News & Analysis as of

Health Care Providers MCOs

McDermott+

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

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Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

Manatt, Phelps & Phillips, LLP

[Webinar] Final Medicaid Rules, Part Three: Home and Community Based Services - June 4th, 10:00 am - 11:00 am PT

This program is part three of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

Manatt, Phelps & Phillips, LLP

[Webinar] Final Medicaid Rules, Part Two: Managed Care Payments, Quality and Oversight - May 21st, 12:00 pm - 1:00 pm PT

This program is part two of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

Manatt, Phelps & Phillips, LLP

[Webinar] Final Medicaid Rules, Part One: Access, Enrollee Engagement and Provider Payment Transparency - May 14th, 12:00 pm -...

This program is part one of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

Bass, Berry & Sims PLC

[Webinar] 9th Annual Nashville Healthcare Fraud Conference - December 14th - 15th, 9:00 am - 2:00 pm CST

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Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more

Bass, Berry & Sims PLC

[Event] 9th Annual Nashville Healthcare Fraud Conference - December 7th, Nashville, TN

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Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more

Bass, Berry & Sims PLC

New 2025 Medicare Advantage Proposed Rule Further Scrutinizes Marketing Practices, Expands Behavioral Health, and Promotes Health...

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On November 15, CMS published a proposed rule, which, as currently written, has potentially significant implications for Medicare Advantage (MA) plans and Medicare Prescription Drug Benefit Program (PDP) plans in Contract...more

Holland & Knight LLP

Holland & Knight Health Dose: July 25, 2023

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

McDermott+

McDermottPlus Check-Up: July 21, 2023

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The House and Senate were both in session this week, with healthcare activity at the committee level. The House Energy and Commerce Committee held a hearing on innovation and a markup of 15 healthcare bills. The Senate...more

Morgan Lewis - Health Law Scan

Don’t Wait to Review CMS’s Proposal to Implement Minimum Managed Care Appointment Wait Times

The Centers for Medicare & Medicaid Services (CMS) proposed on April 23, 2023 two rules that would affect Medicaid managed care: Ensuring Access to Medicaid Services (CMS 2442-P) and Medicaid and Children’s Health Insurance...more

McDermott Will & Emery

Proposed Legislation Would Require Greater Transparency and Disclosure from Hospitals, Reduce Reimbursement to Certain Off-Campus...

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Two bills are moving in the United States House of Representatives that have implications for hospitals and health systems, with material changes proposed regarding pricing transparency requirements, identification and...more

Manatt, Phelps & Phillips, LLP

Prenatal Vaccines in Medicaid and CHIP: Coverage, Reimbursement and State Policy Solutions

Editor’s Note: In a new white paper funded by Pfizer, Inc., Manatt Health discusses the current landscape of Medicaid and Children’s Health Insurance Program (CHIP) coverage and reimbursement for prenatal vaccines, informed...more

Manatt, Phelps & Phillips, LLP

[Webinar] Prenatal Vaccines in Medicaid & CHIP: Current State Payment Rates and Strategies to Increase Access - June 8th, 2:00 pm...

Prenatal vaccines provide important protection for pregnant women and newborns against communicable diseases such as whooping cough and influenza. However, fewer than one out of four pregnant women receives all federally...more

Manatt, Phelps & Phillips, LLP

Prenatal Vaccines in Medicaid and CHIP: Coverage, Reimbursement, and State Policy Solutions to Increase Access

Prenatal vaccines—those administered during a pregnancy—provide crucial protections to pregnant women and/or newborns against communicable diseases such as whooping cough and influenza. Additional prenatal vaccines are in...more

American Conference Institute (ACI)

[Event] 14th Annual Advanced Forum on Managed Care Disputes and Litigation - March 29th - 30th, Chicago, IL

Hosted by ACI, 14th Annual Advanced Forum on Managed Care Disputes and Litigation returns for another exciting year with curated programming that will help you make sense of these developments, and their profound impact on...more

Harris Beach PLLC

New York Issues Technical Specifications Manual that Addresses Medicaid Payment Reporting

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The New York Department of Health (DOH) announced March 8 that the 2022-2023 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual is available....more

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: OMIG's FINALIZED Regulations: What You Need to Do - NOW! - February 9th, 12:00 pm - 1:00 pm ET

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Please join us on February 9 as Partner Bob Hussar and Associates Ashley Algazi and Mary Connolly present on OMIG’s finalized regulations. On December 28th, the Office of Medicaid Inspector General (OMIG) released their...more

Foley Hoag LLP - Medicaid and the Law

Medicaid and the LawFoley Hoag LLP CMS Approves Two New Medicaid Waivers to Expand Coverage, Provide Flexibilities

On September 28, 2022, the Centers for Medicare & Medicaid Services (CMS) issued approval letters for Section 1115 Medicaid demonstration applications previously submitted by Oregon and Massachusetts. Section 1115 waivers...more

Foley & Lardner LLP

Managed Care & the FCA: Are Courts Getting It Right?

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Courts are grappling with unique questions in the context of managed care programs in False Claims Act (FCA) cases. But are they getting it right? Two questions trending in courts relate to: (1) materiality under the FCA when...more

Manatt, Phelps & Phillips, LLP

OMIG Proposes Omnibus Regulations Impacting Medicaid Providers’ and Plans’ Compliance Obligations

On July 13, 2022, the New York State Office of Medicaid Inspector General (OMIG) published proposed rules in the New York State Register to implement provisions of the State Fiscal Year 2020-2021 Enacted Budget and the...more

Manatt, Phelps & Phillips, LLP

[Webinar] In Pursuit of Whole-Person Health: A Review of Drivers of Health Initiatives in Medicaid Managed Care - July 25th, 1:00...

Mounting evidence indicates that addressing the social and economic factors that drive the majority of health outcomes, often called social drivers of health (DOH), can improve health, promote health equity and reduce costs....more

Manatt, Phelps & Phillips, LLP

[Webinar] Health Care Litigation Trends to Watch in 2022…and Beyond - April 27th, 4:00 pm - 5:00 pm ET

Health care is facing a tidal wave of change—from enforcement actions around CARES Act funding to employment issues in a post-COVID workplace to questions around telehealth coverage to controversies over gender identity...more

Manatt, Phelps & Phillips, LLP

The Role of Medicaid in Addressing Social Drivers of Health: MCO Community Investment Requirements

Increasingly, states are using their Medicaid managed care (MMC) contracts to define the role Medicaid and Medicaid managed care plans can play in addressing unmet social needs and promote a “whole person” approach to care. A...more

Sheppard Mullin Richter & Hampton LLP

CMS Announces New Geographic Direct Contracting Model: Letters of Interest Due by December 21, 2020

On December 3, 2020, Centers for Medicare & Medicaid Services (“CMS”) announced key details concerning a new value-based reimbursement and patient care model – the Geographic Direct Contracting Model (the “Model” or “Geo”)....more

Manatt, Phelps & Phillips, LLP

[Webinar] Medicaid Managed Care Payment Policies to Support Pediatric Providers - December 7th, 3:30 pm - 4:30 pm ET

What Actions Can State Medicaid Agencies and Medicaid Managed Care Organizations Take to Support Financial Stability for Pediatric and Other Primary Care Practices During the COVID-19 Pandemic? Find Out in a New Webinar From...more

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