News & Analysis as of

President Signs MACRA: Permanently Reforms Medicare Physician Reimbursement Framework, Includes Other Medicare Payment, Program...

On April 16, 2015” (MACRA), which reforms Medicare payment policy for physician services and adopts a series of policy changes affecting a wide range of providers and suppliers. Most notably, MACRA permanently repeals...more

CMS’s Proposes Rule On Mental Health Parity to Strengthen Access to Medicaid and CHIP Plans

On April 6, 2015, CMS announced a proposed rule intended to align mental health and substance use disorder benefits for low-income Americans with benefits required of private health plans and insurance. The proposed rule...more

CMS Issues Proposed Rule That Would Extend Provisions of Mental Health Parity

On April 6, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule that would extend provisions of the Mental Health Parity and Addiction Equity Act of 2008 (the “Mental Health Parity Act”) to...more

Washington Healthcare Update

This Week: Montana Legislature Reverses Course, Endorses Medicaid Expansion... Final 2016 Medicare Advantage and Part D Rate Announcement and Call Letter... Upcoming: Energy and Commerce Subcommittee Hearing on Post-Acute...more

Permanent Doc Fix Bill Approved by House; Senate to Vote in Coming Weeks

Last week, the U.S. House of Representatives overwhelmingly voted 392-37 to approve the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2), a bill that would, among other things, permanently replace the sustainable...more

Washington Healthcare Update

This Week: House Approves FY 2016 Budget Proposal... House Passes Permanent SGR Reform and Two-Year CHIP Reauthorization... Senate Passes FY 2016 Budget Plan... HHS Report: ACA Led to $7.4 Billion Decline in Uncompensated...more

Health Care Update - March 2015

In This Issue: - King v. Burwell before the Supreme Court and the Potential Congressional Response - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

CMS Extends Moratoria on Enrollment of New Providers and Suppliers in Six Locales

Last week, CMS announced that it has extended temporary moratoria on the enrollment of new ambulance suppliers and home health agencies within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania,...more

Manatt on Health Reform: Weekly Highlights: November 2014 #4

In this week’s highlights, new proposed guidance from the feds would allow default renewals to lower cost plans and bring enhanced transparency to Qualified Health Plan rate increases; open Enrollment hits its stride –...more

Health Care Reform Implementation Update

Looming midterm elections have made the past several months difficult for Democrats and Republicans alike when it comes to the Affordable Care Act. With most of the midterm elections now wrapped up, lawmakers can turn their...more

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

Manatt on Medicaid: CMS Launches Medicaid Innovation Accelerator Program to Advance Delivery System Reform

On July 14 the Centers for Medicare & Medicaid Services (CMS) announced the Medicaid Innovation Accelerator Program (IAP), an initiative to provide $100 million in federal funding for technical assistance (TA) to states to...more

Is $210 Million Enough? How About $54.2 Million?

On June 25, 2014, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) issued and certified, as required by the Small Business Jobs Act of 2010...more

Medicare's LTCH Moratorium - CMS Issues Instructions and Proposed Regulation

From the early 1980s until the end of the first decade of the 21st century, the number of long-term acute care hospitals (LTCHs) expanded many fold. Addressing this growth, Congress, in enacting the Medicare, Medicaid and...more

Health Care Reform Implementation Update - April 21, 2014

On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) reported their findings that show a smaller rise in insurance premium costs under the Affordable Care Act (ACA) than previously...more

Manatt on Medicaid: The Numbers

Even as the news media tries to untangle the latest data on Marketplace enrollment, an equally important and still-evolving story is playing out on the Medicaid side of the open enrollment equation. According to a Centers for...more

CMS Releases Long-Awaited Details for Sunshine Act Compliance

The Physician Payment Sunshine Act (the "Act") was enacted as part of the Patient Protection and Affordable Care Act for the purpose of promoting transparency between the medical industry and health care providers. It...more

CMS Final Rule on Moratoria for the Enrollment of New Home Health Agencies and Ambulance Suppliers and Providers

On February 4, 2014, the Centers for Medicare and Medicaid Services (CMS) issued in the Federal Register a notice of temporary moratoria on enrollment of new home health agencies (HHA) and ambulance suppliers and providers in...more

Health Care Reform Implementation Update - December 19, 2013

The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014...more

Health Care Reform Implementation Update - August 12, 2013

The House Energy and Commerce Committee voted unanimously on legislation that would repeal the sustainable growth rate (SGR) formula that has historically led to annual decreases in physician payments that are fixed at the...more

CMS Imposes Six-Month Moratoria on New Enrollments of Home Health Agencies and Ambulance Suppliers in Three Fraud “Hot Spots”

Last week, CMS announced temporary moratoria on the enrollment of new home health providers and ambulance suppliers in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) in three fraud “hot spots.”...more

CMS Issues Final Rule on Medicaid and Children’s Health Insurance Program Eligibility Provisions, Appeals, and Related...

On July 5, 2013, CMS issued a final rule supplementing the Exchange final rule, reflecting new statutory eligibility provisions and implementing changes related to Medicaid and the Children’s Health Insurance Program (CHIP)...more

Health Care Reform Implementation Update - July 16, 2013

Capitol Hill and the agencies went back and forth last week on the impact and consideration involved in delaying the Affordable Care Act’s (ACA) employer mandate; votes in the House are expected this week on it, as well as a...more

Sunshine Act Requires Reporting All Payments to Physicians

Beginning August 1, 2013, manufacturers of Medicare or Medicaid covered drugs, medical devices, biologicals and medical supplies must collect and make publicly available data on physicians and teaching hospitals with whom the...more

CMS Announces $1 Billion in Funding for Innovation Grants

On May 15, 2013, CMS released a funding opportunity announcement for round two of the Health Care Innovation Awards. The grants are administered by the CMS Innovation Center, which is authorized by the Affordable Care Act to...more

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