States We Serve

Our home market. Five NJ FamilyCare Medicaid plans, an aggressive out-of-network law, and a telehealth parity mandate that just expired.

A two-region Medicaid market (Upstate vs. NYC), a surprise-billing law with a real dollar figure attached, and a Medicare contractor that just renamed itself.

Five HealthChoices Medicaid zones, no state surprise-billing law, and its own medical-debt collections rules most national vendors never check.

One of only four states with zero percent Medicaid managed care. HUSKY Health runs fee-for-service through three separate administrative organizations, not a managed care plan roster.

Vermont's all-payer ACO model just ended. OneCare Vermont wound down at the close of 2025, and providers went back to fee-for-service billing on January 1, 2026.

Rhode Island's largest hospital system renamed itself mid-contract, and the state just abandoned a $15 billion Medicaid procurement rather than risk it.

MassHealth runs three different ACO models at once, a private-equity hospital collapse redrew the map in 2024, and the state's cost regulator just expanded its own oversight power.

MaineCare pays fee-for-service, not managed care, and reimburses hospitals at roughly 72% of Medicare rates, a gap the legislature is actively fighting over in 2026.

New premiums and work requirements hit Granite Advantage enrollees this year, while only 7 of the state's 26 hospitals remain unmerged.

Medi-Cal is the largest Medicaid program in the country, dual-eligible plans just expanded to 41 counties, and California runs its own surprise-billing law separate from the federal one.

Texas's surprise-billing law only protects the 16% of Texans on state-regulated plans, and the Medicare Administrative Contractor just won a fresh recompete this year.

Florida rebuilt its entire Medicaid managed care system in 2025, dropping to 9 regions and losing a major plan, on top of the country's heaviest Medicare Advantage market.

Illinois just awarded new $431 billion HealthChoice Medicaid contracts for the first time since 2018, taking effect January 1, 2027, and one commercial carrier controls 61% of the market.

Ohio just moved its dual-eligible Medicaid population onto a new FIDE-SNP structure, runs a behavioral health carve-out through a single statewide plan, and enforces its own surprise-billing arbitration process separate from the federal one.

Michigan's dual-eligible program is mid-transition to a new statewide structure, its two largest hospital systems just merged into one, and a new legislative push could reshape how nonprofit hospitals set prices.

Georgia runs a limited, work-requirement Medicaid expansion instead of full expansion, its own state surprise-billing law layered on top of the federal one, and a Medicare jurisdiction shared with only two neighboring states.

North Carolina splits Medicaid into Standard Plans and specialized Tailored Plans for complex behavioral health needs, one of its managed care plans is merging into another in 2026, and its legislature is actively debating new limits on hospital facility fees and tax exemptions.

Nearly all of Virginia's Medicaid population runs through Cardinal Care managed care, a new federal provider-enrollment mandate just added a mandatory portal for every biller, and the state's own balance-billing law covers a specific, narrower list of services than the federal one.