Is the tech revolution coming for Medicaid?
The Trump administration is eyeing ways to incorporate tech into Medicaid.
There’s an app for that, at least according to CMS Administrator Oz, who told CBS News over the weekend that people can eventually track their work requirements for Medicaid. It is notoriously hard to incorporate technology into federal and state Medicaid programs due to a whole host of regulatory hurdles, but that isn’t stopping the Trump administration from going full steam ahead with its attempt. The Coalition for Health AI (CHAI) is also convening a “tiger team” to develop best practices for AI use, with hopes to finalize a best practices framework within the year. We’d love to hear what you think of this integration idea. Email us at 80million@manatt.com.
HHS’ PRWORA Notice – What it Means for Community Health Centers
On July 14, the Trump administration announced broad policy changes that will significantly restrict immigrant access to a variety of federal programs (including federal health, nutrition, and education programs), reversing settled policy that had been in place for over 25 years. In particular, several federal agencies, including the Department of Health and Human Services (HHS), issued notices expanding the types of federal programs under their purview that will be considered “federal public benefits,” which are subject to eligibility restrictions based on immigration status pursuant to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA).
As a result of HHS’ policy reversal, which went into effect the day it was issued, PRWORA’s immigrant eligibility restrictions now apply to more than a dozen additional programs, including mental health and substance use disorder programs administered by the Substance Abuse and Mental Health Services Administration, Title X family planning services, Head Start programs, and the Community Health Center Program.
HHS’ extension of “federal public benefit” status to the health center program arguably conflicts with the community-wide nature of the program (as outlined in statute), and we expect this issue to make its way through the courts in the coming months.
For the time being, because community health centers are non-profit entities, they will generally not be required under PRWORA to conduct immigration-status checks for their patients, although we expect the administration to attempt to revisit this policy in the near future.
Keep reading at The 80 Million.
ICYMI: The Rural Health Transformation Fund: What States and Providers Need to Know (and Do) Now.
To offset deep cuts to federal Medicaid funding in H.R.1., Congress made a late addition to the final budget reconciliation legislation: a $50 billion Rural Health Transformation Fund to be distributed to states during fiscal years 2026-2030.
Half of the rural transformation funds will be distributed equally among all states with approved transformation plans; the Centers for Medicare and Medicaid Services (CMS) has discretion over both plan approvals and how to distribute the second half of the funding.
Even if every penny of the $50 billion, which states must spend in full by Oct. 1, 2032, were directed to rural hospitals, it would not be enough to fill the $70 billion funding gap created by H.R.1. Further, there are no guarantees that all those dollars will go to rural providers, much less rural hospitals.
Forthcoming CMS guidance and its approach to allocating federal funds to states are crucial to states and their rural providers. States are working quickly to secure their share of the $50 billion and to develop plans to use the funds as strategically as possible to mitigate the impact of H.R.1 on rural communities.
Keep reading at The 80 Million.
Alaska is seeking to gather information from stakeholders to inform its strategic approach to the Rural Health Transformation Program.
CMS released a State Health Official letter regarding the streamlining of Medicaid enterprise systems to comply with regulatory requirements.
Louisiana’s health department announced an increase in Medicaid reimbursement rates for physicians via state legislature-authorized funding.
Mississippi Gov. Tate Reeves is also seeking public input to develop a Rural Health Transformation Plan and submit an application for the grant funding.
New York Gov. Kathy Hochul anticipates that federal guidance will disrupt health coverage for more than 750,000 children across the state.
The Oregon Department of Health’s Office of Aging and People with Disabilities has begun implementing recommendations from an external assessment of its unit that oversees nursing, assisted living and residential care facilities, and adult foster homes.
New Medicaid Federal Work Requirements Mean Less Leeway for States – KFF Health News
Even in states that fought the ACA, Trump's new law poses health consequences – CBS News
Work Requirements and Red Tape Ahead for Millions on Medicaid – WABE
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