Court vacates CMS medical frailty restriction in Medicaid work requirement
In a ruling considered favorable to Medicaid beneficiaries and providers, a federal court sided with plaintiffs’ argument that CMS exceeded its authority in regulations defining the medical frailty exemption to the Medicaid work requirement. An Oct. 29 summary judgment by a Massachusetts federal court vacated regulatory language that would have complicated the task of deciding…
CMS ends Medicaid coverage of gender-affirming care for minors
Federal Medicaid funding no longer will be available to cover gender-affirming healthcare for minors, according to a CMS final rule issued Aug. 11. The rule blocks Medicaid and Children’s Health Insurance Program (CHIP) federal matching funds from reimbursing providers for what the rule refers to as “sex-rejecting procedures” in beneficiaries younger than 18 in Medicaid…
Medicaid programs mull dropping insurers
Various state Medicaid programs are considering replacing outside managed care plans with in-house management. Such a reversal of the multi-decade trend to outsourcing overall management of Medicaid plans to various insurers and reverting to fee-for-service (FFS) Medicaid could have major ramifications for hospitals and health systems. Bruce Greenstein, secretary of the Louisiana Department of Health…
Utilization review, HIPAA updates and more
Nick Hut talks with HFMA’s Kathy Stull about the Medicaid work requirement and 340B developments. Erika Grotto discusses utilization review with Kevin Coloton, CEO of HURC and HIPAA updates with Jon Bilotti, enterprise technology consultant at BCS365.
FastFinance: Medicaid administrative burdens; Cost cutting plans for 2026
HFMA’s FastFinance newsletter is now a podcast. Host Rich Daly discusses the most current and relevant healthcare news, delivered in an easily digestible format. Hospitals and health systems are facing Medicaid administrative burdens as states scramble to upgrade their programs ahead of OBBBA. Also, this week’s Weird Number: 49.5%. That’s the combined percentage of top…
States boost Medicaid budgets as enrollments decline
Amid ongoing and projected Medicaid enrollment decreases, most states are boosting their Medicaid budget proposals. Nationally, Medicaid enrollment is shrinking. From December 2024 to December 2025, national Medicaid and CHIP enrollment has decreased 4%, from 78.9 million to 75.7 million, according to CMS. That has continued into 2026, with Wells Fargo analysts reporting a 2%…
Hospitals brace for Medicaid cuts, some resort to layoffs
Hospitals and health systems are responding to the OBBBA cuts by reducing staff and increasing revenue, while some are also pursuing mergers and acquisitions to improve efficiency and balance their budgets.
The OBBB’s Medicaid work requirements and the hidden risks for hospitals
The One Big Beautiful Bill (OBBB), passed this summer, contains a provision of great consequence for hospitals: Medicaid work requirements. The new law requires a subset of beneficiaries to log at least 80 hours of employment, volunteering or schooling each month to maintain coverage. The changes carry significant administrative and reputational risk for health systems.…
Hospitals brace for looming federal cuts in Medicaid and elsewhere
The historic healthcare policy changes — and associated Medicaid cuts — in the One Big Beautiful Bill Act have left it to the states to figure out how to keep their residents insured and healthy with $1 trillion less in federal funding. With impacts of the One Big Beautiful Bill Act, or OBBBA, including a…
Hospitals seek to mitigate $1.1 trillion in federal healthcare spending cuts
Hospitals and health systems face large federal funding cuts from the recently enacted reconciliation law, but advocates and observers believe there are opportunities to mitigate them through legislative efforts, state initiatives, and potential rollbacks.