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- November 25, 2025
Prior Authorization in Medicaid Series
Read moreThis issue brief series explores how prior authorization policies shape access to care in public health coverage programs, particularly Medicaid. The first brief introduces the fundamentals of prior authorization, how it operates for Medicaid beneficiaries, and the growing movement for reform. Future installments will explore the legal and policy…
- October 17, 2025
An Advocate’s Guide to Access GAC in CA: Chapter 3 Types of Coverage
Read moreThis chapter is part of NHeLP’s forthcoming Advocate’s Guide to Accessing Gender-Affirming Care in California. It provides an overview of types of health coverage people may have. It will help people to identify what kind of coverage they have, how it is regulated, and what laws and requirements apply…
- September 17, 2025
Medicaid Financing after OBBBA: State Directed Payments and Provider Taxes
Read moreThe so-called "One Big Beautiful Bill Act" (OBBBA) makes changes to complex but crucial Medicaid financing mechanisms that are likely to force states to reduce provider payments and limit benefits. This issue brief provides an overview of state directed payments and provider taxes and explains how they interact; how…
- July 29, 2025
Revisiting Managed Care Sanctions
Read moreThis issue brief is part of the National Health Law Program’s ongoing work on accountability in Medicaid managed care. It updates our research on Medicaid managed care sanctions by revisiting the states we profiled in 2022. We summarize recent sanctions content from the managed care websites of those states…
- July 28, 2025
Internal and External Review: Medi-Cal Managed Care Plans Managed Care in California Series Issue No. 4 (Revised July, 2025)
Read moreFederal and state law and the state and federal Constitutions require that enrollees in Medi-Cal managed care plans receive notice, and grievance and appeal rights when they are denied access to medically necessary services. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do not…
