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Florida lawmakers are considering requiring an estimated 500,000 Medicaid beneficiaries to work or show they are trying to get jobs to keep their health-care benefits, despite recent court rulings that have struck down similar requirements. Members of a House health care panel this week approved the proposal (HB 955), which is now ready to go to the full House. (Rodriguez, 4/11)

The bill to reauthorize Medicaid expansion in Montana failed to pass today when the state Senate locked in a 25-25 tie. Republican co-sponsors of the policy are withholding their support in a play for leverage over other political goals, including the passage of a controversial bill aimed at keeping the coal-fired power plant in Colstrip running. (Cates-Carney, 4/11)

On a tie 25-25 vote, the Senate did not advance House Bill 658, which would extend Medicaid expansion with the addition of work requirements. Because the Senate did not move to indefinitely postpone the bill, it can be placed back on the agenda for another vote. That is expected to happen Friday or Saturday. (Michels, 4/11)

The ambitious plan – to pay managed care companies $30 billion over five years to handle the health-care needs of 1.6 million low-income North Carolinians – is expected to go live in November for 27 counties  in the state’s Piedmont and Research Triangle regions. But four of the eight managed care groups that bid for the Medicaid managed care contracts have filed protests with the N.C. Department of Health and Human Services. Three of those groups – Aetna Better Health, Optima Family Care and My Health by Health Providers – were rejected while the fourth, the N.C. Medical Society-affiliated Carolina Complete Health, received a nod to take on Medicaid patients in just two of six regions in the state. (Ovaska-Few, 4/12)

Lawmakers in the Iowa House voted Thursday to give an additional $150 million to the companies managing Iowa's privatized Medicaid program, fulfilling contract terms negotiated last year. Last August, state officials agreed to give 7.5 percent more state money to the companies managing Iowa's privatized Medicaid program. The money approved Thursday covers the cost of those increases, as well as additional enrollment in the program, which covers about 680,000 poor or disabled Iowans. (Gruber-Miller, 4/11)

The Tennessee House of Representatives has voted in favor a controversial plan to radically restructure the financing of the state's TennCare program. The GOP-backed plan to seek a "block grant" for TennCare passed by a vote of 68-21 Thursday, but the measure's ultimate fate remains uncertain. Although Gov. Bill Lee has signaled his support, the bill has lagged in the state's senate. A Senate committee will take up the measure next week. (Wadhwani, 4/11)

Tennessee would dramatically overhaul how it provides health care to its lower-income and disabled residents under a proposal the House advanced Thursday. The bill cleared the GOP-dominated chamber on party lines, with 68 Republicans in favor and 21 Democrats against. It’s a proposal considered one of the top policy debates of the sessions, yet many in the minority party were visibly upset after being cut off from the debate and forced to cast a vote before all members had a chance to speak. (Kruesi, 4/11)

A Medicaid advisory panel wants Congress to remove a cap on rebates paid for drugs under the program and create a grace period for states to restrict coverage of a drug for 180 days to determine whether it is effective. The Medicaid and CHIP Payment Advisory Commission adopted both policies unanimously during its Thursday meeting in Washington. (King, 4/11)

A Medicaid advisory panel doesn't want to count third-party costs and payments in the calculation of the Medicaid shortfall for disproportionate-share hospitals, a move that could increase DSH payments to hospitals that serve a high share of Medicaid-only patients. Medicaid and CHIP Payment Advisory Commission members cast 15 votes in favor with one abstention to approve a recommendation to Congress to change the definition of a Medicaid shortfall, or the difference between the cost for providing care to Medicaid patients and the payments for the services. Hospitals have challenged the shortfall's calculation in court. (King, 4/11)