Health Business Community

Medicaid Fraud Probes

• 🔥 Florida Under Scrutiny: Federal health officials have expanded a nationwide investigation into Medicaid fraud and...

A Senate Judiciary Committee report accuses UnitedHealth Group of using aggressive strategies to boost Medicare Advantage payments through risk adjustment, spotlighting federal oversight implications for providers and payers.

Trend spotlight: Short-term staffing tech meets long-term training bets amid physician shortages.

• Immediate innovation: SendIt connects systems...

Federal health officials have expanded a nationwide Medicaid fraud investigation to target Florida, heightening risks for local providers.

Federal health officials expanded their nationwide medical fraud investigation, with the Trump Administration setting sights on Florida providers. Critical alert for local healthcare pros.

CMS found a new way to extend Medicare site-neutral payment reductions to previously protected sites, targeting a specific area in the 2026 Drug Administration Rule—healthcare pros, time to reassess reimbursements.

• No expansions: Zero states, including Mississippi, have expanded Medicaid since the Bill's passage last year—momentum stalled.
• Minnesota costs...

• California push: State Senate considering bill to enroll all undocumented residents 19+ in Medi-Cal.
• Broader trend: States stretching Medicaid beyond intended limits.
• Key for healthcare pros: Watch policy shifts impacting coverage and costs.

Providers warn Medicaid cuts and a draft Medicare Advantage rule could slash access to vital home- and community-based services.

Federal Policy Updates

• 🔥 MedPAC March Report: MedPAC submitted its March report to Congress, assessing Medicare payments to providers and...

Todd Myers summarizes Washington's legislative session end with higher spending:

• Government-run healthcare advanced
• Healthcare taxes and Medicaid...

Handy primer for healthcare pros navigating Medicaid admin:

• CDCN YouTube video introduces Medicaid governance
• Short watch: 4:10 duration
• Gained 2,033 views with room for more engagement

Nationwide ED capacity crisis intensifies with labor shortages, burnout, and seasonal volume swings doubling patients winter-to-summer.

Hospitals...

• Federal aid now controls a third of state budgets, evolving from Founding era through Great Society to dominate governance.
• Piper Principle:...

Key scrutiny signals for providers:

• Hospitals and providers testifying before Congress
• Committees eyeing Medicare reform and HSA expansion
• Focus...

• January 2026: CMS deferred hundreds of millions in Medicaid funding to Minnesota
• Targets peer support specialists and non-emergency medical...

Healthcare affordability tops Americans' concerns, outranking other necessities. Leaders must align planning with 2026 policy shifts from a new...

Clinicians: Warn patients about Medicare enrollment traps offsetting 2026's $47,500 senior deduction:

• Late Part B/D signup: Triggers permanent...

For over fifty years, Medicaid Section 1115 waivers have empowered states with flexibility to test innovative ideas and redesign care delivery.

MedPAC submitted its March report to Congress, which evaluates the adequacy of Medicare's fee-for-service payments and offers recommendations for changes in the coming period. Key watch for providers on revenue impacts.