Intelligence archive

Three health systems sue CVS/Caremark for ~$250M in alleged 340B savings diversion (RICO)

Event: May 21

Mount Sinai, Michigan Medicine, and the University of Kansas Health System filed federal racketeering (RICO) suits on May 21, 2026 alleging CVS Health/Caremark secretly diverted roughly $250M in 340B program savings between 2020 and 2025 by paying covered…

La Clínica's October 2025 enrollment campaign illustrates a renewal-workflow need

Event: Oct 24

El Tímpano reported on October 24, 2025 — not June 2026 — that La Clínica de la Raza's community health educators launched an Alameda County campaign before the January 2026 Adult Expansion Freeze.

FTCA CY2027 redeeming applications due June 26

HRSA Program Assistance Letter 2026-01 sets June 26, 2026 as the deadline for all currently-deemed health centers (and their sub-recipients) to submit CY2027 Federal Tort Claims Act redeeming applications — the annual filing that renews free federal…

A Quieter H.R. 1 Cliff: ~100,000 Lawfully Present Immigrants

Event: Apr 6

Beneath the Medi-Cal cuts sits a separate, less-discussed H.R. 1 provision: the law bars Medicare eligibility for several lawfully present immigrant categories — refugees, asylees, people with Temporary Protected Status…

El Centro Regional Medical Center Receives $11M CA Distressed Hospital Payment, Stabilizes Imperial Valley's Only General Acute-Care Hospital

California approved an $11 million distressed hospital supplemental payment for El Centro Regional Medical Center, the only general acute-care hospital in Imperial County. The payment comes through the CA DHCS Distressed Hospital Supplemental Payment Program.

Two Compliance Signals for FQHCs: HRSA's FY2026 340B Manufacturer-Audit Results Go Live, and OCR's Ransomware Settlements Preview a Tougher HIPAA Security Rule

Event: Jun 1

Two federal compliance developments worth a calendar note.

A Rural County on the Record: Tehama Supervisors Warn H.R. 1 Shifts $9.5B/Year onto California Counties and Hits Rural Areas Hardest

Event: Mar 27

The Tehama County Board of Supervisors issued a formal letter warning that H.R. 1 would shift roughly $9.5 billion a year in safety-net costs onto California's state and county governments…

DHCS Confirms California's Current MCO Tax Remains Intact Through December 31, 2026, No June 30 Transition Cliff

Event: Jul 6

Correction (July 15, 2026): DHCS's current financing page states that the February 2026 CMS final rule leaves California's existing Managed Care Organization tax intact through its authorized term ending December 31, 2026.

Final California Primary Results Put Xavier Becerra and Steve Hilton in the November 3 Governor Runoff

California's final official Statement of Vote resolves the uncertainty recorded in the original June 5 item.

California's Health-Ballot Deal Withdraws the Executive-Pay Cap and Union-Spending Countermeasure; Proposition 44 Remains

Event: Jun 25

Correction (July 15, 2026): the anticipated three-measure ballot war did not persist past the June 25 withdrawal deadline.

Contra Costa Voters Reject Measure B

Contra Costa County's Measure B — a 0.625-cent general sales tax projected to raise ~$150 million a year for five years, placed on the June 2 ballot explicitly to 'address deep cuts in federal funding' — failed decisively.

Redding's Sunrise Mountain Wellness Center Closes June 30

Event: Jun 1

Sunrise Mountain Wellness Center in Redding — a Shasta County HHSA-funded behavioral-health peer-support center operated by Kings View — will close June 30…

DHCS Posts Draft Clinic Policy Letter for State-Only FQHC/RHC Services, Stakeholder Webinar June 17, Rules Take Effect July 1

Historical implementation record: on June 3, 2026, DHCS posted a draft Clinic Policy Letter (a Second Addendum on its FQHC/RHC page) that would have operationalized the July 1 shift away from Prospective Payment System (PPS) reimbursement for State-Only /…

Lake County Closes 3 Prop 1 Peer Support Centers June 1

Event: Jun 1

Lake County Behavioral Health closed three peer support centers effective June 1, 2026 amid Proposition 1 (BHSA) funding reallocation: Big Oak Peer Support Center (Clearlake Oaks)…

California Budget Deadlocks 11 Days Before the Deadline, Senate Wants a $285/Employee Fee Instead of Renewing the $4.5B MCO Tax That Funds Medi-Cal Rates

Historical standoff record: as of June 4 — with the June 15 constitutional budget deadline 11 days out — Governor Newsom and the Assembly (who wanted to renew the long-standing Managed Care Organization tax, ~$4.5B/year) were deadlocked with the state Senate…

Texas HB 3794 Did Not Become Law in the 89th Legislature, APRN Delegation Rules Remain

Event: Jun 2

Texas Legislature Online records HB 3794, an APRN licensing and independent-practice proposal, as left pending in House Public Health on April 14, 2025; it did not become law. The item is about APRNs, including nurse practitioners—not a PA full-practice bill.

Texas FQHC Incubator's $650K Project-Based Enrollment Closed Feb. 27, 2026

Event: Feb 27

Texas DSHS sought applications for $650,000 project-based contracts for existing FQHCs and FQHC Look-Alikes to expand services or improve access at existing sites. The official HHS opportunity was released February 2 and closed February 27, 2026.

Healthy Texas Women Runs Through June 2030; Current Texas Manual Still Routes It Through HHSC/TMHP, Not MCOs

Event: Jun 30

CMS extended the Healthy Texas Women §1115 demonstration through June 30, 2030 and authorized Texas to prepare a future managed-care transition.

Texas Again Declines Medicaid Expansion, Eligibility-Simplification Bills Also Died (89th Lege)

Event: Jun 2

SB 232 (Medicaid expansion) got no committee hearing and a budget-day expansion amendment was defeated; enrollment-simplification efforts (HB 321 SNAP-to-Medicaid, 'express lane' eligibility) also failed.

HRSA Defers 2025 nsdu hpsa withdrawals to 2027; Affected Texas Designations Stay Proposed for Withdrawal

Event: Jul 1

On July 1, HRSA announced that HPSA designations identified by the 2025 National Shortage Designation Update would remain in 'Proposed for Withdrawal' status instead of being withdrawn that day.

California's Budget Shortchanges the FQHC Workforce, May Revision Omits $4M for CHW/Promotor Navigation and Pauses a Loan-Repayment Cycle

The Governor's 2026-27 May Revision leaves out a $4M one-time General Fund investment that Community Health Workers / Promotores / Representatives (CHW/P/Rs) would use for enrollment and health navigation through HCAI's Immigrant and Health Resilience Fund…

Texas's 180-Hour CHW/Promotor(a) Curriculum Is in Effect, Pre-February 2026 Graduates Have a Transition Path

Event: Aug 24

Texas DSHS says the nine-competency, 180-hour curriculum took effect February 1, 2026 and training centers were required to align by August 1.

Texas HB 18 'Rural Health Stabilization Act' Signed, New Rural-Hospital Finance Office + Medicaid Rate Work

Event: Jun 20

Gov. Abbott signed HB 18 on June 20, 2025 (effective immediately), creating a State Office of Rural Hospital Finance, directing HHSC to improve rural Medicaid reimbursement (rate enhancements, payment-methodology revisions, reduced regulatory burden)…

Legacy Community Health Begins Taking Appointments at Its Acres Homes Clinic in Houston

Event: Jul 14

Legacy's current Acres Homes page posts July 14, 2026, welcomes new patients, and says appointments are available at 3011 W. Gulf Bank Road.

ACA Enhanced Premium Credits Expired Dec. 31, ~1M Texans Projected to Lose Coverage by 2034

Event: Dec 31

The enhanced ACA premium tax credits expired December 31, 2025.

KFF's 2023-Data Estimate: Texas Holds ~42% of the U.S. Medicaid Coverage Gap (~588,000 Adults)

Event: Feb 25

KFF's February 2025 brief uses 2023 American Community Survey data to estimate 1.4 million uninsured adults in the coverage gap across the 10 non-expansion states. Texas accounts for 42% — about 588,000 people by applying that share — the largest state share.

Riverside County's $10.3B Budget Imposes a Countywide Hiring Freeze; $3.1B for Health Touches RUHS Clinics

Event: May 29

Riverside County released its $10.3 billion FY2026-27 budget for public review with a hiring freeze on all General-Fund-supported departments (plus 'maximum fill rates' on mission-critical roles) and about $66.1M drawn from reserves.

Stanislaus County Warns H.R. 1 Could Cost Its Indigent-Care Program $37M–$66M Over Three Years

Event: May 29

A Stanislaus County Health Services Agency report presented to the Board of Supervisors warns that H.R. 1 could cost the county-mandated Indigent Health Care Program $37 million to $66 million over three fiscal years…

Texas Loses $600M+ in Federal Public Health Funds as OBBBA + Pandemic-Era Streams Expire

Event: Dec 19

The Texas Medical Association reports Texas is losing more than $600 million in expired pandemic-era federal public health funding plus reductions under the One Big Beautiful Bill Act — including ~$270M from infectious-disease programs…

Texas Hits Record 4.17M ACA Marketplace Enrollment for 2026, 2nd Nationally, Despite Subsidy Lapse

Event: Jan 13

Texas recorded 4.17 million marketplace plan selections through Jan. 15, 2026 — up 5% and a new state record, second only to Florida even as national enrollment fell 5%.

Federal CHC Fund: $4.6B for FY2026 Plus a $1.159B Bridge Through Dec. 31, 2026

Event: Feb 3

The current U.S. Code appropriates $4.6 billion to the Community Health Center Fund for FY2026 and another $1,159,452,055 for October 1 through December 31, 2026.

Harris Health (Houston) Draws 2nd $850M of $2.5B Bond for New Community Clinics + Hospital Expansion

Event: Feb 27

In February 2026 Harris County commissioners authorized a second $850 million installment of the voter-approved $2.5 billion bond — funding new community clinics in Precincts 2, 3 and 4 plus Ben Taub and LBJ hospital expansions…

Parkland Adopts FY2026 Budget, Holds Tax Rate Flat, and Flags a Potential $200M+ Annual Federal-Revenue Loss

Event: Sep 17

Dallas County approved Parkland Health's FY2026 budget after an August version projected about $3 billion in revenue and $3.1 billion in operating expenses.

University Health (San Antonio) Adopts $4.27B FY2026 Budget; Warns ACA Subsidy Loss Hits 234K in Bexar

Event: Dec 17

Bexar County's University Health adopted a $4.27 billion FY2026 budget (9% revenue growth) with ~21% of patients uninsured and ED visits up 77% since 2014.

Orange County Releases a $10.5B Recommended Budget; Safety-Net Detail Awaits June Hearings

Event: May 20

Orange County released its $10.5 billion FY2026-27 recommended budget ($5.2B General Fund) in late May, with a budget open house June 3, public hearings June 9, and adoption targeted June 23.

SAC Health Wins ~$3.6M Annual HRSA FQHC Grant

On June 3, 2026, SAC Health — the nation's largest specialty-based, teaching FQHC, with 11 clinics across San Bernardino and Riverside counties — announced HRSA renewed its annual Section 330 FQHC operating grant at roughly $3.6 million to sustain and expand…

CMS Work Rule Targets Expansion and Certain §1115 Adults; Texas's Main Medicaid Groups Are Outside Its Core Scope

CMS-2454-IFC requires 80 hours per month of work or qualifying activities beginning no later than January 1, 2027 for non-pregnant adults ages 19–64 who are enrolled in the ACA adult group or certain §1115 demonstrations that provide minimum essential…