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
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
Several states are considering or have enacted legislation to create prescription drug affordability boards (PDABs)....more
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
5/7/2024
/ Artificial Intelligence ,
Equity ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Reform ,
Inflation Reduction Act (IRA) ,
Legislative Agendas ,
Mental Health ,
No Surprises Act (NSA) ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Physicians ,
Preventive Health Care ,
Provider Payments ,
Regulatory Requirements ,
Reimbursements ,
Webinars
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
4/22/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Data Privacy ,
Data-Sharing ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Lead Generators ,
Marketing ,
Medicare ,
Medicare Advantage ,
PHI ,
Third-Party
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
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
9/25/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Food & Drug Regulations ,
Food and Drug Administration (FDA) ,
Health Insurance ,
Healthcare ,
Life Sciences ,
Medicare ,
Medicare Part D ,
Pharmaceutical Industry ,
Prescription Drugs
From the end of the COVID-19 public health emergency (PHE) to the overturning of Roe v. Wade to the skyrocketing growth of virtual care, multiple forces are converging to remap the health care landscape. In a new webinar,...more
9/15/2023
/ Abortion ,
Children's Health Insurance Program (CHIP) ,
Continuous Coverage ,
Health Care Providers ,
Healthcare Reform ,
Inflation Reduction Act (IRA) ,
Legislative Agendas ,
Medicaid ,
Mental Health Parity Rule ,
No Surprises Act (NSA) ,
Non-Discrimination Rules ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Preventive Health Care ,
Provider Payments ,
Public Health Emergency ,
Regulatory Agenda ,
Reproductive Healthcare Issues ,
Roe v Wade ,
Shield Laws ,
Webinars
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
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
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
3/28/2023
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Continuing Legal Education ,
Enforcement ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Medical Necessity ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Medicare Beneficiaries ,
New Rules ,
Risk Adjustment Formula ,
Webinars
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
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
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
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
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
9/26/2022
/ Abortion ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Healthcare Reform ,
Legislative Agendas ,
Prescription Drugs ,
Regulatory Agenda ,
Reproductive Healthcare Issues ,
State Elections ,
Webinars
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
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
9/7/2022
/ Biosimilars ,
Continuing Legal Education ,
Drug Pricing ,
Generic Drugs ,
Health Care Providers ,
Inflation Reduction Act (IRA) ,
Manufacturers ,
Medicaid ,
Medicare ,
Medicare Beneficiaries ,
Medicare Part D ,
New Regulations ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Section 340B ,
Webinars
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
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
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 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
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
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
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
5/3/2022
/ Coronavirus/COVID-19 ,
Digital Health ,
Disparate Impact ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Reform ,
Healthcare Workers ,
Hospitals ,
Long Term Care Facilities ,
Mental Health ,
Patient Access ,
Pharmaceutical Industry ,
PHI ,
Physicians ,
Public Health ,
Webinars