Patient Protection and Affordable Care Act (PPACA) Medicaid

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
News & Analysis as of

Manatt on Health Reform: Weekly Highlights

Welcome to the first publication of the “Manatt on Health Reform: Weekly Highlights” newsletter. Many of you are familiar with the healthcare reform tracking efforts and weekly newsletters we produced for the KidsWell...more

OIG Proposed Anti-Kickback Safe Harbors and CMP Regulations: The End of Frustration or Just the Beginning?

On October 3, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published an unexpected, yet long-awaited, set of proposed rules that would add new anti-kickback law safe harbors,...more

Sometimes the Government is Here to Help: OIG Proposes More Flexibility in Rules Governing Local Transportation, Beneficiary...

The U.S. Department of Health & Human Services, Office of Inspector General ("OIG") just released a proposed rule (“Proposed Rule”) that provides long awaited guidance on patient transportation services, relaxes the...more

Coverage and Delivery of Adult Substance Abuse Services in Medicaid Managed Care

Medicaid’s role in purchasing and delivering substance abuse services is changing dramatically. Prior to the implementation of the Affordable Care Act (ACA), most state Medicaid programs did not cover childless adults and...more

Hospital Mergers Pave The Way For Antitrust Training

Milton Friedman, an American economist and writer once said, “I was a great supporter of antitrust laws, I thought enforcing them was one of the few desirable things that the government could do to promote more...more

Health Reform + Related Health Policy News - September 2014, Issue 1

In This Issue: - Top News ..The Congressional Agenda is Light as the Focus Shifts to the Midyear Elections ..Physician Supervision Requirement for Small and Rural Hospitals ..CMS Offers Hospitals...more

North Carolina’s Medicaid RAC Program - Don't Let Your Guard Down

With Section 6411(a) of the Patient Protection and Affordable Care Act (ACA) and the Final Rules found at 42 CFR Part 455, the Recovery Audit Contractor (RAC) program has been expanded to the North Carolina Medicaid program,...more

CMS Approves Pennsylvania’s Medical Assistance (Medicaid) Waiver

CMS approved Pennsylvania’s Medical Assistance (“Medicaid”) waiver request entitled Healthy Pennsylvania (“Waiver” or “Healthy Pennsylvania”) by letter dated August 28, 2014. Governor Tom Corbett and the Pennsylvania...more

Manatt on Medicaid: Pennsylvania Receives Federal Approval to Implement Medicaid Expansion

On August 28, 2014, the Centers for Medicare and Medicaid Services (CMS) approved Pennsylvania’s application under Section 1115 of the Social Security Act to implement a Medicaid expansion effective January 1, 2015, through a...more

Academic Medical Centers: Clinical Care, Research and Teaching (or Maybe Not?)—Graduate Medical Education and the Future

In the world of healthcare policy and law, we usually discuss issues impacting providers, but don’t often report about the training and infrastructure behind what allows our healthcare system to treat patients in our...more

Software Glitch Sparks FCA Suit Against Hospitals for Late Repayment of Medicaid Reimbursements

On June 27, the New York Attorney General’s Office and the U. S. Attorney’s Office for the Southern District of New York intervened in a qui tam suit against Continuum Health Partners, Inc., Beth Israel Medical Center and St....more

Health Care Update - July 2014 #2

In This Issue: - Obama Administration Ramps up Efforts to Reduce Medicaid Spending - Senators Press Gilead on Sovaldi - Implementation of the Affordable Care Act - Other Federal Regulatory...more

Do Subsidized Health Care Plans Purchased Under the Affordable Care Act Trigger the Anti-Kickback Statute?

The advent of federally subsidized private pay health insurance under the Affordable Care Act has the potential to expand the application of the federal anti-kickback statute beyond just Medicare, Medicaid, and Tricare. The...more

The Government Intervenes In False Claims Act Case Alleging Failure To Return Overpayments Within 60 Days

On June 27, 2014, the United States intervened in a qui tam action under the False Claims Act alleging that certain New York hospitals failed to refund Medicaid overpayments within 60 days of identifying them, as required by...more

Healthcare Legal News - July 2014 • Volume 4, Number 2

In This Issue: - DO SUBSIDIZED HEALTH CARE PLANS PURCHASED UNDER THE AFFORDABLE CARE ACT TRIGGER THE ANTI-KICKBACK STATUTE? The advent of federally subsidized private pay health insurance under the Affordable...more

Manatt on Medicaid: The Emerging Conversation About the Future of CHIP

During passage of the Affordable Care Act (ACA), a debate erupted over the future of the Children’s Health Insurance Program (CHIP), a well-established program that now offers coverage to 8 million children in low- and...more

Two Significant Decisions Affecting Employers Issued the Final Day of the U.S. Supreme Court Session

On the last day of its 2013-2014 session, the U.S. Supreme Court held today that (1) for-profit companies are protected as "persons" under the federal Religious Freedom Restoration Act of 1993 (RFRA) and (2) that the...more

Health Care Update - June 2014 #3

In This Update: - CMS Getting New Leadership Roles - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other...more

Healthcare Providers Face Increasing Financial Pressure and Bankruptcy Risk

The health of the healthcare industry can be summarized as follows: as go federal reimbursement rates, so goes the financial viability of healthcare providers, whether hospitals, nursing homes or medical practices. These...more

Medicaid Enrollment Continues to Grow

The U.S. Department of Health and Human Services (HHS) has reported that at the close of April, an additional 6 million Americans have enrolled in Medicaid and related health programs for the poor since the launch of coverage...more

Manatt on Medicaid: Addressing Patients’ Social Needs: An Emerging Business Case for Provider Investment

Social and economic factors such as income, educational attainment, access to food and housing, and employment status have a profound impact on health. In fact, these nonmedical factors account for as much as 40 percent of...more

Health Care Reform Implementation Update

Affordable Care Act (ACA) action on Capitol Hill this past week centered on investigations into improper ACA subsidy payments, a potential constitutional amendment proposal, and support for an appeal of the ACA in favor of a...more

CMS Changes to Medicare Advantage and Prescription Drug Benefit Programs for Contract Year 2015

On May 19, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule, published in the Federal Register on May 23, 2014, that sets forth changes to requirements for Medicare Advantage (“MA”) and...more

Weekly Update from the SC State House - May 2014: The House joined the Senate for a Joint Assembly on Wednesday to elect a number...

Details from Each Chamber: HOUSE - The House worked through the Calendar this week, joining the Senate for a Joint Assembly on Wednesday to elect a number of judges. Tuesday, the House cleared some of their...more

OIG Proposes Updates to Exclusion and CMP Authority

The Department of Health and Human Services, Office of Inspector General (OIG) recently issued a pair of proposed regulations to update its exclusion and civil monetary penalty (CMP) authority. The proposed regulations...more

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