHS Secretary.

• Bluestem Health in Lincoln, Nebraska, serving 21,000 low-income and uninsured patients, has operated at a loss for two years and anticipates worsening conditions due to new Medicaid work rules under President Trump's One Big Beautiful Bill Act. • Nebraska becomes the first state to enforce work requirements for certain Medicaid enrollees, risking coverage loss and threatening clinic viability, as stated by CEO Brad Meyer. • The policy darkens the outlook for government-backed clinics nationwide by reducing patient access to care amid rising operational costs.

• A new report warns that hundreds of hospitals serving 6.6 million Americans in 44 states and Washington, D.C., face serious threats from potential Medicaid cuts. • The cuts could force hospitals to reduce services or close, severely impacting healthcare access for lower-income and underserved communities. • Medicaid remains a critical funding source for these facilities, highlighting the broad national implications for public health infrastructure.