Medicaid

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
News & Analysis as of

Grassley Continues To Press CMS on Medicaid Drug Rebate Classifications: What Will Be the Fallout?

Back in early October, we were all transfixed by the announced Mylan settlement with the U.S. Department of Justice (DOJ) over Mylan’s alleged underpayments of Medicaid Drug Rebates for the EpiPen. Although Mylan indicated...more

Looking Forward/Looking Backward – Day 1 Notes from the JPMorgan Healthcare Conference

A large amount of wind, much discussion about the U.S healthcare, and the public getting soaked again – if you were thinking about Washington, DC and the new Congress, you’re 3,000 miles away from the action. This is the week...more

Manatt on Health Reform: Weekly Highlights - January 2017

Physician groups and American Enterprise Institute authors come out against ACA repeal without a replacement; Hawaii’s 1332 waiver is the first to receive federal approval; and North Carolina’s Governor moves to expand...more

The Future of the ACA Week 5: The Rep. Tom Price Plan(s)

This week continues our survey of key Republican proposals to “repeal and replace” the Affordable Care Act (ACA). In the past two weeks, we have reviewed the Trump/Pence transition plan, entitled “Healthcare Reform to Make...more

2016 Nerve-of-a-Burglar Award

Competition for the 2016 Nerve-of-a-Burglar Award was fierce, with health care providers constantly coming up with new and different ways to scam Medicare and Medicaid. Nevertheless, we have a clear winner: the Michigan...more

Capitol Hill Healthcare Update

A growing number of moderate and conservative Republicans in Congress are voicing concerns about the party’s strategy to repeal the Affordable Care Act (Act) in February but then wait months – and possibly even into 2018 –...more

The New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

The total U.S. health care expenditure was $3.2 trillion in 2015, and is projected to grow to nearly $5.6 trillion by 2025. As our nation’s cost of care rises, both Democrats and Republicans recognize the overwhelming need to...more

Episode 06: Obamacare (Part II): What Happens Next? [Audio]

Matt and Beth return to discuss the "repeal and replace" debate (and help separate fact from fiction), practical insights about the Trump administration's Department of Health and Human Services and Centers for Medicare and...more

For Better or for Worse, States Are Turning to Managed Care for Medicaid Long-Term Care

More and more states are switching to a managed care model when dealing with Medicaid long-term care patients, a change that has resulted in a loss of services in some cases. Many states use managed care to deliver care...more

Ohio Medicaid Update: “Disability Determination Redesign” and STABLE Accounts

In my last article, I provided a summary on the “Achieving a Better Life Experience Act of 2014,” (the “ABLE Act”). At the time of publication, the status of ABLE Accounts in Ohio was not known. However, effective June 1,...more

Medical Malpractice and Healthcare Quarterly - Winter 2016

Delaware Superior Court Clarifies “Wrong Body Part” Exception to Affidavit of Merit - The Delaware Superior Court recently dismissed a plaintiff’s claim against a physician and clarified the meaning of one of the...more

OIG Report Examines Minimum Loss Ratio Impact on South Carolina Medicaid Managed Care

OIG recently issued a report determining that South Carolina’s Medicaid Managed Care program would not have realized any savings if the state agency implemented a minimum Medical Loss Ratio (MLR) similar to the current...more

Manatt on Medicaid: Monthly Expansion Recap - January 2017

Arkansas - Task Force Report Highlights Expected Cost Savings From Medicaid Expansion - The Arkansas Health Reform Legislative Task Force met for the last time to approve its final report, which includes findings...more

Overcoming the obstacles and realizing the benefits of a chapter 11 healthcare restructuring

Many healthcare businesses, both for-profit and not-for-profit, have faced financial distress. Among the factors that may contribute are lower reimbursement rates, changes in the delivery of services, regulatory shifts, and...more

Medicaid Demonstration Waivers: A Shorter Path to Increasing State Control Over Healthcare Policy?

Seema Verma’s nomination to head the Centers for Medicare and Medicaid Services (CMS) places Section 1115 Medicaid demonstration waivers into increasing spotlight. This article explores some of the current applications of...more

New Initiatives for the New Year: Highlights of the OIG’s 2017 Work Plan

On November 10, 2016, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued its 2017 Work Plan. The 2017 Work Plan outlines the areas of special concern to the OIG and...more

Health Care Institutions

Originally published in Haig, Business and Commercial Litigation in Federal Courts, Fourth Edition §§ 87:1 et seq. © 2016 American Bar Association. This chapter discusses federal court litigation relating to health care...more

Healthcare Law Update: December 2016

Prompt Payment Discounts Not an Anti-Kickback Statute Violation - In United States of Am. et al. ex rel. Ruscher v. Omnicare, No. 15-20629, 2016 WL 6407128 (5th Cir. Oct. 28, 2016), the court of appeals affirmed summary...more

This Month in Corruption: Snapshots of the Public Trust Betrayed

If I were back in the newspaper business, I’d probably write a lead for this article with the cliché that “crime never takes a holiday.” Yes, clichés are the first resort of lazy scribes, but the good thing is, they are...more

HHS Announces New Medicare-Medicaid Accountable Care Organization Model

On December 15, 2016, HHS announced an Accountable Care Organization (ACO) initiative for beneficiaries who are dually eligible for Medicare and Medicaid. The Medicare-Medicaid ACO Model (Model) builds on the Medicare Shared...more

Medicaid 1115 Waivers Re-Approved for New York Managed Care and HIV Enrollees, Arkansas Works Cost-Sharing and Mandatory Job...

CMS has recently approved five-year extensions for Medicaid Demonstration Waivers under Section 1115 of the Social Security Act in New York and Arkansas. Both extensions allow each state to continue innovative pilot...more

Part 3: Exploring “Repeal and Replace”

In Part II of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we considered potential healthcare market consequences of a partial repeal of the Affordable Care Act (ACA). In...more

The ERISA Litigation Newsletter - December 2016

This month Richard Zall, Chair of Proskauer's Health Care Department, explores developments likely to occur with respect to the Affordable Care Act as a result of the new administration. In our Rulings, Filings and...more

CMS Releases Medicare Outpatient Observation Notice Form

On December 8, 2016, the Centers for Medicare and Medicaid Services (CMS) published the Medicare Outpatient Observation Notice (MOON), which educates Medicare beneficiaries on the effect of outpatient status, particularly as...more

Capping Federal Medicaid Funding: Key Financing Issues for States

President-elect Donald Trump and Republican congressional leadership have called for a repeal of the Affordable Care Act (ACA) and a fundamental overhaul of the Medicaid program that would include imposing caps on federal...more

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