Top 5 Most Interesting Moves
June 26, 2026 - Top 5 Insights
๐งพ CMS tightens Medicaid waiver rules
CMS is signaling a major overhaul of Section 1115 waiver rules, one of the main tools states use to test Medicaid policy changes.
Why it matters: States may face a more rigid, less flexible path for waiver approval just as Medicaid strategy, financing, and redesign pressures keep rising.
What stands out: Under the new approach, the CMS Chief Actuary would have to certify that a proposed waiver will not increase federal spending before it can be approved.
What changes: States would no longer be able to rebase budgets mid-cycle or make the same kind of mid-course corrections that have helped them adjust waiver programs over time.
The takeaway: For states counting on Medicaid waivers to fund or shape new initiatives, the rules may soon get tighter, slower, and harder to navigate.
๐ฅ Texas network may leave United
A large Texas provider network may soon split with UnitedHealthcare.
Why it matters: Contract fights between payers and health systems can quickly become access problems for patients and revenue problems for providers.
What stands out: Texas Health Resources said it plans to terminate UnitedHealthcare and UMR contracts across 45 hospitals and more than 350 clinics if the sides do not reach a new agreement.
What to watch: Unless a deal is reached, the contracts would end Sept. 1, affecting a major provider footprint in one of the countryโs biggest health care markets.
The takeaway: This is a reminder that payer-provider negotiations are still shaping network access, care continuity, and financial pressure in real time.
