Medicaid Programs
Expert articles and analysis related to medicaid programs.
AI Summary — Last 24 Hours
Medicaid operational risk is rising as CMS’ interim final rule on Medicaid work requirements puts states on the hook for implementing a medical frailty exemption—creating near-term challenges around eligibility systems, documentation, care-management workflows, and churn prevention for high-need beneficiaries in Medicaid managed care and VBC arrangements (KFF). At the same time, DOJ announced a $6.5B national health care fraud takedown with record Medicaid enforcement, signaling intensified scrutiny of Medicaid billing, transportation, and managed-care-adjacent services that could affect provider compliance programs, delegation oversight, and network partners ([DOJ](https://news.google.com/rss/articles/CBMivwFBVV95cUxQSW9URzVTTG5tX1E4RWlCY011T0pvLV9ONWh3OU9zeF8zZTFzcVlqclpFbWRXTElvS2VWQ0RNbWNtTnc3OHF5TUR3ajhPa1BYMW5rN2NzTUxKVy1vUFdfMm5qaHJyY0FUMDQ0MGJZa0p5dWtSV2ZqV0lIbkZjc2NGRDVXZkZNLUJy
Related Articles
The Medical Frailty Exemption from Medicaid Work Requirements: Key Takeaways from the CMS Interim Final Rule
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Latham Taxi Operators and Employees Charged in $660,000 Medicaid Fraud and Kickback Scheme - Department of Justice (.gov)
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DOJ announces $6.5B healthcare fraud takedown with record Medicaid enforcement
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DOJ Opinion Reinterprets Olmstead, Says States Are Not Required To Provide Community-Based Services - open minds
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Bipartisan group of senators urges CMS to improve Rural Health Transformation Program implementation
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