Affordable Care Act, Centers for Medicare & Medicaid Services (CMS), Waivers

CMS Issues IPPS and LTCH PPS Final Rule for FY 2024

King & Spalding on 8/9/2023

On August 1, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule for FY 2024 (the Final Rule). In the Final Rule, CMS,...more

Federal Government Approves Georgia’s State Relief and Empowerment Waiver

King & Spalding on 11/13/2020

On November 1, 2020, CMS and the Department of the Treasury approved Georgia’s request for a 1332 State Relief and Empowerment waiver (1332 waiver), permitting the state to implement a new healthcare plan to address growing...more

Trump Administration Approves Georgia’s Limited Expansion of Medicaid and Work Requiremen

King & Spalding on 10/23/2020

CMS approved Georgia’s Section 1115 demonstration project to partially expand Medicaid coverage for adults not otherwise eligible for Medicaid coverage with incomes up to 95 percent of the Federal Poverty Line (FPL)—short of...more

A Review of the Affordable Care Act at 10 Years, Part 4: Alternative Payment and Delivery Models

Mintz - Health Care Viewpoints on 4/14/2020

Today's post is the last in our series on the 10-year anniversary of the Affordable Care Act (ACA). While the Congress that passed the ACA recognized that health care delivery reform was necessary, the law included few...more

CMS Releases Tools to Support States’ Medicaid and CHIP Programs During the COVID-19 Outbreak

King & Spalding on 4/1/2020

On March 22, 2020, CMS announced a suite of four new tools intended to help states combat the coronavirus by allowing states to streamline enrollment into long-term care and home-based services and by expediting application...more

South Carolina Receives Approval from CMS to Implement Medicaid Work Requirements

King & Spalding on 12/27/2019

On December 12, 2019, CMS approved South Carolina’s proposal for a demonstration project that would add work, or community engagement, requirements as part of the eligibility determinations for the state’s Medicaid plan. ...more

Georgia Releases Section 1332 and 1115 Waivers

Manatt, Phelps & Phillips, LLP on 11/26/2019

On November 4, Georgia released two draft waiver applications for public comment—a Section 1332 State Relief and Empowerment Waiver (“1332 waiver”) to restructure the state’s individual insurance market and a Section 1115...more

CMS Releases New Tools to Aid Applicants for State Relief and Empowerment Waivers

King & Spalding on 7/26/2019

On July 15, 2019, CMS released new resources, which are available here, that are intended to support states as they apply for waivers under Section 1332 of the Affordable Care Act. These materials follow guidance issued by...more

New 1332 Guidance Gives States Lots to Think About

Manatt, Phelps & Phillips, LLP on 2/25/2019

Editor’s Note: While Democratic victories in the U.S. House have fueled national conversations about some variant of Medicare for all, most of the policy change in the near term is likely to continue to be at the state level....more

2019: What to Expect in Health Care Policy

Baker Donelson on 2/12/2019

Health care issues will remain a central focus in Washington throughout 2019. Having gained control of the House following the 2018 mid-term elections, Democrats now have the ability to block President Trump's legislative...more

Manatt on Health: October 2017

Manatt, Phelps & Phillips, LLP on 10/11/2017

Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary - On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its...more

Manatt on Health: August 2017

Manatt, Phelps & Phillips, LLP on 8/8/2017

Next Steps on Healthcare Reform - Though President Trump has continued to call for action on repeal and replace in the wake of the Senate’s failed vote at the end of July, congressional Republicans have been fairly muted...more

Wisconsin Releases Draft Waiver Amendment Proposing New Eligibility Requirements

Manatt, Phelps & Phillips, LLP on 4/24/2017

On April 19, 2017, Wisconsin released for public comment a proposed amendment to its BadgerCare Reform Section 1115 demonstration. BadgerCare Reform currently provides coverage to approximately 150,000 childless adults ages...more

Manatt on Medicaid: Monthly Expansion Recap, March 2017 #2

Manatt, Phelps & Phillips, LLP on 3/31/2017

Arkansas - Governor Proposes Changes to Medicaid Expansion Waiver as House Passes Bill to Cap Expansion Enrollment - Governor Asa Hutchinson (R) released a proposal to amend the State's Medicaid expansion waiver by...more

Manatt on Health Reform: Weekly Highlights - March 2017

Manatt, Phelps & Phillips, LLP on 3/10/2017

House Republicans release long-awaited ACA repeal and replace legislation, Arkansas proposes a new waiver amendment to lower expansion adult eligibility levels, and California and Maine are considering new policies to tackle...more

Manatt on Medicaid: Monthly Expansion Recap - March 2017

Manatt, Phelps & Phillips, LLP on 3/3/2017

Arizona - Appeals Court Hears Arguments in Medicaid Expansion Lawsuit - A three-judge State Appeals Court panel heard an appeal of the Maricopa County Superior Court's decision that Arizona's Medicaid expansion plan...more

Medicaid Outlook: Policy and Regulatory Change in 2017

Epstein Becker & Green on 2/17/2017

Perspectives on Health Care and Life Sciences - Medicaid has been a vital part of the American health care safety net for more than 50 years. Today, Medicaid, along with the State Children’s Health Insurance Program...more

Manatt on Health Reform: Weekly Highlights - October 2016

Manatt, Phelps & Phillips, LLP on 10/5/2016

Vermont moves closer to launching the country’s first all-payer ACO; CMS approves Arizona’s 1115 waiver extension but rejects the State’s proposed work requirement and premiums for those earning below the FPL; and CMS issues...more

Medicaid Managed Care Transitions’ Impact On Brain Injury Waiver Populations

Mintz - ML Strategies on 9/9/2016

As of June 2015, 24 states utilize a traumatic or acquired brain injury waiver,1 as provided under section 1915(c) of the Social Security Act, which are designed to help individuals with traumatic brain injury (TBI) live in...more

Manatt on Medicaid: Monthly Expansion Recap - August 2016

Manatt, Phelps & Phillips, LLP on 8/27/2016

California - Medicaid Enrollees Are Largest Share of Newly Insured - A new survey from the Kaiser Family Foundation found that 33% of Californians uninsured in 2013 are now enrolled in Medi-Cal, the State’s Medicaid...more

Manatt on Health Reform: Weekly Highlights - August 2016 #3

Manatt, Phelps & Phillips, LLP on 8/17/2016

CMS’s risk adjustment program data signals an improving risk pool while the agency announces plans to modify the program; California enrolls 134,000 undocumented immigrant children into Medicaid; and Oregon approves increases...more

Manatt on Health Reform: Weekly Highlights - July 2016 #4

Manatt, Phelps & Phillips, LLP on 7/27/2016

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

Manatt on Health Reform: Weekly Highlights - June 2016#3

Manatt, Phelps & Phillips, LLP on 6/15/2016

CMS targets short-term insurance plans in efforts to stabilize the individual market risk pool; Illinois mandates Medicaid coverage for opioid addiction treatment; and Michigan seeks to restructure State Medicaid financing....more

Manatt on Health Reform: Weekly Highlights - April 2016 #3

Manatt, Phelps & Phillips, LLP on 4/20/2016

Funding for Arkansas' Medicaid expansion hangs in limbo; Tennessee's House Speaker appoints Medicaid reform task force in light of public groundswell; and CMS delays requirement for State-based SHOP online enrollment....more

Manatt on Marketplaces: Vermont Posts State Innovation Proposal to Waive SHOP Requirement

Manatt, Phelps & Phillips, LLP on 3/5/2016

Vermont posted a draft 1332 waiver proposal for public comment on February 8, 2016. Vermont proposes to eliminate the ACA requirement that small employers enroll through a Small Business Health Options Program (SHOP) web...more

Patient Protection and Affordable Care Act (PPACA) › Centers for Medicare & Medicaid Services (CMS) › Waivers

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