Today's deep dives: Arizona's AHCCCS cut nine Legend DDD group homes after a quality probe, as a Phoenix family describes an August air-conditioning outage before a resident's death, and KFF explains Access rule fee-for-service pay transparency that now includes home-care hourly rates. Here is the rest of today's news.
Maine corrects ICF/IID day habilitation rates and reprocesses claims MaineCare says several Section 50 Day habilitation (0907) rate updates were delayed or never loaded. Correct 15-minute rates are $8.42 (Jan. 1–June 30, 2025), $8.58 (July 1–Dec. 31, 2025) and $8.67 (calendar 2026). MaineCare will adjust overpaid claims; providers must adjust underpayments within one year of the latest payment date. Source: Maine DHHS / MaineCare
Oklahoma DDS hires case managers to shrink the I/DD waitlist Oklahoma Human Services is recruiting Developmental Disabilities Services case managers statewide, with a Nov. 10 webinar and hiring events in Tulsa and Oklahoma City. The push is framed as part of an effort to eliminate the waitlist for Medicaid waiver services. Sources: KTUL, Oklahoma Human Services careers
KFF: 21 states will swear in new governors amid Medicaid overhauls Thirty-six states held gubernatorial elections in November 2026; 21 elected a new governor (and D.C. a new mayor) as states implement 2025 reconciliation-law Medicaid changes, including work requirements on tight timelines. At least five of the new governors will be from a different party than the incumbent. Source: KFF
"Big Five" Medicaid MCO enrollment down 7.4% since mid-2025 Georgetown CCF reports Centene, CVS/Aetna, Elevance, Molina and UnitedHealth Group's combined Medicaid enrollment fell from 36.2 million on June 30, 2025 to 33.5 million on Sept. 30, 2026—before January 2027 work-reporting and six-month redetermination rules. Source: Georgetown Center for Children and Families
Colorado Phase 2 caregiver-hour exceptions close Nov. 30 Colorado's weekly caregiver limit for HCBS and related services is already in Phase 2: providers and CDASS employers may submit exception requests through Nov. 30, 2026 for members getting more than 70 hours a week from one caregiver without an approved exception. The limit steps down to 70 hours on Jan. 1, 2027 and 56 hours on July 1, 2027. Source: Colorado HCPF LTSS Sustainability Update Blog
Addus says caregivers want 40-hour weeks, reshaping personal-care census Addus HomeCare told investors a slight personal-care census drop came mainly in low-hour cases as caregivers seek fuller schedules; same-store personal-care hours still rose. The company is rolling out its caregiver app and being more selective about low-hour referrals while still serving those clients. Source: Home Health Care News