West Virginia to Implement More Frequent Medicaid Provider Validation
West Virginia Governor Patrick Morrisey announced that the state will more frequently revalidate Medicaid providers, following the Trump administration’s efforts to reduce potential fraud, waste, and abuse. Starting June 1, 2026, West Virginia Medicaid providers will transition to a two-year revalidation cycle, prioritizing providers that have not had a review in the last year. The Medicaid agency will also identify high-risk providers based on trends identified in the state’s data (WVVA, May 6).
Elevance Expands Into Wisconsin Medicaid Long-Term Care Program
Elevance Health’s Anthem Blue Cross Blue Shield subsidiary has entered Wisconsin’s Medicaid long-term care market after receiving a contract to participate in the state’s Family Care program, with coverage that includes the Milwaukee area. The move adds a new insurer to a program that serves older adults and people with disabilities needing long-term services and support. Wisconsin’s Family Care model has historically been difficult for insurers financially, as participating plans have faced ongoing profitability challenges. The contract follows a recent state procurement process in a market previously led by Humana’s Inclusa and Molina’s My Choice Wisconsin (Health Payer Specialist, May 11).
Oklahoma Pushes November Medicaid Expansion Ballot Measure
Oklahoma lawmakers are pursuing a single state question for the November ballot that combines two previously separate Medicaid proposals after earlier efforts to advance separate measures stalled. The revised House Joint Resolution 1067 would ask voters to remove Medicaid expansion from the Oklahoma Constitution while also allowing the Legislature to reconsider or end expansion coverage if the federal funding match falls below 90%. If approved, the measure would give lawmakers greater authority over a program of voters adopted in 2020 that now covers more than 200,000 low-income adults. Supporters say the proposal is aimed at addressing long-term state budget concerns and preserving flexibility if federal funding changes. Revised language added following negotiations with tribal leaders would also maintain certain fully federally funded healthcare services, including coverage tied to Indigenous populations. Tribal leaders, including Cherokee Nation Principal Chief Chuck Hoskin Jr., have supported preserving Medicaid expansion, while legal questions remain over whether combining multiple policy changes into one state question could face challenges under Oklahoma’s constitutional single-subject rule (Oklahoma Voice, May 6).
Utah’s Medicaid Program for Homeless and Justice-Involved Adults in Danger of Sunsetting
Currently, Utah’s Targeted Adult Medicaid (TAM) program, which is authorized under the state’s 1115 federal waiver program, is set to expire on June 30, 2027. Since 2017, the program has provided 12 months of continuous coverage to adults without dependent children, who earn up to 5% of the federal poverty level (FPL), and are chronically homeless, are justice-involved, or in need of mental health or substance abuse treatment. The state has indicated it will eliminate the TAM program unless CMS approves 6 months of continuous coverage for the program. Advocates and service providers urge state officials to continue TAM coverage, citing how vital the program is to the stability of justice-involved individuals. The Utah Chiefs of Police Association and the Sheriffs’ Association are also aligned in the pursuit of continued coverage, noting how the program is an effective and practical tool for this population, and is associated with a 61% reduction in recidivism. If the waiver demonstration is not renewed, the approximately 6,500 adults currently served by TAM will transition to the expansion population program on July 1, 2027. The state’s public comment period is open until May 21, 2026 (Utah News Dispatch, May 11).
