Safety net hospitals play a vital role in serving marginalized communities, however, their efforts to advance health equity are undermined because in many states Medicaid payment rates do not cover costs. Though many states...more
On July 1, North Carolina announced a new plan to relieve past medical debt for low- and middle-income consumers and mitigate the impact of medical debt going forward. Under the proposal, hospitals that choose to implement...more
7/18/2024
/ Debt Collection ,
Financial Regulatory Reform ,
Financial Services Industry ,
Health Care Providers ,
Health Insurance ,
Medicaid ,
Medical Debt ,
North Carolina ,
Patients ,
Regulatory Agenda ,
State Medicaid Programs ,
Uninsured Patients
In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, and this week CMS is expected to make a first set of...more
7/5/2024
/ Budgets ,
Centers for Medicare & Medicaid Services (CMS) ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Hospitals ,
Medicaid ,
Medicare ,
Revenue ,
Rural Health Care Providers
On Monday, April 22, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated final rules. Together, these rules reshape the federal regulatory landscape for Medicaid and the Children’s Health...more
This program is part two of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series.
After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more
4/16/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Continuing Legal Education ,
Fee-for-Service ,
Final Rules ,
Health Care Providers ,
Home and Community Based Services (HCBS) ,
MCOs ,
Medicaid ,
Medical Loss Ratio ,
Provider Payments ,
Transparency ,
Webinars
On December 1, 2023, North Carolina will become the 40th state to implement Medicaid expansion under the Affordable Care Act (ACA), extending Medicaid eligibility to more than 600,000 adults with incomes up to 138% of the...more
In 2020, Medicaid spent $220.8 billion on hospital care. Hospital care accounted for 33% of Medicaid spending.
Supplemental payments are critical for closing the gap between hospital costs and Medicaid reimbursement,...more
Editor’s Note: Section 1115 Medicaid demonstrations enable states to develop innovative programs for improving the health and well-being of Medicaid enrollees. Long-standing federal policy requires that 1115 waivers be...more
On June 28, 2022, the Centers for Medicare & Medicaid Services (CMS) approved a five-and-a-half-year renewal of Vermont’s Global Commitment to Health (Global Commitment) Section 1115 demonstration. The Global Commitment...more
Section 1115 of the Social Security Act permits the secretary of the Department of Health and Human Services to waive certain Medicaid program rules and provide federal funding for states to test innovative coverage and...more
As the COVID-19 pandemic approaches the two-year mark, the United States leads the world in new COVID-19 cases and deaths. These tragic numbers reflect both the rise of the highly contagious Delta variant, as well as...more
10/26/2021
/ American Rescue Plan Act of 2021 ,
CARES Act ,
Children's Health Insurance Program (CHIP) ,
Coronavirus/COVID-19 ,
Employee Incentive Plans ,
Employer Liability Issues ,
Federal Funding ,
Federal Labor Laws ,
Healthcare ,
Infectious Diseases ,
Medicaid ,
Public Health Emergency ,
Regulatory Standards ,
Vaccinations ,
Workplace Safety
The Big Picture -
In late December, following several weeks of dynamic negotiations, Congress passed the Consolidated Appropriations Act, 2021 (the Act).1 The massive legislative package includes appropriations through...more
As the COVID-19 pandemic continues to progress, providers across the continuum of care are experiencing significant changes in utilization resulting in declining revenue and jeopardizing access to care. The federal government...more
Over the past several years, federal Medicaid oversight and advisory bodies, including the Government Accountability Office (GAO) and the Medicaid and CHIP Payment and Access Commission (MACPAC), have issued reports calling...more
On October 24, 2018, North Carolina received approval from the federal Centers for Medicare & Medicaid Services (CMS) of its 1115 waiver for a five-year demonstration period. The waiver provides the North Carolina Department...more
On August 22, 2018, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter (SMDL) memorializing its long-standing budget neutrality policies requiring that waivers under Section 1115 of...more
On November 20, 2017, North Carolina submitted an amended 1115 waiver application to the Centers for Medicare & Medicaid Services (CMS) seeking authority to invest $1.2 billion over five years in a range of targeted...more
Congress is currently debating whether and how to repeal and replace the Affordable Care Act (ACA). This report provides an analysis of the potential impact to the State of Montana of a possible repeal of one portion of the...more
Since its inception, Medicaid has been fi nanced jointly by the federal and state governments. There are no caps on the federal government’s fi nancial obligations; federal funding is guaranteed as a share (known as a...more
President-elect Donald Trump and Republican congressional leadership have called for a repeal of the Affordable Care Act (ACA) and a fundamental overhaul of the Medicaid program that would include imposing caps on federal...more
Section 1332 Waivers: Will We See More State Innovation? -
Editor's Note: In a new essay for the National Institute of Health Care Management (NIHCM), summarized below, Manatt Health examines Section 1332 waivers and the...more
8/25/2016
/ 1332 Waiver ,
Assisted Suicide ,
Customer-Loyalty Programs ,
Department of Health and Human Services (HHS) ,
Discounts ,
Dispute Resolution ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Long Term Care Facilities ,
Medicaid ,
Off-Label Promotion ,
Patient Privacy Rights ,
PHRMA ,
Prescription Drug Coverage ,
Section 340B ,
Unfair or Deceptive Trade Practices
Editor's Note: This Manatt on Medicaid is the third in a series of updates focused on CMS's new Medicaid/CHIP managed care regulations. In the coming weeks, Manatt will be exploring key provisions of the regulations and...more
Better Late Than Never: CMS Provides Much-Needed Clarity on the 60-Day Overpayment Refund Requirements -
On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the long-awaited final rule (Final...more
2/26/2016
/ 60-Day Rule ,
ACOs ,
Affordable Care Act ,
Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
Certificate of Need ,
Health IT ,
Interstate Commerce ,
Knox Keene ,
License Agreements ,
Look-Back Measurement Period ,
Medicaid ,
Medicare Shared Savings Program ,
Overpayment Recovery Time Limits ,
Risk Allocation ,
Telehealth
Supporting Informed Decision Making in the Health Insurance Marketplace: A Progress Report -
Editor’s note: As Affordable Care Act (ACA) implementation moves forward and the marketplace continues to evolve, there is a...more
In a highly anticipated speech on January 22, 2015, the newly inaugurated Governor of Arkansas, Asa Hutchinson, laid out his vision for charting the future of Medicaid in Arkansas. Governor Hutchinson outlined a plan that...more