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Medicaid

a bottle of pills
National / Social Services

Most Favored Nation Drug Pricing Expands Across Medicaid

September 20, 2026September 19, 2026 - by Maryann Pugh

WASHINGTON, D.C. — All 50 states have applied to participate in the Trump administration’s Medicaid drug-pricing model, expanding an effort to tie net prices for selected medicines to prices paid …

Most Favored Nation Drug Pricing Expands Across Medicaid Read More

Judge
Crime & Safety / Pennsylvania

Home Care Owner Gets Prison in $1.8 Million Fraud Case

September 12, 2026September 10, 2026 - by Zainuddin Harinder

HARRISBURG, PA — The owner of an Erie County home care agency was sentenced this week to 11 to 23 months in prison and ordered to pay more than $1.8 …

Home Care Owner Gets Prison in $1.8 Million Fraud Case Read More
Judge
Crime & Safety / Pennsylvania

Home Care Owner Gets Prison in $1.76 Million Medicaid Fraud

August 22, 2026August 21, 2026 - by Timothy Alexander

HARRISBURG, PA — The former owner of a Montgomery County home care agency was sentenced Wednesday to 17 months to 10 years in state prison and ordered to repay $1.76 …

Home Care Owner Gets Prison in $1.76 Million Medicaid Fraud Read More

Health and Human Services
Health / Medical / National

HHS Refers Pediatric Gender-Care Billing for Fraud Review

August 19, 2026August 16, 2026 - by Maryann Pugh

WASHINGTON, D.C. — The Department of Health and Human Services last week referred hospitals and clinics involved in pediatric gender-transition care for possible federal investigation after a commissioned report identified …

HHS Refers Pediatric Gender-Care Billing for Fraud Review Read More
Centers for Medicare & Medicaid Services
Health / Medical / National

CMS Ends Federal Medicaid, CHIP Funding for Youth Gender Care

August 18, 2026August 16, 2026 - by Maryann Pugh

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services will end federal Medicaid and Children’s Health Insurance Program funding for certain gender-transition treatments for minors beginning Oct. 13, imposing …

CMS Ends Federal Medicaid, CHIP Funding for Youth Gender Care Read More

Centers for Medicare & Medicaid Services
National

CMS Targets Autism-Therapy Oversight as Medicaid Spending Surges

August 10, 2026August 10, 2026 - by Maryann Pugh

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services is urging states to strengthen oversight of applied behavior analysis services for children with autism after federal data showed Medicaid …

CMS Targets Autism-Therapy Oversight as Medicaid Spending Surges Read More
Arrest
Crime & Safety / Pennsylvania

Care-Dependent Resident Found Dead; 4 Caregivers Face Charges

August 6, 2026August 6, 2026 - by Zainuddin Harinder

HARRISBURG, PA — Four Warren County home care workers are accused of neglecting a care-dependent resident who was later found dead at a shared care home, according to the Pennsylvania …

Care-Dependent Resident Found Dead; 4 Caregivers Face Charges Read More

Centers for Medicare & Medicaid Services
National

CMS Says Fraud Unit Blocked $203 Million in Medicaid Payments

August 3, 2026August 2, 2026 - by Maryann Pugh

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services said its Medicaid Fraud War Room helped stop more than $203 million in potentially improper payments during its first 88 …

CMS Says Fraud Unit Blocked $203 Million in Medicaid Payments Read More
Sherlock Company
Regional

Health Plan Administrative Costs Rise as Staffing Ratios Decline

August 2, 2026August 1, 2026 - by Timothy Alexander

PHILADELPHIA, PA — Administrative costs for independent and provider-sponsored health insurance plans continued to rise in 2025, although at a slower pace than the previous year, reflecting higher labor expenses …

Health Plan Administrative Costs Rise as Staffing Ratios Decline Read More
Dentist
Dental / National

CMS Presses States to End Medicaid Amalgam Coverage

July 29, 2026July 29, 2026 - by Maryann Pugh

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services is urging state Medicaid programs to restrict or eliminate coverage for mercury-containing dental fillings, a federal push that could shift …

CMS Presses States to End Medicaid Amalgam Coverage Read More

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