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The CMS on Monday issued new guidance for states and Medicaid managed care programs to change up their Medicaid drug utilization review programs by the end of this year. Medicaid programs have been on the front lines fighting the opioid epidemic. The CMS' new mandates, which include setting opioid prescription limits and monitoring Medicaid patients for potential abuse, apply equally to state Medicaid fee for service programs and private managed care companies. (Luthi, 8/5)

Yeccenia Nuez worried that her granddaughter was still suffering from a nasty stomach bug picked up during a visit to the Dominican Republic, and that the 13-month-old baby needed another trip to the emergency room. Ms. Nuez called pediatrician Vanessa Baracaldo, who assured her on the phone that such a trip wasn’t needed and instead encouraged her to come to her Harlem office the next day for an early-morning appointment. By the time Dr. Baracaldo examined the baby, the worst symptoms had largely subsided. (West, 8/5)

The Louisiana Department of Health has picked four companies it intends to award multi-billion dollar contracts to in exchange for managing care for 1.7 million Medicaid patients in the state. The agency picked AmeriHealth Caritas Louisiana, Community Care Health Plan of Louisiana (Healthy Blue), Humana Health Benefit Plan of Louisiana and United Healthcare Community Plan. The terms of the deals are still being worked out but are expected to begin in January. (Karlin, 8/5)

For more than a year, dozens of complaints about KanCare fraud, waste and abuse went to an email account no one was checking, according to a report released Monday by the Kansas Attorney General’s Office. The Kansas Legislature voted in 2017 to move the long-vacant Medicaid Inspector General watchdog position out of the Kansas Department of Health and Environment to the attorney general’s office. (Marso, 8/5)

Democratic state lawmakers said Monday they will try again to expand Medicaid as allowed under federal health law, a move the Republican-controlled Legislature has repeatedly opposed. Sen. Jon Erpenbach, D-West Point, and Rep. Daniel Riemer, D-Milwaukee, said they would introduce a standalone bill to expand Medicaid eligibility to 133% of the federal poverty level and accept additional federal funding under the Affordable Care Act. (Wahlberg, 8/6)

Governor Mike Parson signed an executive order earlier this summer creating a task force to look into something that could bring big changes to how Missourians get—and pay for—their health care. The task force will look at applying for a waiver from the federal government on the Affordable Care Act, also known as “Obamacare.” These waivers allow states to bypass some federal rules and use their own creative ways to use the federal money in their states. (Moore, 8/5)