Nevada has become the third state to launch a public health insurance option, after Washington and Colorado, with the rollout of the Battle Born State Plans (BBSPs) administered by three of the state’s Medicaid managed care plans. BBSPs were designed as a public option to improve access and affordability, according to the Final Nevada 1332 Waiver…

New legislation in California, signed on October 6, 2025, directs health plans and health insurers to phase out prior authorization for health care services with approval rates of 90% or higher by January 1, 2028. The legislation is supported by the California Medical Association (CMA). The goal is to reduce the administrative burden on health…

Centauri Health Solutions (Centauri), a Phoenix, Arizona-based health information technology company, announced the launch of Member Insights—a comprehensive, member-centric solution designed to address the financial, social, and clinical needs of dual-eligible Medicare Advantage members who are enrolled in both Medicare and Medicaid. Member Insights combines personalized outreach with Centauri’s proprietary technology to improve care coordination,…

Pear Suite, a digital health company empowering community health workers (CHWs), announced that it has raised $7.6 million in Series A funding to advance the development of its artificial intelligence (AI)-powered platform, fuel its provider organization network growth, and expand its impact through new Medicaid and Medicare health plan contracts. Pear Suite helps health plans…

Epicured Inc., a “food-is-medicine” organization dedicated to combating and preventing chronic disease, announced a partnership with Fallon Health, which offers the Program of All-Inclusive Care for the Elderly (PACE)—a comprehensive, community-based model of care that helps older adults remain independent and in their homes for as long as possible. Together, they provide Medically Tailored Meals…

The Delaware Division of Substance Abuse and Mental Health (DSAMH), in partnership with Bamboo Health, announced the rollout of the Delaware Treatment and Referral Network 360 (DTRN360) behavioral health care coordination platform, which is designed to connect provider organizations, improve care transitions, and reduce silos across the behavioral health system. DTRN360 is the result of…

The Centers for Medicare & Medicaid Services (CMS) issued guidance explaining its updated interpretation of when states can claim federal financial participation (FFP), or matching funds, for emergency Medicaid-covered services provided to immigrants who are ineligible for full benefits. Under its new interpretation of section 1903(v) of the Social Security Act, CMS stated its intention…

Cambia Health Solutions (Cambia) and Blue Cross Blue Shield of North Dakota (BCBSND) announced a strategic affiliation, making BCBSND the newest single-state Blue plan to affiliate with Cambia. The affiliation will unify operations and enable the organizations to share best practices for local plan innovation and services, deliver personalized member experiences, and leverage Cambia’s robust…

On September 9, 2025, the Centers for Medicare & Medicaid Services (CMS) issued preliminary guidance to states on implementing new federal payment limits for state-directed payments (SDPs) in Medicaid managed care. SDPs enable states to direct Medicaid managed care organizations (MCOs) and other managed care entities to pay higher reimbursement rates to some provider organization…