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Policy changes, funding updates, and developments across the Adult Day Care and Adult Day Health industry.

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Illustration of a Virginia adult day care claims calendar and filing deadline with a Cardinal Care / Aetna-style notice motif, no readable PHI or claim numbers.

Aetna Better Health of Virginia Updates Cardinal Care Billing Requirements

Aetna Better Health of Virginia posted a Sept. 9, 2026 Billing Requirements Update for Cardinal Care. When a member supplies eligibility info at least 21 days before the filing deadline, providers must file the claim.

September 10, 2026

Illustration of adult day health centers behind a closed gate with a spotlight on the buildings, representing Massachusetts' 2026 enrollment moratorium and program-integrity focus, with no readable client information.

Article

MassHealth's ADH Enrollment Moratorium: What Existing Centers Should Know

MassHealth stopped enrolling new Adult Day Health providers on May 19, 2026. Existing centers keep the field to themselves — and inherit the scrutiny. What changed, current rates, where claims go, and what to document.

September 2, 2026

Generic illustration of a scheduled system maintenance outage, with no readable names or PHI.

Article

What TMHP’s September 20, 2026 System Maintenance Outage Means for Providers

TMHP scheduled a system maintenance outage Sunday, September 20, 2026, from 5:00 a.m. to 11:00 p.m. Central. All web-based applications and functions are unavailable during that window.

August 28, 2026

Illustration of a generic remittance and claims-processing workflow with no readable names, no PHI, and no government-form copy.

Article

What TriWest’s Non-Network Claims Processing Issue Means for TRICARE West Providers

TriWest says a recent operational issue processed certain TRICARE claims as non-network in error. Adjustments are underway, and updated Remittance Advice and/or EOBs will be issued as needed.

August 28, 2026

Illustration of a generic Texas Medicaid EFT payment calendar with a one-business-day delay after fiscal year end, and no readable names.

Article

What TMHP’s Fiscal Year-End EFT Delay Means for Texas Providers

TMHP delayed the EFT cycle normally paid Monday, September 7, 2026. Its August 25 fiscal-year-end notice said funds by September 8; its September 4 Labor Day notice now says Monday, September 14, 2026.

August 26, 2026

Illustration of a generic federal rate table, a Free/Reduced/Paid label, and a daily meal-check grid as three separate items, with no readable names.

Article

2026–2027 CACFP Reimbursement Rates for Adult Day Care Centers

The 2026–2027 CACFP reimbursement rates for adult day care centers run July 1, 2026 through June 30, 2027. Keep USDA rates, Meal Type, and daily meal records separate.

August 25, 2026

Illustration of a generic adult day care claim connection to an Availity MFT mailbox, with a password update path and no readable names.

Article

What Availity’s New MFT Account Rules Mean for ElderSuite Claim Connections

Availity’s new MFT account rules took effect August 15, 2026. They apply to the mailbox ElderSuite uses to send claims, not the Availity Essentials portal login.

August 24, 2026

Illustration of a generic audit binder, a chart-review flow, and a generic ElderSuite-style clinical screen with no readable facility or client data.

Article

HHS OIG Finds Widespread Noncompliance at Texas DAHS Facilities

HHS OIG's March 2025 audit of 20 Texas DAHS facilities found 253 instances of noncompliance. Nineteen providers missed health and safety rules; nineteen missed administrative rules.

August 16, 2026

Illustration representing the TMHP data security incident and notifications to Medicaid clients and providers

Article

TMHP Reports Data Security Incident Affecting Medicaid Clients and Providers

TMHP reported a data security incident that may have involved information associated with 1,828 Medicaid clients and 217 health care providers. Notices and identity-protection information were mailed to affected individuals.

August 14, 2026

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