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The Affordable Care Act gave states federal dollars to raise Medicaid reimbursement rates for primary care services—but only temporarily. The federal spigot ran dry on Jan. 1. Fearing that lowering the rates would exacerbate the shortage of primary care doctors willing to accept patients on Medicaid, ... 15 states are dipping into their own coffers to continue to pay the doctors more. It seems to be working. (Ollove, 4/17)

Gov. Terry Branstad's plan to privatize the state's Medicaid program is moving forward, though critics are raising questions about how the shift will impact patients. Earlier this year, the state began an effort to shift Medicaid administration to two or more managed care organizations, to which Iowa will pay a fixed amount per enrollee to provide health coverage. State officials predict cost savings and say patients will still have access to quality health care. But Democratic Senate President Pam Jochum, of Dubuque, said this week that she is not convinced. (Lucey, 4/19)

Iowans with serious disabilities have the most to lose — or gain — as the state moves swiftly to have national insurance companies run its giant Medicaid program. Tens of thousands of people with serious disabilities, including cerebral palsy, brain injuries and Down syndrome, rely on the public health insurance program, even if they also have private insurance coverage. That's because private insurance usually doesn't cover the wide array of services needed to keep them at home. (Leys, 4/19)

Rocky Nichols, executive director of the Disability Rights Center of Kansas, warns Iowans that they should watch closely as their state hires managed-care companies to run their Medicaid program. Kansas has made the same shift over the past two years, and it has not gone well, he said. "Kansas is not just on the leading edge — it's on the bleeding edge when it comes to Medicaid managed care," Nichols said. (Leys, 4/18)

Florida Medicaid, which has been touting its "Managed Medical Assistance" program as a national model, may want to hold off. The program, which shifts virtually all Medicaid recipients into managed-care plans, underestimated how much their care would cost. (Gentry, 4/17)

New York's comptroller has approved the state award of a $565 million contract to Xerox to redesign and operate the information management system for its Medicaid program. The comptroller's office says its review found insufficient grounds in the protests by Computer Sciences Corp. and Hewlett-Packard to overturn the award. (4/17)