Montana plans to launch Medicaid work requirements July 1, per a state DPHHS presentation to a legislative interim committee on March 9. Becker's reported Florida is moving toward adding similar requirements as H.R. 1 pushes expansion states to require work, volunteering, or education. KFF also launched a state-by-state tracker for the 2025 reconciliation law, with required implementation starting in January 2027. Expect more eligibility churn and compliance overhead, shifting Medicaid MCO membership and capitation cash flow, and leaving safety-net providers holding the bag.

In its March 12, 2026 MLN Connects newsletter, CMS flagged Quality Payment Program claim adjustments to correct the Medicare conversion factor. Modern Healthcare reports CMS' Medicare Ambulatory Specialty Model is already sparking provider concerns about payment levels. Read together, CMS is tweaking fee schedule plumbing while pushing specialty-focused alternative payment models. Actuarial and provider finance teams should reforecast 2026 Medicare revenue, as retro claim adjustments and model-specific rates move unit price and performance risk.

Carrum Health partnered with Virta Health to offer a comprehensive weight-loss solution, linking medication-based care with surgical options. Virta provides nutrition coaching and GLP-1 medications, while Carrum provides surgeries for weight management. The companies said members can be referred and coordinated between the two programs based on clinical need. For payers and employers, tighter routing can shift obesity spend between ongoing GLP-1 pharmacy costs and episodic surgical bundles.

New Jersey Gov. Mikie Sherrill said March 10 in her 2027 budget address she wants to fine employers whose workers rely on Medicaid. Employers with at least 50 workers on Medicaid would have to offer coverage or pay the penalty, according to Becker's Payer. Sherrill projected the fines would raise about $145 million a year to offset Medicaid strains she blamed on President Donald Trump's policies. If adopted, it effectively prices "Medicaid dumping" and pushes more benefit cost back onto employers, changing stop-loss and wage assumptions for affected industries.

On March 3, 2026, FDA issued 30 warning letters to telehealth firms over false or misleading marketing of compounded GLP-1 drugs. STAT reported March 12 that many telehealth brands rely on the same prescriber networks; 30% of 70+ warned firms tie to four medical groups. FDA flagged claims implying compounded products are the same as approved semaglutide or tirzepatide, plus branding that obscures the actual compounder. For payers, a crackdown on compounding shifts utilization to covered brands or abandonment, pushing GLP-1 PMPM and PA workload back into the plan.