Weekly StateVitals Update: Volume 58 (March 2, 2026)

National

• States Sue Trump Administration on Vaccine Recommendations. This past week, fifteen states sued the Trump Administration for its decision to cut the number of vaccines that it recommends for children. The new U.S. Centers for Disease Control and Prevention (CDC) guidance no longer includes recommendations for children to be vaccinated against the flu, rotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV. Recommendations for those vaccines are limited to only high-risk groups or when physicians recommend them in a “shared clinical decision-making” process with the patient. In the lawsuit, the states claim that such guidance is a threat to the health and safety of children and ignores long-standing medical guidance, both of which conflict with existing federal and undermines public health infrastructure that citizens rely upon. The states that are part of the lawsuit include Arizona, California, Colorado, Connecticut, Delaware, Maine, Maryland, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Wisconsin and Governor Josh Shapiro in his capacity as Governor of Pennsylvania. 

• NASHP Opens Applications for State Medicaid Policy and Strategy Learning Collaborative. This past Tuesday, the National Academy for State Health Policy (NASHP) released applications for five states to join its State Medicaid Policy and Strategy Learning Collaborative. Selected states will receive technical assistance focused on the following topics: 

  • Medicaid and state budget decision-making,

  • Identifying program efficiencies and addressing cost drivers while maintaining program goals,

  • Supporting strategic partnerships and alignment across health and human services programs impacted by the One Big Beautiful Bill Act, and

  • Fostering communication with key partners (e.g., legislative leaders,  providers, and consumers).

  Applications are due by 8 pm ET on April 6th, 2026, and accepted applicants will be notified by April 13th. 

• CMS Releases Toolkit for Children’s Behavioral Health Services & EPSDT Requirements. Recently, the Centers for Medicare & Medicaid Services released its toolkit for state Medicaid and CHIP programs related to Children’s Behavioral Health Services and Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements. The toolkit was produced due to enactment of the 2022 Bipartisan Safer Communities Act and a 2022 informational bulletin reminding states that children EPSDT requirements under Medicaid and CIHP are applicable to behavioral health services. The toolkit reiterates this same point, that state Medicaid programs are required to cover medically necessary mental health and substance use disorder services under the EPSDT benefit. Among the new policy directives and clarity driven from the toolkit: 

  • The behavioral health service continuum that CMS defines as applicable covered services in this type of situation is open-ended in nature, albeit aligned with past guidance. 

  • States are authorized to provide covered behavioral health services without a formal diagnosis. 

  • Requirement that utilization management controls and fair hearings are to be consistent with EPSDT.

  • A call to action to states encouraging their pivotal role in building workforce and ensuring that post-hospitalization follow up happens. 

Arkansas

• State to Test Pilot Medicaid Work Requirement Checks. At a recent Legislative Council subcommittee meeting, the Department of Human Services announced their intent to “soft launch” Medicaid work requirement verification procedures in July 2026. The intent is to test pilot the procedures and checks prior to full implementation and enforcement in January 2027. During the soft launch period, the Department will notify Medicaid enrollees whether they appear to meet the upcoming requirement of 80 monthly hours of work or qualifying activities. The state intends to offer extensive outreach prior to this summer to enrollees and will offer a call center support service beginning this summer, too.

Indiana

• General Assembly Passes Healthcare Reforms and Wraps Up Regular Session. On Friday, the General Assembly adjourned its regular session. Over the course of the session, lawmakers considered a number of healthcare measures, with several notable bills now on their way to Governor Mike Braun (R), including:

  • HB 1271: Requires hospitals to provide notice of payment assistance programs to patients. Establishes limitations and requirements related to downcoding, including using an automated process, system, or tool, including artificial intelligence, as the sole basis to downcode a claim. Prohibits a provider from using an automated process, system, or tool, including artificial intelligence, to submit a health benefits claim without review by a provider or person involved in developing the claim. Sets limitation on the time frame in which an insurer may request repayment of an overpayment, adjust a subsequent claim, recoup a paid claim, or retroactively audit a paid claim; and is required to correct a payment error to a provider.

  • SB 1: Establishes the rural health transformation fund and makes various changes to the Medicaid and SNAP programs. Requires biannual Medicaid eligibility redeterminations for non-elderly Medicaid recipients whose eligibility is determined upon income and annually for any other Medicaid recipient.  Requires the Office of the Secretary of Family and Social Services to transmit certain information to the federal government to prevent multiple state Medicaid enrollments. Modifies immigration status and work requirements for the Medicaid expansion program.

  • SB 225: Prohibits a hospital, debt collector, or third party from pursuing medical debt collection if a hospital is noncompliant with statutes related to financial disclosures, charity care, pricing transparency, and nonprofit hospital reporting. Requires a hospital to provide 60 day written notice to the Department of Health of plans to close and permanently terminate all hospital operations or completely eliminate a service line for more than 90 days. 

  • SB 282: Establishes requirements for drug compounding and requires the Department of Health to annually publish a report on drug compounding oversight and its risks and benefits. Requires medical spas to register under the Medical Licensing Board and establishes various requirements for medical spas, including designating a responsible practitioner and advertising requirements. 

Minnesota

• CMS to Withhold $259 Million in Federal Medicaid Funding to the State. This past week, the Centers for Medicare & Medicaid Services (CMS) confirmed that they will defer $259.5 million of an upcoming quarterly federal Medicaid payment to Minnesota. The intent by CMS is that such deferral would help prevent payment of questionable claims while a Medicaid fraud, waste and abuse investigation is ongoing. While Minnesota was notified of the intent to have federal funds withheld back in January, the announcement this week came as part of a broader sweep of fraud, waste and abuse oversight efforts by CMS and the White House. The amount withheld is said by CMS to be related for unsupported or potentially fraudulent Medicaid claims or claims involving individuals that may lack a satisfactory immigration status. CMS has threatened to defer more than $1 billion from Minnesota in federal Medicaid matching funds over the next calendar year if Minnesota fails to carry out its existing corrective action plan as intended by CMS. 

New York

• Senate Passes Package Focused on Healthcare Affordability. This past week, the state Senate passed a package of bills that focused on lowering prescription drug costs, attempting to expand access to healthcare, and enhancing the integration of health equity in the delivery system. The package of bills will now head to the Assembly for consideration where it’s unlikely to move quickly in the immediacy. The bills that are engrossed include: 

  • S. 1618: Authorizes the Department of Health to establish partnerships with drug manufacturers that would be built with the purpose to lower the cost of drugs by enhancing access to generic alternatives.

  • S. 3203: Prohibit drug manufacturers from entering into pay-for-delay agreements.

  • S. 4950: Requires the Office of Addiction Services and Supports (OASS) to establish fee schedules for services provided at facilities overseen by the OASS. The measure would further prohibit such facilities from denying treatment due to a patient’s inability to pay. 

  • S. 2128: Requires health insurers to calculate an enrollee’s cost sharing for a prescription drug at the point of sale based on a price that is reduced by at least 85 percent of all rebates received or expected to be received in connection with dispensing or administering the prescription drug. 

  • S. 634: Requires insurers to provide coverage for diabetes and prediabetes screenings.

  • S. 438: Requires pharmacy services administrative organizations, switch companies, and rebate aggregators to register with the Department of Financial Services and provide certain disclosures (i.e., ownership, structure, and audited financials) for publication by the Department.

  • S. 371: Establishes a wholesale prescription drug importation program from counties with consumer safety on par with the U.S. drug supply chain system and where consumer savings may be feasible.

  • S. 5939B: Requires that pharmacy benefit managers (PBMs) must reimburse network pharmacies at the National Drug Acquisition Cost rate or at the pharmacy acquisition cost rate in certain circumstances, and ensure that PBMs pay a dispensing fee on par with the Medicaid professional dispensing fee.

Oregon

• Senate Passes Bill to Regulate ICE Presence in Hospitals. This past week, the Senate engrossed SB 1570, which intends to provide enhanced authority for hospital personnel to respond to federal law enforcement when they arrive on site. Notably, the bill requires hospitals to designate areas that are closed to the public and prohibits hospitals from disclosing a person’s immigration status unless required by court order or to ensure continued care. The bill further prohibits hospitals from retaliating against employees for sharing informational materials on immigration rights and legal services. The measure iterates that hospitals are to treat a person’s citizenship or immigration status as protected health information. It’s expected to receive consideration in the House that may allow it to get to the floor. However, an opinion from the Legislative Counsel’s office has iterated that the bill may violate the U.S. Constitution in that states are prohibited from interfering with the operations of the federal government.

South Carolina

• Senate Unanimously Passes Teledentistry Regulatory Bill. Recently, the Senate voted 44 to 0 to pass S. 453, which requires dental professionals to conduct in-person examinations and review radiographic records before initiating any orthodontic treatment. The bill builds upon the Telehealth and Telemedicine Modernization Act (H. 4159), passed in 2024, which expanded teledentistry within the state. Notably, South Carolina is not alone in its efforts; as eight other states (FL, GA, IL, NV, OK, UT, TX, WV ) have passed similar legislation to require in-person examinations before beginning orthodontic treatment. The legislation now awaits consideration in the House Medical, Military, Public and Municipal Affairs Committee.

South Dakota

• Governor Signs Rural Health Care Recruitment Bill. This past week, Governor Larry Rhoden (R) signed HB 1043 into law. The measure is a part of the state’s larger Rural Health Transformation Program (RHTP), and provides the appropriations necessary to reimburse eligible health care professionals that have complied with the requirements of the rural recruitment assistance programs. Notably, the recruitment program includes an incentive payment that authorizes a healthcare professional to receive in an amount twice of what the University of South Dakota School of Medicine resident tuition for the four most recently completed academic years for their respective profession (i.e., physician, physician assistant, and nurse practitioners). The total amount appropriated included $978,294 for incentive payments for four family physicians, two physician assistants, and six nurse practitioners. An additional $370,000 is appropriated for reimbursing other eligible health care professionals. This measure follows enactment of HB 1044, which appropriated the majority of funds for the RHTP.

Texas

• Attorney General Files Another Abortion Medication Lawsuit. This past Tuesday, Attorney General Ken Paxton (R) filed a lawsuit against a non-profit telehealth abortion service, its physician founder, and a California physician. The filing claims the defendants operate an “international abortion-by-mail enterprise” to ship abortion drugs into Texas illegally. AG Paxton has filed similar lawsuits against a doctor in New York and a nurse practitioner in Delaware. These cases add to growing legal tension surrounding abortion medication access in states that restrict abortion and shield laws in states that intend to maintain access and protect abortion medication providers and patients. 

Wyoming

• Abortion Care Bills Advance Through Legislature. This past week, two bills set to limit abortion care in Wyoming, HB 126 and HB 117, passed the House with votes of 51 to 7 and 52 to 9, respectively. The first bill, HB 126, prohibits terminating a pregnancy if a fetal heartbeat is detected and provides exceptions if the person’s life is in danger or if continuing the pregnancy could cause serious or irreversible impairment of a major bodily function. Moreover, it establishes a felony penalty for violations and revokes the professional license of any healthcare provider convicted of violating these provisions. The second bill, HB 117, requires abortion providers to obtain informed written consent from a patient at least 24 hours prior to an elective abortion. Additionally, it authorizes interested parties to bring civil action against a person who performs an elective abortion without valid informed consent. These bills represent legislators’ response to the Wyoming Supreme Court’s recent 4-1 ruling deeming the state’s near-total abortion ban and ban on abortion pills unconstitutional.

• Senate Advances Bill Pertaining to Medicaid Eligibility Checks & OB3 Implementation. This past week, the Senate passed SF 106. As engrossed, the measure would increase the frequency of eligibility verification for certain public assistance programs and would mandate monthly data checks across varying platforms to ensure eligibility for enrollees. Related to providers, the bill would also require hospitals, clinics and other qualified settings that accept Medicaid to collect patient citizenship or lawful presence status on admission forms and have them report that data to the state. However, prior to engrossment, an amendment to the bill in the Senate had removed a provision that would have required the state to adhere to semi-annual redeterminations for certain Medicaid recipients. The bill is currently over in the House for consideration. 

For additional information and updates on state activity this past week relative to state COVID-19 vaccine guidance, StateVitals Subscribers can check out our guidance tracker.