Author Archives: Elyse VanderWoude

AL Medicaid Spending, Share of State Budget Increases

The Alabama Reflector reported on May 28, 2024, that funding for the Alabama Medicaid agency has increased by 313 percent from $231 million in 2002 to more than $955 million in 2025. Funding for Medicaid and the Department of Corrections comprised more than half the state’s General Fund spending budget in 2024, up from a third of spending in 2002. The budget for the General Fund is projected to reach $3.36 billion in 2025, the largest in the state’s history. Read More

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CA Improperly Claimed $52.7 Million in Federal Medicaid Reimbursements for Noncitizens, OIG Audit Finds

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) released an audit in May 2024 that found that California improperly claimed $52.7 million of the total $372.9 million in federal Medicaid reimbursement for capitation payments made on behalf of noncitizens with unsatisfactory immigration status. The proxy percentage that California applied to capitation payments was outdated and did not correctly account for the costs of providing nonemergency services to this population. California plans to provide the refund via a manual process and will collaborate with the Centers for Medicare and Medicaid Services (CMS) to identify improper reimbursements potentially claimed during other time periods. Read More

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DE Senate Passes Provider Tax to Support Medicaid

Delaware Online reported on May 28, 2024, that the Delaware Senate unanimously passed a bill, sponsored by Senator Sarah McBride (D-Bellefonte), that would impose a 3.58 percent tax on hospitals’ and behavioral facilities’ net patient revenues to generate approximately $100 million in new Medicaid funding for the state. The additional funds can be used to increase inpatient and outpatient payments to hospitals and develop funding for Medicaid initiatives. The bill now moves to the House. Read More

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Elevance Health Foundation to Provide $10 Million in Funding to Address Health-related Social Needs

Fierce Healthcare reported on May 24, 2024, that Elevance’s philanthropic organization, the Elevance Health Foundation, will provide $10 million in loans to small businesses to address social needs such as access to care, food insecurity, and health disparities. Loans will be offered at below prime rates to businesses that focus on equity, such as those owned by women or people of color. Initially, investments will be focused in California, Florida, Georgia, Indiana, Nevada, Missouri, and Texas. The Elevance Health Foundation has also selected California-based organization, Mission Driven Finance, to manage $8 million of the $10 million commitment, and will provide further details on the remaining funding in the future. Read More

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Native American Communities Face Heightened Health Disparities Amid Medicaid Eligibility Redeterminations Process

The South Dakota Searchlight reported on May 28, 2024, that Native American communities in Alaska, Arizona, Idaho, Montana, New Mexico, and other states have been significantly impacted by the Medicaid eligibility redeterminations process, which has further exacerbated existing health disparities. Tribal leaders have indicated a lack of information and data regarding the process or the eligibility status of individuals living on reservations. Approximately 30 percent of Native American and Alaska Native people under age 65 utilize Medicaid, according to a survey by the Tribal Self-Governance Advisory Committee of the Indian Health Service. Tribal health systems typically rely on Medicaid reimbursement due to the chronic underfunding of the Indian Health Service. Read More

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WV Medicaid Managed Care Enrollment is Down 7%, May-24 Data

Medicaid managed care enrollment in West Virginia was down 7% in May 2024, compared to year-end 2023, after decreasing 14.3% in 2023, and increasing 5.7% in 2022, 10.6% in 2021, and 18.5% in 2020.

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NY Medicaid MLTC Plans to Pay $10 Million to Federal, State Medicaid Programs After Failing to Provide Services

The Brooklyn Daily Eagle reported on May 23, 2024, that Medicaid managed long-term care non-profit organizations RiverSpring Living Holding Corp. and ElderServe Health, which does business as RiverSpring at Home, must pay $10 million in restitution to federal and state Medicaid programs after failing to provide services to seniors in New York City and surrounding counties between 2012 and 2018. Under the settlement reached with New York Attorney General Letitia James, $6 million will be returned to the state’s Medicaid program. Read More

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LA Medicaid Managed Care Enrollment is Down 4.7%, Mar-24 Data

Medicaid managed care enrollment in Louisiana is down 4.7% to 1.6 million in March 2024, compared to year-end 2023, after decreasing 11.6% in 2023 and increasing 5.8% in 2022, 6.5% in 2021 and 11.7% in 2020.

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MI Disenrolls 18,316 Medicaid Beneficiaries During April Redeterminations

The Michigan Department of Health & Human Services announced on May 24, 2024, that it has disenrolled 18,316 Medicaid beneficiaries during April eligibility redeterminations. Of those disenrolled, 15,737 lost coverage due to ineligibility and 2,579 lost coverage for procedural reasons. Read More

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NJ Medicaid Managed Care Enrollment is Down 7.6%, Apr-24 Data

Medicaid managed care enrollment in New Jersey is down 7.6% to 1.9 million in April 2024 compared to year-end 2023, after a 6.3% decrease in 2023 and a 7%, 9.8%, and 15.8% increase in 2022, 2021, and 2020 respectively. Enrollment decreased by 2.5% in 2019.

Starting in 2022, New Jersey changed Medicaid managed care enrollment data sources. Enrollment data can be found here.

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