Healthcare Reform

News & Analysis as of

Issue 100: Agencies Propose ACA Regulations on Expatriate Plans and Excepted Benefits

This is the one-hundredth issue in our health care reform series of alerts for employers on selected topics in health care reform. (Our general summary of health care reform and other issues in this series can be accessed by...more

Obama Administration Asks Court to Dismiss ACA Risk Corridor Litigation

Yet another challenge is being brought against the Affordable Care Act (ACA), this time regarding the ACA's risk corridor program. The first of several lawsuits over this program was filed in February 2016 by an Oregon health...more

Health Care IT Program Discusses Alternative Payment Model Opportunities

A distinguished panel of providers, consultants and IT firms convened on Tuesday, June 21st in New York at the Foley and Lardner LLP offices to share a discussion focused on the convergence of IT spend and new value based...more

Medicaid in Iowa: What's Next

In my previous blog post, I provided a brief history of Medicaid in Iowa, including sharing details on it’s current modernization and challenges. In this post, we’ll cover what’s next for Medicaid members with the move to...more

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

Massachusetts releases $1.8 billion DSRIP program waiver for public comment; CMS awards $32 million in grants to enroll uninsured children in Medicaid/CHIP; and Wisconsin withdraws proposed changes to Medicaid long-term care....more

Energy & Commerce Committee Approves Mental Health System Reform Bill

The House Energy & Commerce Committee has unanimously approved an amended version of H.R. 2646, the Helping Families in Mental Health Crisis Act, which is intended to reform the nation’s mental health care system. Among other...more

Recent Congressional Health Policy Hearings and Markups

A number of Congressional committees have recently considered legislation and/or held hearings on various health policy proposals. ..The Ways and Means Committee approved seven bills related to health care coverage and...more

Judge Allows Advocate-NorthShore Merger to Proceed; FTC May Appeal

For the second time in just over a month, a federal judge has denied a Federal Trade Commission (FTC) motion to enjoin the merger of two hospital systems, this time the 13-hospital Advocate Health Care and the 4-hospital...more

Why Arizona’s New Telemedicine Law Sends an Important Message

Arizona Governor Doug Ducey signed a bill (S.B. 1363) into law, on May 17, 2016, requiring private health plans to pay for telemedicine services across the whole state rather than only services received in rural areas of the...more

Manatt on Medicaid: CMS Introduces Time-Limited MMC Supplemental Payments

Editor's Note: This Manatt on Medicaid is the third in a series of updates focused on CMS's new Medicaid/CHIP managed care regulations. In the coming weeks, Manatt will be exploring key provisions of the regulations and...more

Federal Judge Refuses FTC Request to Block Hershey/Pinnacle Deal; FTC to Appeal

Hospitals and other providers who have been tracking Federal Trade Commission (FTC) and Department of Justice Antitrust Division hospital merger challenges over the last several years will want to take note of the federal...more

Coordinating your reimbursement and regulatory strategies for a successful product launch

Ensuring appropriate third-party reimbursement for a new pharmaceutical or medical product involves an intricate interplay of considerations. There is no doubt that government and private payers have been under increasing...more

CMS Finalizes Major Reforms of Medicaid/CHIP Managed Care Rules

On May 6, 2016, CMS is publishing a final rule to update Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations to more closely align with Medicare Advantage (MA) and private health plan standards,...more

CMS Announces Major Multi-Payer Comprehensive Primary Care Plus (CPC+) Model

CMS has launched a new “Comprehensive Primary Care Plus” (CPC+) model to improve how primary care is delivered and reimbursed. According to CMS, the CPC+ initiative (which builds on the ongoing Comprehensive Primary Care...more

State Efforts to Combat Drug Price Increases

Growth in health care costs has long been a source of political and administrative tension for public health agencies across the country. More and more, health officials, legislators, patient advocacy groups, and third-party...more

CMS Finalizes MHPAEA Mental Health/Substance Abuse Disorder Parity Rules for Medicaid Managed Care and Alternative Benefit Plans,...

CMS has released its final rule to apply provisions of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) to Medicaid beneficiaries who receive services through managed care organizations or alternative...more

House Budget Committee Clears FY 2017 Budget Resolution with Medicare, Medicaid Cuts

The House Budget Committee has approved the budget resolution providing instructions to Congressional committees on the federal spending framework for FY 2017. The resolution calls for the adoption of major reforms to the...more

CMS Ahead of Schedule in Push for Medicare Alternative Payment Models

CMS has announced that has reached its goal of tying 30% of Medicare payments to alternative payment models that reward quality of care rather than volume of service — 11 months ahead of the target CMS set last year....more

House Unanimously Approves Legislation to Remove Terminated Providers from Medicaid, CHIP

The House of Representatives has unanimously approved H.R. 3716, the Ensuring Access to Quality Medicaid Providers Act. The bill, which still awaits Senate consideration, would implement several OIG recommendations to improve...more

Energy & Commerce Committee Advances Medicaid/CHIP Legislation with Lower Provider Tax Limit

The House Energy & Commerce Committee has voted to approve H.R. 4725, Common Sense Savings Act of 2016, which includes a number of Medicaid and Children’s Health Insurance Program (CHIP) reforms. Among other things, the bill...more

COPN Reform Efforts Delayed

Few legislative issues during the 2016 General Assembly have garnered more attention in the health care community than the efforts to reform Virginia’s Certificate of Public Need (“COPN”) process. Despite considerable effort...more

Manatt on Health Reform: Weekly Highlights - March 2016 #2

The IRS releases guidance on resolving Form 1095 conflicts; New Hampshire's Medicaid expansion renewal clears a hurdle in the State; and New York providers get $1.5 billion in long-awaited DSRIP capital and infrastructure...more

GAO Reviews Safeguards on State Supplemental Medicaid Payments to Hospitals

According to the GAO, 505 hospitals received Medicaid payment surpluses (payments that exceeded the costs of providing services) totaling about $2.7 billion in 2012, resulting in part from lump-sum supplemental payments...more

Update No. 2: Is This The Year Florida Recognizes Direct Primary Care?

House Bill 37 (“HB 37”), a bill intended to codify and regulate direct primary care in the State of Florida, which had sailed through the Florida House with virtually unanimous support, died in the Senate as the legislative...more

Donald Trump Proposes Prescription Drug Importation as Element of Health Reform Plan

Donald Trump has released his plan for “Healthcare Reform to Make America Great Again”, which includes a proposal for allowing importation of cheaper prescription drugs from other countries as one of the reforms he believes...more

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