Tony Leys

Depending on where they lived, demands for repayment can drain the assets that a patient on Medicaid leaves behind after they die. Iowa aggressively collects "clawback" funds.

The pandemic brought billions of extra federal dollars to the long-term care industry, which was inundated with COVID-19 infections and more than 160,000 resident deaths. Many facilities saw business decline amid lockdowns and reports of outbreaks. Staff members faced extra danger and stress. The industry is still feeling the effects.

Mike Randol took over May 31 as head of Montana’s Medicaid program, which serves 280,000 people who live in low-income households or have disabilities in a state of 1.1 million people. The program has a roughly $2.3 billion annual budget, with the federal government picking up about 80% of the total.