North Carolina completed its transition from traditional Medicaid to a managed care model in recent years, and 2026 is proving to be an active year for the program — a…
Colorado runs one of the more structurally distinctive Medicaid programs in the country. Rather than a straightforward fee-for-service or managed-care-organization model, Health First Colorado splits physical health and behavioral health…
New Jersey's telehealth payment parity requirement — extended twice since the pandemic — reached its scheduled expiration on July 1, 2026. If your practice bills a meaningful volume of telehealth…
New Jersey's Division of Medical Assistance and Health Services (DMAHS) has confirmed its implementation plan for federal OBBBA eligibility changes, and the timeline lands this fall — right in the…
New Jersey runs one of the most heavily managed Medicaid programs in the country — 90% or higher managed care penetration — through NJ FamilyCare, the state's Medicaid and CHIP…
If your practice orders CT scans, MRIs, or PET scans for patients covered by Molina Healthcare of Illinois — your prior authorization workflow is changing on September 1, 2026. Molina…
Tennessee's Medicaid program — TennCare — stands among the most distinctive in the country for two reasons that work in opposite directions. First, Tennessee has not expanded Medicaid under the…
Virginia Medicaid entered 2026 following one of the most significant restructuring events in the state's managed care history. Effective July 1, 2025, the Virginia Department of Medical Assistance Services (DMAS)…
Wisconsin's Medicaid program occupies a unique position in the national landscape. The state is one of a small number that chose not to expand Medicaid under the ACA — but…
Ohio Medicaid entered 2026 in the middle of one of the most ambitious Medicaid redesign efforts in the country. The Ohio Department of Medicaid (ODM) began its Next Generation managed…