| Alabama | | CMS is taking comments to Nov. 6, 2026, on Alabama's request to renew its Community Waiver Program for intellectual disability to 2031. The state would drop the little-used Group 5, and CMS has extended the current demonstration to Sept. 30, 2027, while talks continue. |
| Arizona | | AHCCCS cut nine Legend DDD group homes after a DDD quality probe that began in November 2025. A Phoenix family says Mark Johnson died weeks after an August air-conditioning outage at one home. |
| Arkansas | | At an Oct. 2, 2026, hearing, families said Arkansas’s nearly 2,500-person CES waitlist needs faster help. DHS said $17 million in reserves covers supportive living only through June 30, 2027. |
| California | | California has filed felony charges against 103 IHSS caregivers accused of defrauding Medi-Cal of more than $4.5 million. Prosecutors say they billed for care while recipients were in hospitals or nursing facilities. |
| Colorado | | Colorado’s Medical Services Board gave final adoption Oct. 9, 2026, to group rates for CFC personal care, homemaker and IHSS HMA, plus LTHH CNA services, set at 50% of individual rates pending a SPA for Jan. 1, 2027. |
| Connecticut | | Four Connecticut residents with intellectual disability diagnoses are suing over the IQ cutoff DDS uses to decide eligibility. A state-ordered plan for a new definition is due July 1, 2027. |
| Delaware | | Delaware DHSS's FY2028 request has $2.6 million for a first HCBS rate phase; home care providers asked Nov. 10 for $26.6 million. The department also wants money for 54 new residential habilitation clients and 366 new community-based services clients. |
| Florida | | Florida ABA providers say claims for children in the CMS Health Plan have gone largely unpaid since Molina took over Oct. 1, and the state is investigating. An attorney says almost 700 providers report the problem. |
| Georgia | | Claratel Behavioral Health has canceled two state-funded DeKalb County, Georgia, homes for adults with IDD after neighborhood opposition. The plan included 24/7 staffing, a $20-an-hour starting wage and about $3.5 million a year in operating money. |
| Hawaii | | Medicaid Fraud Control Units recovered $1.97 billion in FY 2025 with 15,810 open cases, KFF reported September 28, 2026. HHS-OIG is intensifying recertification reviews: New York and Hawaii lost federal funding after June denials, and 11 other states were conditionally recertified as of September 17. |
| Idaho | | Idaho's House Bill 863, signed in March 2026, takes $21.8 million in general funds out of residential habilitation rates for fiscal 2027. It also adds annual cost surveys. |
| Illinois | | A DD waiver amendment posted Sept. 10, 2026, would lift Illinois' DSP rate-model wage to $21.90 from Jan. 1, 2027, with comments due Oct. 8. |
| Indiana | | Indiana FSSA said Oct. 2 it will end an Aug. 31 pause on interRAI ICF/IID level-of-care determinations on Monday, Oct. 5. The Arc of Indiana filed a public-records request seeking how assessment data becomes eligibility decisions. |
| Iowa | | Iowa Medicaid set unskilled attendant care at $6.69 per 15 minutes and skilled at $7.23 effective Oct. 1, 2026, under Informational Letter 2740. The rates cover the Intellectual Disability waiver and five other HCBS waivers. |
| Kansas | | Kansas had 5,383 people on its I/DD waiver waitlist as of Aug. 31, 2026, KDADS told lawmakers Oct. 6, far above a 4,000-person budget cap. An inspector general audit also found missing records in most sampled waitlist files; KDADS disputes the findings. |
| Louisiana | | Louisiana's Oct. 1, 2026, I/DD rate increase is about 3%, with the DSP wage floor rising to $9.27, far below the 14.4% its rate study modeled. |
| Maine | | Maine's draft 2027 MaineCare rate schedule opens the first review of ICF/IID rates since the state's rate reform law, with comments due Nov. 24. A group of HCBS rate reviews, including personal support and care coordination, carries over and is expected to finish by the end of 2026. |
| Maryland | | CMS is reviewing complaints that Maryland's DDA let disability appeals run past the federal 90-day limit, Spotlight on Maryland reported Oct. 21. Records released in September showed 219 of 247 pending appeals had already missed it. |
| Massachusetts | | A federal judge ruled Oct. 29 that CMS can't make medically frail Medicaid enrollees also prove they can't meet work rules to be exempt. A 12-month lookback and a one-attestation limit stand, and the Jan. 1, 2027, start date does not move. |
| Minnesota | | CMS has permanently denied Minnesota $112.75 million in Medicaid reimbursement for services from the quarter that ended Sept. 30, 2025. The state has 60 days to appeal, and another $350 million in frozen claims is still undecided. |
| Missouri | | Missouri's DD division will move the 5,152 people it still case-manages to contracted agencies by Dec. 31, 2027, the Missouri Independent reported. The state expects to save about $3 million a year; some families and advocates worry about disruption and oversight. |
| Montana | | Montana is making about 71,000 Medicaid enrollees document work, school, or an exemption by October 1, 2026. That is months ahead of the January 1 federal deadline. Advocates say confusing notices and thin help lines risk coverage loss for people who already qualify, including caretakers of children with autism. |
| Nebraska | | Nebraska's Medicaid work rules, live since May 1, led to about 1,100 denials by August as calls to the state rose 66%, KFF Health News reported. Officials call the rollout a success; advocates say most losses come from unanswered paperwork. Here is who the rules cover and who is excluded. |
| New Hampshire | | Up to 29,000 New Hampshire adults could lose Medicaid by 2028 under work rules starting January 2027, a think tank said Oct. 20, 2026. The state will require documents, not self-attestation, and checks every quarter. |
| New Jersey | | New Jersey DDD will stop taking new Medicaid provider applications after Dec. 31, 2026, and plans two yearly windows starting about September 2027. DDD will now review applicants before Medicaid does and issue a Certificate of Provider Readiness. Approved providers don't need to reapply. |
| New York | | A federal judge gave final approval Nov. 10, 2026 to a $162 million wage settlement for about 200,000 downstate New York CDPAP caregivers paid by PPL. Payments are expected in early 2027 if there are no appeals, and workers don't need to file a claim. |
| North Carolina | | North Carolina's $0.30-per-unit Innovations direct care raise now starts Oct. 1, 2026, not July 1, under a Nov. 10 NC Medicaid bulletin. The add-on, the $21.3 million in state funds and the attestation rules are unchanged; retro pay back to Oct. 1 waits on LME/MCO validation. |
| North Dakota | | A June 16, 2026 OIG audit found 182 compliance failures in North Dakota I/DD residential habilitation, from late background checks to broken alarms. |
| Ohio | | Voters in at least five Ohio counties rejected county DD board levies on Nov. 3, 2026, while Cuyahoga and Delaware counties approved theirs. Champaign, Logan, Meigs, Mahoning and Tuscarawas boards now weigh cuts or a return to the ballot. |
| Oklahoma | | After a $32.5 million push in 2022, Oklahoma's developmental disability services wait shrank from 13 years to two, the state said in November 2024. |
| Oregon | | Oregon wants to raise the cap on its paid-parent Children's Extraordinary Needs waiver from 155 to 230 children at a time, backdated to July 1. Public comments are due Nov. 25. |
| Pennsylvania | | A federal judge in Pittsburgh ruled Oct. 29 that the Labor Department overstepped in barring 2 home care agencies from the live-in overtime exemption. The rule's companionship section stands, the ruling covers only the two plaintiffs, and Pennsylvania wage law still requires overtime. |
| Rhode Island | | Rhode Island began phasing in Medicaid rate increases on Oct. 1, 2026, including developmental disability and home- and community-based services, with about $116.6 million in extra state and federal funding this year, the Rhode Island Current reported. |
| Texas | | Texas HHSC's 2028-29 budget request zeroes out the $13.7 million Children's Autism Program, which pays for ABA therapy outside Medicaid. It is part of a 3% cut ordered by state leaders; HHSC says children would keep services through August 2027 if lawmakers agree. |
| Virginia | | Virginia voters decide Nov. 3, 2026 whether only a court finding that a person can't understand voting may take away the right to vote. A state law in effect since July 1 already sets that test for people under guardianship. |
| Washington | | Washington's DSHS has floated tighter functional eligibility rules for developmental disability services that would end them for about 2,655 people. The budget option would save $13.4 million in 2027-29 and about $60.7 million a year after that, and it now goes to Gov. Bob Ferguson as he writes his December budget. |
| West Virginia | | West Virginia advocates say Medicaid’s ABA rates — called the nation’s lowest — leave fewer than half of about 20 centers taking Medicaid. Mountaineer Autism Project asked BMS on Sept. 29, 2026, to finish a rate study and raise reimbursements. |
