News & Analysis as of

Health Care Providers Healthcare Medicaid

Manatt, Phelps & Phillips, LLP

Community Reinvestment: Forging New Partnerships in Medicaid

At least 10 states have implemented, or are in the process of implementing, a community reinvestment requirement in which Medicaid managed care organizations (MCOs) are required to reinvest in the communities they serve to...more

Alston & Bird

Health Care Week in Review: Biden Administration Announces $100 Million for ACA Marketplace Navigators and $81.3 Million for...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Manatt, Phelps & Phillips, LLP

CMS Releases Guidance to Promote Continuity of Coverage for Individuals Receiving HCBS

On August 19, the Centers for Medicare & Medicaid Services (CMS) released a Center for Medicaid and CHIP Services (CMCS) Informational Bulletin (CIB) and an accompanying slide deck reminding states of their obligation to...more

McCarter & English, LLP

CMS Adopts New Age-Friendly Hospital Measure for Care of Older Adults for CY 2025 Reporting

The Centers for Medicare & Medicaid Services (CMS) has adopted an age-friendly quality hospital measure in its most recent final rule addressing prospective payment systems, policy changes, and quality program requirements...more

Epstein Becker & Green

CMS Issues Mandatory “TEAM Model” for Acute Care Hospitals to Improve Episode-Based Alternative Payments and Advance Accountable...

Epstein Becker & Green on

On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released a final rule updating the Medicare inpatient prospective payment system (IPPS) for acute care hospitals and the Medicare prospective payment...more

Alston & Bird

Health Care Week in Review: CMS Finalizes the TCET Pathway for Breakthrough Technologies; HRSA Awards Health Centers Funding for...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Alston & Bird

Health Care Week in Review: CMS Finalizes FY 2025 Payment Rules for Inpatient Hospitals, Inpatient Rehab Facilities, Inpatient...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Manatt, Phelps & Phillips, LLP

New CMS Guidance on the Provision of Medicaid and CHIP Services to Incarcerated Children and Youth

This is an excerpt from a recent Manatt article published on State Health & Value Strategies. Click here to download insight. On July 23, 2024, the Centers for Medicare & Medicaid Services (CMS) released a State Health...more

Manatt, Phelps & Phillips, LLP

CMS Approves Seven Reentry Section 1115 Demonstrations in July

In July, the Centers for Medicare and Medicaid Services (CMS) approved seven new Reentry Section 1115 Demonstrations in Illinois, Kentucky, New Hampshire, New Mexico, Oregon, Utah, and Vermont. These states join California,...more

Manatt, Phelps & Phillips, LLP

CMS Releases Technical Guidance to States on Complying with Medicaid Access Final Rule

On July 12, CMS released a companion guide to the Ensuring Access to Medicaid Services final rule (the “Access Final Rule”). This technical guidance—which focuses on the provisions regarding fee-for-service (FFS) payment...more

Nelson Mullins Riley & Scarborough LLP

Medicaid Overpayment Audits: What Medical Providers Need to Know

The Audit Process - While Medicaid audits are meant to ensure integrity and efficiency of the Medicaid Program, they can often be incredibly cumbersome and challenging for medical providers to navigate. During an audit,...more

Alston & Bird

Health Care Week in Review: CMS Releases Final Medicare Prescription Payment Plan Part 2 Guidance

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Alston & Bird

Health Care Week in Review: CMS Issues Calendar Year 2025 Proposed Medicare Payment Rules for Physicians and Hospitals

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott Will & Emery

Trending in Telehealth: July 2 – 8, 2024

McDermott Will & Emery on

Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate...more

Alston & Bird

Health Care Week in Review: Senate Democrats Released Draft Legislation to Prevent Labor and Delivery Unit Closures; CMS Announced...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Troutman Pepper

Massachusetts AG Secures Landmark $4M Settlement Over Alleged Staffing Violations

Troutman Pepper on

Massachusetts Attorney General (AG) Andrea Joy Campbell announced a $4 million settlement with Next Step Healthcare, LLC (Next Step), a Massachusetts-based long-term care management company, in a deal that the AG described as...more

Ankura

OIG Testimony Puts a Spotlight on Clinical Documentation and Payer Risk

Ankura on

In recent testimony before the United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Christi A. Grimm, Inspector General of the Department of Health and Human Services (HHS)...more

McCarter & English, LLP

New Jersey Statutory Update Part II

Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more

McDermott Will & Emery

Trending in Telehealth: May 28 – June 3, 2024

McDermott Will & Emery on

Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate...more

McDermott+

Second Annual CMS Health Equity Conference: Key Takeaways

McDermott+ on

The Centers for Medicare & Medicaid Services (CMS) recently hosted its second annual CMS Health Equity Conference on May 29 – 30, 2024, focusing on the theme “sustaining health equity through action.” The event was a...more

McDermott+

CMS Hosts Health Equity Conference: Key Insights and Perspectives

McDermott+ on

Last week, the Centers for Medicare & Medicaid Services (CMS) held the second annual CMS Health Equity Conference. The event drew several hundred in-person attendees, including my colleague Kayla Holgash, and thousands of...more

Manatt, Phelps & Phillips, LLP

2024 Medicaid in Montana - How Medicaid Impacts Montana’s State Budget, Economy, and Health

Montana Medicaid provides health care coverage to nearly 300,000 Montanans, including low-income children, pregnant women, people with disabilities, and adults. We produce the Medicaid in Montana annual report to help...more

Troutman Pepper

North Carolina Attorney General Reaches $500,000 Settlement in False Claims Act Lawsuit Against Health Care Providers

Troutman Pepper on

North Carolina Attorney General Josh Stein and the U.S. Attorney’s Office for the Middle District of North Carolina have reached a $500,000 settlement with Sharon Raynes Halliday and RAPHA Healthcare Services LLC, resolving a...more

Quarles & Brady LLP

DOJ Enforcement:  Urine Drug Testing

Quarles & Brady LLP on

On April 11, 2024, a jury convicted Northern Kentucky Center for Pain Clinic owner Dr. Timothy Ehn (who was not a medical doctor) and medical director, Dr. William Lawrence Seifert, for their roles in a scheme that defrauded...more

Akerman LLP - Health Law Rx

When a Gift Becomes a Kickback: Gifts from Florida Pharmacies to Long-Term Care Facilities

The Florida Board of Pharmacy permits pharmacies serving residents and patients at long-term care facilities (nursing homes, ALFs, homes for DD residents, etc.) as either Special Closed System Pharmacies or Community...more

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