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Medicare & Medicaid

Traditional Medicare, Medicare Advantage, Medi-Cal fee-for-service and managed care, D-SNP, and California MAC guidance translated into operational actions.

Latest published edition Oct 11, 2026 Listed sources reviewed through Oct 10, 2026 Editions 6

Choose an edition to read its leading stories, browse every article or open the complete report.

Latest published editionCorrected · Version 3

October 11, 2026 edition

Coverage Oct 4, 2026 to Oct 10, 2026

102 articles7 high-priority findingsCoverage note ↓

Leading stories

  • Unpaid qualifying APM participants face October 13 billing-information cutoff
  • Medi-Cal clinic institutional claims require diagnosis codes from October 15
  • DHCS warns assisted living waiver facilities of denials and reprocessing

Published October 11, 2026 · Listed sources reviewed through Oct 10, 2026

Past editions

October 2026

Archived editionCorrected · Version 2

October 4, 2026 edition

Coverage Sep 27, 2026 to Oct 3, 2026

79 articles6 high-priority findingsCoverage note ↓

Inside this edition

  • Medi-Cal youth gender-affirming services: October 13 reimbursement and continuity requirements
  • Hospice election addendum is mandatory for every new election starting October 1

Published October 4, 2026 · Listed sources reviewed through Oct 3, 2026

September 2026

Archived editionCorrected · Version 2

September 20, 2026 edition

Coverage Sep 13, 2026 to Sep 19, 2026

36 articles1 high-priority finding

Inside this edition

  • CMS reports $1.6 billion in Medicare laboratory program integrity actions across revocations, suspensions, recoupments and referrals
  • CMS announces broad state participation in the GENEROUS Medicaid drug payment model and a September 30 signing date

Published September 20, 2026 · Reviewed through Sep 19, 2026

Archived editionCorrected · Version 2

September 6, 2026 edition

Coverage Aug 30, 2026 to Sep 5, 2026

25 articles3 high-priority findings

Inside this edition

  • CMS opens the second CY 2027 Medicare Plan Finder benefit and drug-pricing preview through September 11
  • CMS opens CY 2027 Medicare Advantage provider-directory preview and sets September 18 attestation deadline

Published September 6, 2026 · Reviewed through Sep 5, 2026

August 2026

Archived editionCorrected · Version 2

August 30, 2026 edition

Coverage Aug 23, 2026 to Aug 29, 2026

7 articles1 high-priority finding

Inside this edition

  • CMS reports $1.6 billion in Medicare laboratory program integrity actions across revocations, suspensions, recoupments and referrals
  • Medi-Cal requires quarterly validation of the public fee for service provider directory beginning October 1, 2026, with Provider Portal Transaction Center access at stake

Published August 30, 2026 · Reviewed through Aug 29, 2026

Coverage notes

These limitations belong to the dated editions below. The complete report includes its coverage record.

October 11, 2026 edition: limited coverage

Limited coverage. Coverage limitation for 2026-10-04 through 2026-10-10: DMHC enforcement actions: The canonical enforcement form did not yield a date-filtered result set. Web access failed and the bounded direct request failed DNS. The official newsroom alternative did not establish dated window actions. DHCS audit and investigation actions: The canonical page yielded an undated program description, and the bounded direct request failed DNS. The official program-integrity alternative failed access and did not establish dated window actions. This edition reports verified findings from the listed sources; it does not establish complete activity for these authorities.

Read the complete report →
October 4, 2026 edition: limited coverage

Limited coverage. Coverage limitation for 2026-09-27 through 2026-10-03: DHCS audit and investigation actions: The canonical DHCS action pages did not expose a complete dated action set. Two HTTP 200 responses contained an Incapsula JavaScript shell, and official descriptive alternatives supplied no bounded weekly records. This edition reports verified findings from the listed sources; it does not establish complete activity for these authorities.

Read the complete report →
September 27, 2026 edition: limited coverage

Limited coverage. Coverage limitation for 2026-09-20 through 2026-09-26: DMHC enforcement actions: The date-filtered official enforcement search remains blocked. The official alternative CSV ends May 22, 2026 and cannot establish September 20-26 activity. DHCS audit and investigation actions: Direct canonical requests return a browser challenge. Readable official A&I and sanctions descriptions do not establish a complete dated September 20-26 action list. This edition reports verified findings from the listed sources; it does not establish complete activity for these authorities.

Read the complete report →

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