Federal Register Final Rule: Streamlining Medicaid; Medicare Savings Program Eligibility Determination and Enrollment
Policy FR-2023-20382 • Medicaid
HighThe new rule streamlines the enrollment and eligibility processes for the Medicare Savings Programs, potentially increasing enrollment among eligible individuals and enhancing reimbursement effectiven
Federal Register Proposed Rule: Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole Proposed Rule
Policy FR-2025-08566 • Medicaid
RoutineThe proposed rule aims to close a loophole in Medicaid funding which has allowed higher tax rates on Medicaid taxable units than on non-Medicaid units. This change is expected to strengthen the redist
Federal Register Final Rule: Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole
Policy FR-2026-02040 • Medicaid
HighThe new rule aims to preserve Medicaid funding by closing a loophole that allowed for unequal taxation on Medicaid versus non-Medicaid units. This regulatory change could impact reimbursement rates, p
Federal Register Final Rule: Medicaid Program; Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program
Policy FR-2024-21254 • Medicaid
HighThe new rule under the Medicaid Drug Rebate Program will significantly impact billing and reimbursement processes by ensuring stricter compliance with drug classification and pricing integrity. This m
Federal Register Final Rule: Medicaid Program; Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality
Policy FR-2024-08085 • Medicaid
HighThe new Medicaid and CHIP managed care rule aims to enhance access to care and improve health equity, which will likely streamline billing processes and reimbursement timelines. With the introduction
Federal Register Final Rule: Medicaid Program; Streamlining the Medicaid, Children's Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes
Policy FR-2024-06566 • Medicaid
HighThe new Medicaid rule streamlines application and eligibility processes, enhancing efficiency in billing and reimbursement for providers. It ensures timely redeterminations and reduces barriers, poten
Federal Register Proposed Rule: Medicaid Program; Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program
Policy FR-2023-10934 • Medicaid
RoutineThe proposed rule aims to strengthen the Medicaid Drug Rebate Program by addressing drug misclassification and pricing data inaccuracies, which could lead to improved reimbursement accuracy and progra
Federal Register Proposed Rule: Medicaid Program; Ensuring Access to Medicaid Services
Policy FR-2023-08959 • Medicaid
RoutineThe proposed Medicaid rule aims to enhance access to care and improve health outcomes through increased transparency and standardized monitoring. This could lead to significant changes in billing prac
Medicare and Medicaid Programs; Organ Procurement Organizations Conditions for Coverage: Revisions to the Conditions for Coverage
Policy 2026-01833 • Medicaid
HighThis proposed rule would revise the Conditions for Coverage for Organ Procurement Organizations (OPOs) to clarify outstanding procedural questions and enable OP
Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole
Policy 2026-02040 • Medicaid
HighThis final rule addresses a loophole in a regulatory statistical test applied to State proposals for Medicaid tax waivers. The test is designed to ensure, as re
2025 National Health Care Fraud Takedown Media MaterialsJune 30, 2025
Policy 2025-NATIONAL-HEALTH-CARE-FRAUD-TAKEDOWN-MEDIA-MATERIALSJUNE • Medicaid
Routine2025 National Health Care Fraud Takedown Media MaterialsJune 30, 2025
Medicaid Fraud Control Units Annual Report: Fiscal Year 2024 VideosJune 25, 2025
Policy MEDICAID-FRAUD-CONTROL-UNITS-ANNUAL-REPORT-FISCAL-YEAR-2024 • Medicaid
RoutineMedicaid Fraud Control Units Annual Report: Fiscal Year 2024 VideosJune 25, 2025
Acting Inspector General Juliet T. Hodgkins Remarks on the 2025 National Health Care Fraud Takedown VideosJune 30, 2025
Policy ACTING-INSPECTOR-GENERAL-JULIET-T-HODGKINS-REMARKS-ON-THE-2 • Medicaid
RoutineActing Inspector General Juliet T. Hodgkins Remarks on the 2025 National Health Care Fraud Takedown VideosJune 30, 2025
Combating Durable Medical Equipment Fraud VideosNovember 25, 2025
Policy COMBATING-DURABLE-MEDICAL-EQUIPMENT-FRAUD-VIDEOSNOVEMBER-25 • Medicaid
RoutineCombating Durable Medical Equipment Fraud VideosNovember 25, 2025