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Government Will Seek Supreme Court Review of Preventive Services Decision

On August 27, the government filed a motion indicating that it intends to seek Supreme Court review of the U.S. Court of Appeals for the Fifth Circuit’s decision in Braidwood Management v. Becerra. In June, the Fifth Circuit...more

Five Things to Watch When First “Maximum Fair Prices” for Selected Drugs Announced

The Centers for Medicare & Medicaid Services (CMS) is required to make public by September 1 the “maximum fair prices” (MFP) that CMS is setting for the first ten drugs subject to the Medicare Drug Price Negotiation Program...more

Understanding State Prescription Drug Affordability Board Landscape in Three Infographics

Several states are considering or have enacted legislation to create prescription drug affordability boards (PDABs)....more

[Webinar] The Regulatory and Legislative Trends Reshaping Health Care - May 16th, 10:00 am - 11:00 am PST

From the end of the COVID-19 public health emergency (PHE) to the overturning of Roe v. Wade to the growth of AI in health care, multiple forces are converging to remap the health care landscape. In a new webinar, Manatt...more

CMS Restricts Marketing Companies From Sharing Medicare Beneficiary Data

Half of Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans. This extensive growth, which represents a doubling of MA enrollment since 2010, has been driven in part by an extensive network of insurance agents...more

[Webinar] Understanding the State Prescription Drug Affordability Board Landscape in 2024 - February 27th, 10:00 am - 11:00 am PT

Several states are considering or have enacted legislation to create prescription drug affordability boards (PDABs). Although their powers vary by state, PDABs are generally charged with assessing the affordability of...more

Anti-Obesity Medications as Medicare Part D Drugs - Legal and Health Policy Rationales

Obesity is a complex, multifactorial disease that has serious health consequences, affects millions of Americans and drives hundreds of billions of dollars in annual health care spending. Scientific understanding of the...more

Upcoming Regulatory Changes Associated With the End of the PHE

At 11:59 p.m. on Thursday, May 11, 2023, the COVID-19 public health emergency (PHE) declaration will conclude, more than three years after taking effect in January 2020. The PHE declaration has enabled the U.S. Department of...more

District Court Blocks ACA Provision Mandating Coverage of Preventive Services

The Affordable Care Act (ACA) requirement for commercial coverage of certain preventive services without cost sharing is unenforceable, according to a March 30 decision in Braidwood Management, Inc. v. Becerra by Judge Reed...more

[Webinar] Navigating the Rapidly Changing Medicare Advantage Regulatory Landscape - April 11th, 1:00 pm - 2:00 pm ET

Medicare Advantage (MA) plans now cover about half of Medicare beneficiaries, and with that enrollment growth has come increased scrutiny from federal and state regulators. As federal regulators complete a busy season of...more

What Changes if the COVID-19 Public Health Emergency Ends May 11

The Biden Administration has announced that May 11, 2023, will be the final day of the COVID-19 public health emergency (PHE) declaration, which has been in effect since January 2020. Following the White House’s announcement...more

CMS Finalizes Medicare Advantage Risk Adjustment Rule

On January 30, the Centers for Medicare & Medicaid Services (CMS) released a long-awaited final rule addressing how it will calculate and collect overpayments from Medicare Advantage (MA) plans arising from risk adjustment...more

What Health Plans Should Know About Federal Changes for Dual Eligibles (UPDATED)

Editor’s Note: Approximately 12 million people in the United States are dually eligible for both Medicare and Medicaid. Most dual-eligible individuals live below the poverty line and have complex health needs. Because...more

What Health Plans Should Know About Federal Changes for Dual Eligibles

Approximately 12 million people in the United States are dually eligible for Medicare and Medicaid. Because dual-eligible individuals and health plans serving this population must navigate two disparate coverage programs,...more

[Webinar] What Will the Midterm Elections Mean for Health Care? - September 28th, 1:00 pm - 2:00 pm ET

Americans are strongly focused on the upcoming midterm elections. An NBC News survey shows that 68% of Republicans and 66% of Democrats are expressing high interest in the midterms. Which issues are most critical to voters...more

No Surprises Act Final Rule Addresses Dispute Resolution Provisions Invalidated by District Court

The Big - Picture On August 19, the Biden Administration released a final rule on the No Surprises Act (NSA) that primarily addresses regulatory provisions invalidated by the United States District Court for the Eastern...more

[Webinar] Implications Across the Health Care System of the New Federal Drug Price Regulation - September 22nd, 1:00 pm - 2:00 pm...

The Inflation Reduction Act of 2022 (IRA) includes the most dramatic change to U.S. drug price regulation in history. The new law allows the federal government to “negotiate” the price of many drugs dispensed to Medicare...more

The Inflation Reduction Act: Medicare Part D Benefit Redesign

On August 16, President Joe Biden signed into law H.R. 5376 , the Inflation Reduction Act of 2022, which makes arguably the most significant changes to U.S. prescription drug price regulation ever, including by...more

The Inflation Reduction Act: Implementation of the Medicare Prescription Drug Inflation Rebates

On August 16, President Joe Biden signed into law H.R. 5376 , the Inflation Reduction Act of 2022, which makes arguably the most significant changes to U.S. prescription drug price regulation ever, including by...more

The Inflation Reduction Act: Implementation of Prescription Drug Medicare Price Regulation

On August 16, President Joe Biden signed into law H.R. 5376, the Inflation Reduction Act of 2022, which makes arguably the most significant changes to U.S. prescription drug price regulation ever, including by...more

Biden Administration Proposes Substantial Revisions to Health Care Nondiscrimination Rules

The Big Picture - On July 25, the Department of Health and Human Services (HHS) released a proposed rule interpreting Section 1557 of the Affordable Care Act (ACA), which prohibits any health program or activity that...more

Major Issues for Compliant Health Care Billing Practices Under the No Surprises Act

Editor’s Note: In a recent articlefor Health Law Weekly, summarized below, Manatt Health examines the implementation challenges of the No Surprises Act (NSA)—and shares three key areas providers should focus on to ensure...more

CMS Revives Standardized Plans and Federal Network Adequacy Review

The Centers for Medicare & Medicaid Services (CMS) released the final 2023 Notice of Benefit and Payment Parameters (NBPP), the annual rule outlining key policies for the individual and group health insurance markets for plan...more

[Webinar] Ten Health Care Imperatives for the 2020s: Navigating Through the Surges - May 24th, 12:00 pm - 1:00 pm ET

In January 2021, Manatt Health described the ten health care imperatives essential for improving our health care system and advancing health equity in the 2020s. Now two years into the decade, we have released our 2022...more

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