Intelligence archive

Texas Medicaid requires modifier U8 when an FQHC bills a contraceptive device purchased through 340B

Event: Jun 30

The July 2026 Texas Medicaid Provider Procedures Manual says an FQHC seeking reimbursement for an IUD or implantable contraceptive capsule must submit the family-planning service and device codes on the same claim.

National Study Finds About One-Third of Eligible FQHCs Lack Onsite Prenatal Care

Event: Jul 14

An observational study published July 14 in Annals of Internal Medicine analyzed 1,326 FQHCs operating in 2024 after excluding U.S. Territories and centers serving fewer than 100 adult female patients.

San Francisco Lists $76.1M Chinatown Public Health Center Renovation In Progress

At the July 19 source-review checkpoint, San Francisco Public Works listed the $76.1 million seismic retrofit and modernization of Chinatown Public Health Center as in progress.

TMHP Release 4 Is Effective August 24 for LTC, EVV and Care Forms, Confirm Access and Assigned Roles

Event: Aug 24

TMHP's current notice makes Release 4 effective August 24, 2026 for the Long-term Care Online Portal, LTC Dashboard, Electronic Visit Verification Portal, and Care Forms.

Prism Health North Texas Adds OB/GYN Capacity at Oak Cliff and South Dallas Health Centers

Event: Jun 10

Prism Health North Texas announced that board-certified OB/GYN Lori Morales is accepting new patients at its Oak Cliff and South Dallas health centers.

New Federal Data: ACA Marketplace Enrollment Fell to 19.2M, Down ~2.6M Year-Over-Year, After Enhanced Subsidies Expired; Ohio and Oklahoma Each Lost a Third of Enrollees

Event: Jul 6

Federal effectuated-enrollment data posted in late June — analyzed in an ASPE issue brief (June 26) and reported state-by-state by the Associated Press on July 6 — shows about 19.2 million people had ACA Marketplace coverage in February 2026…

CMS Issues State Medicaid Director Letter #26-003, Chief Actuary Must Certify Section 1115 Demonstrations Won't Increase Federal Spending Starting Jan. 1, 2027

Event: Jun 11

On June 11, 2026, CMS released State Medicaid Director Letter 26-003, giving states early notice of a new statutory requirement (Section 71118 of H.R. 1, the law also referred to as the Working Families Tax Cut Act) that the CMS Chief Actuary must certify…

Eli Lilly's 340B Termination Turns Into Litigation and Congressional Pushback, Tampa General Sues in Federal Court, 72 House Members Demand HHS Act

Event: Jul 10

Eli Lilly's June 1 five-day ultimatum escalated on June 18, 2026, when the manufacturer cut off 340B pricing for covered entities that refused to share in-house pharmacy claims data — Lilly directed wholesaler McKesson to end Tampa General Hospital's…

California's Budget Funds Public Hospitals and Enrollment but Zero for Indigent Care, Sonoma County Projects CMSP Caseload Could Jump From 97 to ~11,560

Event: Jul 2

California's enacted FY2026-27 budget provides $250 million for public hospitals and $420 million for benefits-enrollment staffing, but $0 for the mandated indigent-care costs counties must absorb as H.R. 1's Medicaid changes phase in.

8th Circuit Rejects Novartis's Bid to Block Missouri's 340B Contract-Pharmacy Law, Another State Shield Survives a Manufacturer Challenge

Event: Jul 1

On July 1, 2026, the 8th U.S. Circuit Court of Appeals (Novartis Pharmaceuticals Corp. V. Hanaway, No. 25-1619) affirmed the district court's denial of Novartis's preliminary-injunction bid against Missouri's S.B. 751…

CenCal CEO projects 25,000 Santa Barbara County residents could lose coverage in 2026, rising to 50,000 in 2027

The Santa Barbara Independent reported that CenCal Health CEO Marina Owen projected 25,000 Santa Barbara County residents could lose health insurance in 2026, with the projected figure rising to 50,000 in 2027.

CMS Keeps the 35% Essential Community Provider Standard in the 2027 Marketplace Final Rule

Event: Jul 8

In the 2027 Notice of Benefit and Payment Parameters final rule (published May 15, 2026; effective July 20), HHS declined to finalize its proposal to cut the Essential Community Provider contracting standard from 35% to 20% — qualified health plans must still…

CMS Proposes Medicare-Based Caps on Medicaid State-Directed Payments (CMS-2449-P), Comments Close July 21

Event: May 22

CMS's proposed rule on Medicaid managed-care state-directed payments and fee-for-service targeted Medicaid practitioner payments (CMS-2449-P, published in the Federal Register May 22, 2026; FR doc 2026-10292) implements Section 71116 of H.R. 1…

CY2027 Physician Fee Schedule Proposed Rule Lands, CMS Proposes the FQHC PPS Base Rate Rise to $212.91 (+2.5%), Comments Close September 14

CMS published the CY2027 Physician Fee Schedule proposed rule (CMS-1848-P, FR doc 2026-14327) in today's Federal Register — 91 FR 43842–44557, comments close September 14, 2026.

DHCS Reports CalAIM ECM Up 59% Year-Over-Year, Then Proposes Utilization 'Refinements' Saving $184M in 2026-27, Growing to Over $530M/Year by 2029-30

Event: Jun 26

DHCS's June 26, 2026 quarterly update shows Enhanced Care Management served nearly 227,500 members in Q3 2025 — up 59% from Q3 2024…

At House Oversight Hearing, California's Medicaid Director Testifies CMS Cited 'No Instances of Fraud' to Justify Its $1.3B Medi-Cal Deferral

Event: Jun 25

At a House Energy & Commerce oversight subcommittee hearing on June 25, 2026, California Medicaid Director Tyler Sadwith testified that despite CMS's May deferral of roughly $1.3 billion in federal Medicaid funds — the largest such deferral in CMS history…

Petaluma Health Center Recruits 14 Bilingual, Bicultural Physicians and Psychiatrists From Mexico Under California's AB 2860/2864 Program

Event: Jul 8

Petaluma Health Center — whose roughly 130 clinicians treat 46,000 patients a year across Petaluma, Rohnert Park, Bolinas, and Point Reyes — has enrolled 14 physicians, psychiatrists, and dentists from Mexico under California's 2024 AB 2860/AB 2864 program…

Redwoods Rural Health Center Cuts Its Community Supports Program in Southern Humboldt as Federal and State Funding Reductions Bite

Event: Jun 29

Redwoods Rural Health Center — the FQHC serving Southern Humboldt County, with a second site in Fortuna — announced 'strategic organizational adjustments' in a social-media post…

Stanislaus County's 18-Year-Old RAIZ Promotores Program Closes Most Groups June 30 as BHSA Redirects Prevention Dollars to Treatment

Event: Jun 30

Stanislaus County's RAIZ Promotores program — 13 community health worker groups founded in 2008 that serve close to 400 mostly Latino immigrant residents from Patterson to Hughson — is closing most of its groups by June 30, 2026.

Texas February Marketplace Effectuated Enrollment Was 3.28M in 2026, 4% Below 2025 and Distinct From Plan Selections

Event: Jul 9

CMS's February effectuated-enrollment data show about 3.28 million Texans with active Marketplace coverage in 2026, down from about 3.42 million in the comparable 2025 file.

CommUnityCare Reports a Parking-Lot Immigration Detention and More Missed or Canceled Visits

Event: Jul 8

KXAN reports that CommUnityCare's CEO told the Central Health Board about an immigration-enforcement detention in a north-central Austin health-center parking lot and an increase in missed appointments and cancellations.

Georgetown CCF: Texas Had the Nation's Highest Reported Under-6 Uninsured Rate in 2024, at 10.8%

Event: Jun 1

Georgetown University's Center for Children and Families reports that 10.8% of Texas children under age 6 were uninsured in 2024, the highest state rate shown in its analysis, versus 5.3% nationally.

CMS Open-Enrollment Plan Selections Fell in Rural and Exurban Texas Even as Statewide Selections Rose, Bastrop Down 17%, Caldwell Down 10%

Event: Jul 2

The Daily Yonder's analysis of CMS 2026 open-enrollment files reports that plan selections rose about 5% statewide while falling more than 3% across rural Texas counties and about 5% across its defined exurban group.

SAC Health Acquires a Former Rite Aid in Victorville for Its Second High Desert Clinic, ~150,000 Medi-Cal-Eligible Residents in the Victor Valley

Event: Jul 7

SAC Health — the largest specialty-based teaching FQHC in the United States, with 11 clinics across San Bernardino and Riverside counties — announced July 7…

SF Budget Committee Reverses $750K of Mayor Lurie's Cuts to HIV and Health Access Points, Full Board Votes July 21 and 28

Event: Jun 26

San Francisco's Board of Supervisors budget committee, chaired by Sup.

TrueCare to Merge With Palomar Family Counseling Service, Expanding FQHC Behavioral Health Across North San Diego County (Effective Sept. 1, 2026)

Event: Jun 19

TrueCare — one of San Diego County's largest nonprofit community health centers — announced plans to merge operations with Palomar Family Counseling Service (PFCS), a North County behavioral-health nonprofit operating since 1956, effective September 1, 2026.

Baker Institute: Texas Won the Largest Rural Health Transformation Award ($281M) but the Smallest Per-Capita Share ($66/Rural Resident)

Event: Jun 18

A June 18 Baker Institute (Rice University) analysis of the federal Rural Health Transformation Program (RHTP; $50B over five years) finds Texas received the largest first-year state award nationally (more than $281M, per KFF) but — because of its huge rural…

Episcopal Health Foundation Approves 74 Grants Totaling $19.2M in First Open Cycle, Much of the Largest Share Goes to Texas FQHCs

Event: Jun 8

Episcopal Health Foundation approved 74 grants totaling $19.2 million in the first round awarded through an open application process under its 2025-2030 'Igniting Change' strategic framework…

St. David's Foundation Awards $2.04M to Four Hays County Perinatal-Care Organizations, Including CommuniCare Health Centers

Event: Jun 25

St. David's Foundation awarded four grants totaling $2.04 million (announced April 13, 2026) to Hays County organizations providing perinatal care, part of a broader rural-focused shift after initially concentrating funding in Travis County.

36 Texas Organizations Petition HHSC to Study and Update YES Waiver Children's Mental-Health Rates, 397 Providers Lost Since 2019

Event: Jun 15

On June 15, 2026, 36 Texas organizations sent a letter to the Texas Health and Human Services Commission asking the agency to study Medicaid reimbursement rates for the YES (Youth Empowerment Services) Waiver — the program that lets children with serious…

Fresno's CHW Certification Program Graduates a Second Cohort of 29 and Opens Recruitment for a Third

Event: Jun 3

Twenty-nine participants completed the intensive 13-week community health worker training in the second cohort of Fresno's CHW Certification Program — a partnership of Fresno State's Central Valley Health Policy Institute (CVHPI), Cultiva La Salud…

Vista Community Clinic Opens Glendale PACE Center, FQHC Expands Coordinated Senior Care in Los Angeles County

Event: Jul 8

Vista Community Clinic (VCC) — an FQHC with sixteen locations across North San Diego, Orange, Los Angeles, and Riverside counties serving more than 70,000 residents — opened a new Program of All-Inclusive Care for the Elderly (PACE) center in Glendale (425…

HealthPoint's Current Leadership Page Identifies Mary Wauters as CEO

Event: Jun 2

HealthPoint's current first-party leadership page identifies Mary Wauters as chief executive officer and lists the organization's executive and board leadership.

Alameda County Adopts a $6.7B Budget With an $85.3M Community Health Center Line

Event: Jun 25

The Alameda County Board of Supervisors unanimously adopted a $6.7 billion FY2026-27 budget on June 25, closing a ~$91M gap without layoffs or major service cuts.

OMB Proposes the Biggest Rewrite of the Federal Grant Rulebook Since 2013, Every Section 330 Grantee Would Have to Run E-Verify; Comments Closed July 13

Event: May 29

OMB has proposed a government-wide rewrite of the Uniform Guidance (2 CFR Part 200) — the rulebook every Section 330 grant, subaward…

TMHP Moves Five More Texas Medicaid Applications to IAMOnline on August 3, Provider Access Owners Need a Release-3 Cutover Check

Texas Medicaid & Healthcare Partnership announced that Custom Reports, the Medicaid Client Portal, Document Uploads, the Provider Message Dashboard, and My Account will move to TMHP IAMOnline on August 3.