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Kansas Democratic Gov. Laura Kelly on Thursday offered a Medicaid expansion plan that would ask hospitals to provide funding and includes a work requirement — long a must-have item for many Republicans to support expansion. (Shorman and Ritter, 12/14)

Two lawmakers are bringing back a resolution that would have South Dakotans vote on a “clarification” to Medicaid expansion that passed in 2022. The resolution, introduced by Rep. Tony Venhuizen, R-Sioux Falls, and Sen. Casey Crabtree, R-Madison, would allow voters to decide on the 2024 ballot if the state should consider work requirements for those enrolled in Medicaid. A similar resolution was introduced during the 2023 session by Venhuizen but failed in a Senate committee because the language had been too broad, Venhuizen said. (Todd, 12/15)

Nearly 1.7 million Texans have lost their health insurance — the largest number of people any state has removed — in the months since Texas began peeling people from Medicaid as part of the post-pandemic “unwinding.” Around 65% of these removals occurred because of procedural reasons, according to the state. (Bohra, 12/14)

It was “the elephant in the room” that almost nobody wanted to talk about. Instead of accepting the $4 billion to $5 billion in federal money that would come with Medicaid expansion in Florida, Republican leaders are pursuing a plan to spend nearly $900 million in state taxpayer and federal trust fund dollars to make medical care more accessible by increasing the health care workforce, building clinics and other means. (Schweers, 12/15)

A federal budget watchdog raised concerns that the Medicaid agency lacks sufficient guardrails to ensure states’ spending on supplemental payments to providers is appropriate. A report released Thursday by the Government Accountability Office notes the federal approval process lacks sufficient oversight of state-directed payments, which are compensation arrangements where states allocate additional payments to medical providers via a managed care plan in order to meet state-wide health objectives. (Belloni, 12/14)

Senior physicians may avoid seeing racial minorities and lower paying Medicaid-insured patients compared to junior physicians in the same practice, according to a new study led by Harvard T.H. Chan School of Public Health. “It’s a widely known ‘secret’ that in some practices, the older doctors push patients with lower-paying insurance, and by extension patients of minority races to the more junior doctors in their clinic. But this is rarely discussed openly,” said lead author Michael Barnett, associate professor of health policy and management. “Our study finds evidence to back up this hidden practice, which raises concerns of a two-tiered system by physician seniority that promotes racial and economic segregation.” (12/13)

A mental health therapist in the District has been charged with stealing more than $263,000 from the city’s Medicaid program through fraudulent claims, the U.S. attorney’s office said. Bridgette White-Chase, 61, was indicted by a grand jury Wednesday for 20 alleged crimes related to Medicaid claims, including felony fraud and first-degree theft, according to documents filed in D.C. Superior Court. The documents say White-Chase operated Chase Counseling and Consulting Services and was licensed by D.C. Health to provide professional counseling services. (Alexander, 12/14)

Medicare officials are urging health plans and other payers not to put pharmacies in a cash squeeze when a new policy kicks in that may reduce how much they're paid upfront for dispensing drugs. The Centers for Medicare and Medicaid Services wrote to pharmacy benefit managers and insurers Thursday suggesting they make special payment arrangements with pharmacies before the policy takes effect on Jan. 1. (Goldman, 12/15)

Federal authorities have stepped up oversight of the health insurance exchange marketplaces since President Joe Biden took office. The Centers for Medicare and Medicaid Services, for example, has enforced rules governing marketing practices and the names of insurance policies as more people enroll and more insurers join the market. (Tepper, 12/14)