The Local Health Care Protection Act of 2026 allows certain hospitals to continue participating in the federal drug discount program, known as Section 340B, even if they no longer meet specific financial thresholds related to serving low-income patients. This provision applies to hospitals that were already eligible for the program on July 3, 2025, and protects their access to discounted medications through cost reporting periods ending by September 30, 2030. The bill directly affects rural and underserved hospitals that may lose eligibility due to changes in Medicaid funding or Medicare payment formulas. Additionally, it requires the Government Accountability Office to conduct a study within one year on how these financial criteria are calculated and how declining payments impact essential health services in rural areas.
To amend sections 3701.021, 3701.023, 3701.025, 3701.027, and 3701.029 and to repeal section 3701.024 of the Revised Code to eliminate county contributions to the Program for Medically Handicapped Children and to make an appropriation.
Establishes a Medicaid fraud tip board which shall develop and administer a system offering monetary rewards to certain individuals reporting Medicaid fraud; creates a Medicaid fraud tip reward fund.
Relates to the handling of tips received through the office of the Medicaid inspector general's Medicaid fraud hotline; provides that the office of the Medicaid inspector general's Medicaid fraud hotline shall be the official Medicaid fraud hotline of the state of New York; directs the Medicaid inspector general to compile and provide to the governor, the temporary president of the senate, the speaker of the assembly, the minority leader of the senate, the minority leader of the assembly and the attorney general an annual report containing information on tips received through the Medicaid fraud hotline.
Michigan House Bill 6274 establishes a state basic health program to provide medical coverage for low-income residents who do not qualify for Medicaid or affordable employer-sponsored insurance. The bill targets individuals aged 65 and under with incomes between 133% and 200% of the federal poverty guidelines, as well as lawfully present noncitizens earning below 200% of that threshold. It creates a dedicated trust fund to finance the program and requires the state department to develop a program blueprint for federal certification within six months of forming a stakeholder advisory group. Key provisions include automatic enrollment for individuals transitioning from Medicaid, sliding-scale premiums based on income, and a requirement that no one earning below 133% of the poverty line pay any premiums or cost-sharing.
Michigan House Bill 6288 directs the state Department of Health and Human Services to seek federal approval for enrolling specific Medicaid-eligible individuals into managed care plans, while requiring these plans to spend at least 12% of their annual budget on primary care over an eight-year period. The bill mandates that hospitals accept Medicare rates as full payment from uninsured patients with incomes up to 250% of the federal poverty level and establishes a performance bonus system for health plans based on quality metrics such as fraud detection, substance use disorder treatment, and consumer satisfaction. Additionally, it requires contracted health plans to submit annual reports detailing their primary care spending levels and outlines provisions for telemedicine access, pharmaceutical cost controls, and the sharing of state data with qualified vendors to improve population health management.
The Community Mental Wellness Worker Training Act authorizes the Department of Health and Human Services to award grants to community behavioral health clinics, mental health centers, and hospitals to train and certify new workers in providing basic mental health screening and counseling. These trained workers would assist individuals with mild to moderate conditions, such as depression or anxiety, by delivering evidence-based interventions that are culturally and linguistically competent. The bill prioritizes funding for entities located in areas with high poverty, unemployment, substance use rates, or significant numbers of dual Medicare-Medicaid beneficiaries. Additionally, the legislation provides legal protections against malpractice suits for participating staff and requires the Secretary to submit interim and final reports to Congress on the number of workers trained and certified through the program.
The Medicaid Dental Benefit Act of 2026 requires states to cover comprehensive dental and oral health services for adult Medicaid enrollees, with the mandate taking effect in January 2028. To support this expansion, the federal government will reimburse 100% of state expenditures for these new benefits for a period of three years, effectively shifting the financial burden from state budgets to federal funds. The bill also directs the Department of Health and Human Services to establish standardized quality and equity measures for adult oral care and requires states to submit annual reports on access disparities and benefit limitations. Additionally, it authorizes funding for outreach programs designed to educate eligible adults about their new coverage and connects them with culturally competent dental providers.
The HCBS Access Act would require states to cover home and community-based services (HCBS) as a mandatory benefit under Medicaid, effectively eliminating waiting lists for individuals with disabilities and older adults who need support to live in their communities rather than institutions. To fund this expansion, the bill provides a 100% federal matching rate for these services if states meet specific requirements, such as improving workforce wages, removing access barriers, and establishing infrastructure to support self-directed care models. Additionally, the legislation creates a national technical assistance center and authorizes grants to recruit, train, and retain direct care workers, while also prohibiting states from placing liens on the assets of Medicaid recipients for medical assistance correctly paid.
The Improving CARE for Youth Act amends the Social Security Act to prevent state Medicaid plans from denying payment for mental health or primary care services provided on the same day as a qualifying service. This legislation directly affects individuals receiving Medicaid coverage, particularly those who visit outpatient facilities for both physical and mental health treatments during a single visit. By establishing that states cannot prohibit reimbursement for these concurrent services, the bill ensures that patients are not financially penalized for combining different types of care in one appointment. The measure defines "same-day qualifying services" as primary or mental health visits occurring at the same facility on the same day, regardless of whether the providers are identical.
