Intelligence archive

Third Circuit rules drugmakers' 340B contract pharmacy limits are legal

The Third Circuit unanimously ruled in January 2026 that drugmakers' limits on 340B contract pharmacies are lawful and that HRSA's policy barring them is unlawful, Bass Berry & Sims noted. Eighteen manufacturers now restrict contract pharmacy access.

San Joaquin County projects a $76.9 million hit from H.R. 1

San Joaquin County projects a $76.9 million budget impact from H.R. 1, the Lodi News-Sentinel reported in March 2026. County clinics could lose up to $9 million, and 314,058 residents, 39% of the county, rely on Medi-Cal.

Clinica Sierra Vista buys its first owned headquarters in Bakersfield

Clinica Sierra Vista, one of California's largest health centers, bought a 99,368-square-foot building from Chevron at 9525 Camino Media in Bakersfield for $15.7 million, effective April 1, 2026.

Proposed $1 billion Medi-Cal dental cut could push 49% of dentists out

Governor Newsom's proposed $1 billion Medi-Cal Dental cut would have lowered rates 40% to 80% from July 1, 2026, and a coalition of 70+ groups fought it. Of Medi-Cal dentists, 49% said they would leave the program and 30% would see fewer Medi-Cal patients.

Health Net commits $1 million to prepare Medi-Cal members for work rules

Health Net launched a $1 million Get Informed, Stay Covered campaign in April 2026 to prepare its 4.7 million Medi-Cal members for work requirements starting January 2027. California will check eligibility every six months.

HHS cuts minority health offices that offer free CLAS training

HHS restructured its Office of Minority Health and the CMS Office of Minority Health, eliminating about 40 CMS staff, as Healthcare Dive reported in April 2026. OMH runs Think Cultural Health and the free CLAS Standards training health centers use for staff.

HRSA may widen its 340B rebate model to all negotiated drugs

After a Maine federal court vacated the first 340B rebate pilot, HRSA opened a 60-day comment window that closed April 20, 2026. HRSA signaled it may apply rebates to all drugs picked for Medicare price negotiation through 2027.

Nebraska becomes the first state to enforce Medicaid work requirements

Nebraska will enforce an 80-hour monthly Medicaid work requirement starting May 1, 2026, eight months before the federal January 2027 date, KFF reported. KFF estimates work requirements will leave 5.3 million people newly uninsured nationally.

Ninth Circuit lets False Claims Act suits over 340B overcharges proceed

The Ninth Circuit unanimously revived United States ex rel.

CMS opens $100m maha elevate lifestyle medicine model, and FQHCs are eligible

CMS Innovation Center is funding up to 30 cooperative agreements (~$3.3M each over 3 years) for whole-person lifestyle medicine in Original Medicare, and FQHCs are eligible.

Corrected Sep 28, 2026: CMS says MAHA ELEVATE award notices go out in fall 2026 and the first cohort launches in October 2026, not September.

Fresno County warns H.R. 1 could open a $69-$295 million deficit

Fresno County projects a $69 million to $295 million budget deficit from H.R. 1, as Fresnoland reported in March 2026. Public Health Director Joe Prado estimates 11,000 to 30,000 residents will need county indigent care, costing $41 million to $241 million.

Counties need 2,400+ eligibility workers for H.R. 1, with none funded

The Legislative Analyst's Office reported in March 2026 that counties estimate they need 2,000+ more Medi-Cal eligibility workers and 400+ CalFresh workers to carry out H.R. 1, and the Governor's proposed budget funds none.

AB 2161 would keep work rules off state-funded Medi-Cal

Assemblymember Mia Bonta introduced AB 2161 in March 2026 to bar California from applying federal work requirements to people whose Medi-Cal is fully state-funded, including undocumented immigrants, CalMatters reported.

NACHC estimates $7 billion a year in new health center costs

NACHC estimated in March 2026 that the reconciliation law will add $7 billion a year in uncompensated care and other costs for health centers.

2023 Kaufman Hall analysis put 1 in 5 California hospitals at risk

An April 2023 Kaufman Hall analysis, which the California Hospital Association still cites as its baseline, found 1 in 5 California hospitals at risk of closure, and nearly half of rural hospitals lose money.

NACHC wants patients to meet work rules by volunteering at health centers

NACHC's March 2026 guidance on Medicaid work requirements, 80 hours a month starting December 31, 2026, urges states to let patients volunteer at health centers to meet them. CBO estimates 10.9 million people will lose coverage.

UCI Health lays off 150 and closes pediatric units at Fountain Valley

UCI Health laid off 150 workers and closed the pediatrics department and pediatric ICU at Fountain Valley Regional Hospital on March 23, 2026, moving patients mid-care, NBC Los Angeles reported.

CCALAC holds its first workforce summit June 17, 2026 in Los Angeles

The Community Clinic Association of Los Angeles County, whose members serve 2.02 million patients at 450+ sites, announced in March 2026 its first workforce summit on June 17 in Los Angeles.

CalOptima and IEHP each project losing 650,000 members by 2028

CalOptima in Orange County forecasts losing 650,000 of its 2.2 million members by 2028, and IEHP in the Inland Empire projects a similar 650,000 loss from 2.5 million, IE Voice reported in March 2026. Together, 1.3 million members could lose coverage.

Fresno County faces a $241 million gap in uncovered health costs

Fresno County faces an estimated $241 million in uncovered health costs as residents lose Medi-Cal, GV Wire reported in March 2026.

H.R. 1 caps Medi-Cal directed payments, pushing rates toward Medicare by 2028

H.R. 1 caps state-directed payments, ending California's ability to have managed care plans pay providers at commercial rates, a CHCF analysis explained in March 2026. Provider rates will move toward Medicare levels starting in 2028.

DHCS filed its H.R. 1 implementation plan with the California Senate

DHCS filed its H.R. 1 plan with the Senate Budget Committee in February 2026, proposing asset tests and enrollment freeze in January 2026, six-month renewals in December 2026, work requirements in January 2027 and copays in October 2028.

St. John's saw a week of canceled visits during June 2025 raids

CalMatters reported on June 14, 2025 that St. John's Community Health's CEO estimated about a third of medical and half of dental appointments across its 28 sites were canceled that week as immigration raids intensified.

CHCF looks at how AI can safely widen language access

The California Health Care Foundation published a brief in March 2026 on how AI interpretation and translation tools could cut language service costs and widen access for patients with limited English.

HRSA moves health center grants to four-year periods, awarding $828 million

HRSA is moving health center grantees from three-year to four-year performance periods starting in FY2026, with 192 non-competitive awards totaling about $828 million, according to a Federal Register notice.

OCHIN brief finds many California health centers unprepared for Medicare patients

An OCHIN brief with CHCF in March 2026 found many California health centers lack the billing, credentialing and clinical workflows Medicare patients need. As Medi-Cal patients age into Medicare, those gaps put revenue at risk.

Federal court vacates HRSA's 340B rebate pilot

In AHA v. Kennedy, the federal court in Maine vacated HRSA's 340B Rebate Model Pilot in February 2026, calling the agency's record threadbare and faulting it for ignoring the cost of paying full price and waiting for rebates.

Part 2 violations now carry HIPAA-level penalties

In February 2026, HHS's Office for Civil Rights began enforcing confidentiality rules for substance use treatment records under 42 CFR Part 2, with HIPAA penalty tiers. Violations can bring settlements, corrective plans or civil money penalties.

UC Berkeley says Medicaid cuts could cost California up to 217,000 jobs

The UC Berkeley Labor Center estimated in March 2026 that federal Medicaid cuts could eliminate up to 217,000 California jobs, about 145,000 of them in health care.

Court strikes HRSA's 340B child site registration rule

A federal district court vacated HRSA's rule that off-site locations must be on a hospital's Medicare cost report and registered in OPAIS before buying 340B drugs, Forvis Mazars noted in March 2026. That restores pandemic-era flexibility.

CalOptima membership falls to about 877,000 as Medi-Cal rules tighten

CalOptima, Orange County's Medi-Cal plan, has fallen from nearly 1 million members in 2024 to about 877,000, with about 27,000 leaving in a recent two-month span, NBC Los Angeles reported in March 2026. Some cite immigration fears.

AltaMed earns Great Place to Work certification with 85% staff approval

AltaMed Health Services, the nation's largest health center, earned Great Place to Work certification in March 2026, with 85% of its 5,700+ employees calling it a great place to work, 28 points above the 57% national average.

HRSA widens its FY2026 340B audit language with the word furnished

HRSA's FY2026 340B audit Data Request List adds furnished to administered or dispensed, widening how covered entities must document drug transactions, CPS noted in March 2026.

NACHC Select partners with Pointcare to help patients keep Medicaid

NACHC Select, NACHC's subsidiary, announced a partnership with Pointcare in March 2026. Pointcare already serves 80+ health centers managing coverage for 1.8 million patients, flagging those at risk of losing Medicaid and automating re-enrollment.

California hospitals have laid off 3,400+ workers since mid-March

California hospitals have laid off more than 3,400 health care workers since mid-March 2026, 1,600 of them from Santa Barbara to Orange County and the Inland Empire, the Orange County Register reported. Executives warn of a second wave as H.R. 1 phases in.

Dan Walters calls Medi-Cal a $200 billion funding emergency

In a March 2026 CalMatters commentary, Dan Walters called Medi-Cal a $200 billion-plus a year funding emergency, as Governor Newsom pulls back immigrant coverage after wrongly projecting a surplus.

Neighborhood Healthcare secures $7.8 million for a new Lakeside facility

Neighborhood Healthcare, a San Diego County health center, secured funding in March 2026 for a $7.8 million facility in Lakeside, saying community need has outgrown its capacity, the San Diego Business Journal reported.

San Ysidro Health plans three new centers in 2026

San Ysidro Health planned three new centers in 2026: Julian Family Medicine in March, the Joe & Vi Jacobs Center in the fall and Chula Vista Specialty Care in winter, the San Diego Business Journal reported.

CHCF says federal Medicaid cuts would devastate rural Northern California health systems

A CHCF analysis in March 2026 found that at Shasta Community Health Center, 82% of visits are Medi-Cal, bringing 60% of revenue. Hill Country's CEO said a 30% revenue loss would mean a 30% cut in staff and services.

STAT News analysis says health centers face structural insolvency

A STAT News analysis in March 2026 found health center net margins fell from 5.3% in 2020-2022 to negative 2.1% in 2024, and the program posted a 2% loss in 2025. Federal grants stayed flat from 2019 to 2023 while costs rose 25% or more.