In February, CMS deferred $259.5 million in federal Medicaid payments to Minnesota. By July, the same approach had reached California. We look at how CMS is using payment deferrals and data analytics ...

This request for information (RFI) solicits stakeholder feedback on potential regulatory changes that might be included in a potential upcoming CRUSH proposed rule, as well as other programmatic chang...

This brief describes recent HHS actions (state-specific and nationwide) related to Medicaid program integrity and outlines some open questions about the future of Medicaid program integrity, including...

More than a year after the passage of HR 1, the conversation about its impact on home and community-based services has shifted. The question is no longer what the law says, but how states will choose ...

We've covered what the community engagement requirements are and who's exempt from them. Now the question becomes practical: how does a person actually prove it? States must verify status at applicati...

The bottom line: Not all exemptions from the Medicaid work requirements work the same way. Whether someone is fully excluded from the requirement or simply has an exception to it determines whether t...

The paradox this creates is real. A person may be considered disabled enough that their caregiver qualifies for an exclusion, while that same person cannot qualify for an exclusion themselves.

On June 3, CMS released an interim final rule implementing Medicaid work requirements under HR 1 — and if you're enrolled in Medicaid Expansion, or through certain 1115 waivers in Georgia, Tennessee, ...

What started as a corrective action request to one state has rapidly evolved into a nationwide Medicaid enforcement campaign. In just five months, CMS has expanded from targeting Minnesota to pressuri...

Disability advocacy organizations often have more potential influence than they realize. The challenge is knowing how to deploy it strategically. Here is the framework we use to help organizations mov...

HR 1's new Medicaid community engagement requirements take effect January 1, and CMS must release an interim final rule by June 1. One key question still unanswered: how will education count toward th...

women in government relations

If you’re only lobbying Congress, you’re missing where policy is actually shaped. Inside the executive branch, influence happens quietly—and earlier than most think.

The U.S. is undergoing the deepest remaking of health care in generations. The Trump administration and its signature Make America Healthy Again movement have quickly influenced policy emanating from ...

New Medicaid work requirements introduce critical questions around exemptions for medically frail individuals. With updated statutory language and pending federal guidance, the application of lookback...

What determines whether a policy idea actually moves? It’s not just the idea — it’s whether policy, politics, and process align.