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5 Facts: Medicaid Fraud, Waste, Abuse and Improper Payments

Program integrity efforts work to prevent and detect fraud, waste, and abuse; increase program transparency and accountability; and recover improper payments. This brief explains what we know about these issues and efforts to address program integrity.

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

Tracking Medicaid Work Requirements:
Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

understanding medicaid

Medicaid Financing

Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term care. This brief examines key questions about Medicaid financing and how it works.

Medicaid and Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

5 Facts: Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

Medicaid Home Care in 2025

This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services”) is, who is covered, and what services were available in 2025.

5 Facts: Medicaid Program Integrity

This brief explains what is known about improper payments and fraud and abuse in Medicaid and describes ongoing state and federal actions to address program integrity.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage

  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.

  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.

  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • Health Coverage for Children and Families in Medicaid and SCHIP:  State Efforts Face New Hurdles

    Report

    Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles The seventh annual 50-state survey of eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and SCHIP for children and families reports that nearly two-thirds of states expanded access to Medicaid and SCHIP between July 2006 and January…

  • Pulling It Together: Perspectives on State Health Reform

    Perspective

    This Pulling It Together column is the fourth in my new series. All four so far have dealt with different dimensions of health reform. This time I write about one of my favorite topics, the states.

  • Key Issues in State Implementation of the New and Expanded Home and Community-Based Services Options Available Under the Affordable Care Act

    Issue Brief

    This brief summarizes the key issues identified and discussed by participants in Kaiser Family Foundation’s Commission on Medicaid and the Uninsured's July 16, 2013 roundtable meeting on state adoption of the new and expanded Affordable Care Act home and community-based services (HCBS) options. While states have made overall progress in rebalancing their long-term care systems in favor of community-based care, state adoption of ACA HCBS options has been relatively slow to date, despite the growing demand for HCBS among beneficiaries and the enhanced federal funding associated with several of these options.

  • Obamacare and You

    Fact Sheet

    Obamacare and You is a series of one-page papers explaining how the Affordable Care Act, also known as “Obamacare,” will affect different groups of people.

  • The 65 and Over Population Will More Than Double and the 85 and Over Population Will More Than Triple by 2050

    Feature

    The 65 and Over Population Will More Than Double and the 85 and Over Population Will More Than Triple by 2050 Download Source A. Houser, W. Fox-Grage, and K. Ujvari. Across the States 2013: Profiles of Long-Term Services and Supports, AARP Public Policy Institute, September 2012, available at: http://www.aarp.org/content/dam/aarp/research/public_policy_institute/ltc/2012/across-the-states-2012-full-report-AARP-ppi-ltc.pdf.

  • Leveraging Medicaid in a Multi-Payer Medical Home Program: Spotlight on Rhode Island’s Chronic Care Sustainability Initiative

    Issue Brief

    Rhode Island's Chronic Care Sustainability Initiative (CSI) is a multi-payer patient-centered medical home program in which the one Medicaid health plan and all commercial health plans in the state participate. Hallmarks of the initiative are engaged leadership, mandatory participation but participatory governance, a common contract used by all payers, and investments in health information technology and other support for practice transformation.

  • The ACA’s Basic Health Program Option: Federal Requirements and State Trade-Offs

    Report

    The Patient Protection and Affordable Care Act (ACA) gives states the option to implement a Basic Health Program (BHP) that covers low-income residents through state-contracting plans outside the health insurance marketplace, rather than qualified health plans (QHPs). In March 2014, the Centers for Medicare & Medicaid Services (CMS) issued final regulations on the requirements for a BHP and the methodology for calculating federal payments to states. States can choose to implement BHP beginning in 2015. This report summarizes these federal policies, including the requirements for BHP as well as the methodology for determining federal BHP payments. It then analyzes the key trade-offs facing states as they decide whether and, if so, how to implement BHP, with a particular focus on the impact of BHP on state budgets and the size, stability, and risk level of state marketplaces.