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AI Navigator Launched to Support Medicaid and SNAP Members Amid Policy Shifts
12/22/2025
Hannah Musick
Social health platform Pyx Health has launched an AI-driven navigator aimed at helping US Medicaid and Supplemental Nutrition Assistance Program (SNAP) beneficiaries comply with new policy requirements under the One Big Beautiful Bill Act...
Social health platform Pyx Health has launched an AI-driven navigator aimed at helping US Medicaid and Supplemental Nutrition Assistance Program (SNAP) beneficiaries comply with new policy requirements under the One Big Beautiful Bill Act...
Social health platform Pyx...
12/22/2025
First Report Managed Care
News
CMS Unveils LEAD Model to Succeed ACO REACH in 2027
12/19/2025
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) is set to replace the Accountable Care Organization (ACO) REACH model with its longest-ever accountable care demonstration, a 10-year Long-Term Enhanced ACO Design (LEAD) model aimed at...
The Centers for Medicare & Medicaid Services (CMS) is set to replace the Accountable Care Organization (ACO) REACH model with its longest-ever accountable care demonstration, a 10-year Long-Term Enhanced ACO Design (LEAD) model aimed at...
The Centers for Medicare &...
12/19/2025
First Report Managed Care
News
A New Era for Medicaid: CMS Unveils the Blueprint for Engagement, Integrity, and Sustainability
12/09/2025
Danielle Sposato
The Centers for Medicare & Medicaid Services (CMS) released new guidance detailing how states should implement major Medicaid reforms included in the Working Families Tax Cut (WFTC) legislation (Public Law 119-21). These reforms mark some of...
The Centers for Medicare & Medicaid Services (CMS) released new guidance detailing how states should implement major Medicaid reforms included in the Working Families Tax Cut (WFTC) legislation (Public Law 119-21). These reforms mark some of...
The Centers for Medicare &...
12/09/2025
First Report Managed Care
News
CMS Issues New Guidance to Tighten Oversight of Medicaid Financing
11/18/2025
Juliet Gallagher
The Centers for Medicare & Medicaid Services (CMS) released preliminary guidance to states on implementing new federal limits on Medicaid health care-related taxes and closing financing loopholes. The guidance, stemming from the Working...
The Centers for Medicare & Medicaid Services (CMS) released preliminary guidance to states on implementing new federal limits on Medicaid health care-related taxes and closing financing loopholes. The guidance, stemming from the Working...
The Centers for Medicare &...
11/18/2025
First Report Managed Care
News
CMS Announces 2026 Medicare Premiums and Deductibles: Moderate Increases Across Parts A, B, and D
11/17/2025
Juliet Gallagher
On November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) announced the 2026 Medicare Parts A and B premiums, deductibles, and coinsurance rates, along with the updated income-related monthly adjustment amounts for Part D. The...
On November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) announced the 2026 Medicare Parts A and B premiums, deductibles, and coinsurance rates, along with the updated income-related monthly adjustment amounts for Part D. The...
On November 14, 2025, the...
11/17/2025
First Report Managed Care
News
Medicaid Unwinding Led to Millions Losing Coverage but Modest Increases in Uninsurance, Study Finds
10/31/2025
Grace Taylor, MS, MA
A new analysis shows that the end of Medicaid’s pandemic-era protections triggered massive disenrollments but only modest rises in uninsurance, revealing sharp differences across states and demographic groups.
A new analysis shows that the end of Medicaid’s pandemic-era protections triggered massive disenrollments but only modest rises in uninsurance, revealing sharp differences across states and demographic groups.
A new analysis shows that the...
10/31/2025
First Report Managed Care
News
Medicaid Work Requirements Under HR 1 Could Affect 5 Million Adults, Many With Chronic Illnesses
10/28/2025
Grace Taylor, MS, MA
A national study found that many adults who could lose Medicaid coverage under HR 1’s work requirements are managing multiple chronic illnesses, highlighting potential risks for patients and payers alike.
A national study found that many adults who could lose Medicaid coverage under HR 1’s work requirements are managing multiple chronic illnesses, highlighting potential risks for patients and payers alike.
A national study found that many...
10/28/2025
First Report Managed Care
News
OIG Report Reveals Limited Behavioral Health Networks and “Ghost” Providers in Managed Care Plans
10/27/2025
Grace Taylor, MS, MA
A US Department of Health and Human Services Office of Inspector General (OIG) review warns that many Medicare Advantage and Medicaid managed care plans overstate behavioral health access by listing clinicians who are inactive or unwilling to...
A US Department of Health and Human Services Office of Inspector General (OIG) review warns that many Medicare Advantage and Medicaid managed care plans overstate behavioral health access by listing clinicians who are inactive or unwilling to...
A US Department of Health and...
10/27/2025
First Report Managed Care
News
CMS Issues Updated Guidance on Medicaid Managed Care Payments for Emergency Services to Noncitizens
10/16/2025
Grace Taylor, MS, MA
The Centers for Medicare and Medicaid Services (CMS) has reinterpreted Section 1903(v) of the Social Security Act to restrict federal Medicaid funding for noncitizens’ emergency care to only services actually rendered, ending managed care...
The Centers for Medicare and Medicaid Services (CMS) has reinterpreted Section 1903(v) of the Social Security Act to restrict federal Medicaid funding for noncitizens’ emergency care to only services actually rendered, ending managed care...
The Centers for Medicare and...
10/16/2025
First Report Managed Care
News
CMS Issues Preliminary Guidance on Medicaid State Directed Payments Ahead of Final Rule
09/15/2025
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) has released preliminary guidance to states on new payment limits for Medicaid State Directed Payments, giving payers and managed care programs an early look at significant changes taking...
The Centers for Medicare & Medicaid Services (CMS) has released preliminary guidance to states on new payment limits for Medicaid State Directed Payments, giving payers and managed care programs an early look at significant changes taking...
The Centers for Medicare &...
09/15/2025
First Report Managed Care
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