News & Analysis as of

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 -

Wisconsin Releases Draft Waiver Amendment Proposing New Eligibility Requirements

On April 19, 2017, Wisconsin released for public comment a proposed amendment to its BadgerCare Reform Section 1115 demonstration. BadgerCare Reform currently provides coverage to approximately 150,000 childless adults ages...more

Congress returns with Trump pressing anew for ACA repeal/replace, but with what?

Welcome back, Republicans in Congress. When you went home for spring break, constituents made raucous complaints, if you held town halls, about the GOP’s failure to repeal and replace the Affordable Care Act, aka Obamacare....more

Home Health Agencies May Get More Time to Prepare for New Rules

The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule that would delay the effective date of the revised Conditions of Participation (CoP) for home health agencies (HHAs) from July 13, 2017 until...more

ML Strategies Alert - FY2018 Massachusetts Budget Update: House Ways and Means Budget

On Monday, April 10th, the House Ways and Means Committee proposed a $40.3 billion budget for FY2018 that calls for increasing spending by 3.8 percent, or about $1.47 billion, above FY2017 levels. The spending increase is...more

New State Substitution Laws, and a Busy Spring for Biosimilars

We recently updated our chart that tracks state biosimilar substitution laws to include new laws in Iowa and Montana. These new laws bring the total number of states with biosimilar substitution laws to 27, plus Puerto Rico....more

Manatt on Health Reform: Weekly Highlights - April 2017 #3

The focus is on the Marketplaces this week as CMS publishes a new Marketplace stabilization rule, even as President Trump threatens to withhold cost-sharing reduction payments to insurers. In the states, Florida announces...more

WARNING: New York Percentage Billing Arrangements Under Attack. Medicaid Frad Unit Is Seeking Recoupment from Providers Using...

New York’s Medicaid Fraud Control Unit (“MFCU”) has sent demand letters seeking recoupment from certain healthcare providers in New York State who have percentage of collection arrangements with their outside billing...more

13 Steps For Closing A NJ Medical Practice

Thinking of closing your medical practice? Whether this decision stems from wanting to retire or to seek new employment, as the owner of a medical practice in New Jersey, you must take certain steps prior to closing your...more

Tennessee Health Services and Facilities Report: April 2017 Newsletter

by Burr & Forman on

The Tennessee Health Services and Development Agency (“HSDA”) is responsible for regulating the health care industry in Tennessee through the Certificate of Need Program. A Certificate of Need (“CON”) is a permit for the...more

CMS Proposes Six-Month Delay for New Medicare and Medicaid Conditions of Participation for Home Health Agencies

by Stinson Leonard Street on

The Centers for Medicare & Medicaid Services (CMS) recently proposed a six-month delay for home health agencies (HHAs) to implement the revised conditions of participation (CoPs) that HHAs must satisfy to participate in the...more

Manatt on Health Reform: Weekly Highlights - April 2017 #2

HHS's position on cost-sharing reduction payments remains unclear as insurers seek certainty before Marketplace rate filing deadlines; states continue to finalize Medicaid budgets and seek waiver flexibility; and North...more

More Federal Legislation Aimed at Expanding Medicare Coverage of Telehealth Services

by McDermott Will & Emery on

Late last month, Senator Cory Gardner (R-CO) and Senator Gary Peters (D-MI) introduced Senate Bill 787, the Telehealth Innovation and Improvement Act (Telehealth Improvement Act), which is focused on expanding Medicare’s...more

News From the Vermont Statehouse - An Analysis from DRM’s Government & Public Affairs Team - April 2017

by Downs Rachlin Martin PLLC on

Trial Bar Proposes Anti-Ride-Sharing Amendments to Insurance Bill - The Senate Judiciary Committee considered amendments this week proposed by the Vermont Trial Lawyers Association that would likely force Uber out of...more

Medicaid Reform Beyond the AHCA

While we continue to monitor Congressional efforts to repeal and replace the ACA, we are also monitoring CMS’s efforts to implement the administration’s Medicaid program goals without Congressional action. The future of the...more

Leasing to Health Care Tenants: What You Need to Know

by Pepper Hamilton LLP on

Commercial office building landlords frequently find themselves leasing to health care provider tenants. A landlord may not consider doctor’s offices or diagnostic labs as specialty uses, but there are several lease...more

Legislative Solutions: 2017 Virginia Legislative Recap

by Williams Mullen on

The following is a summary of key legislation impacting the health care industry in Virginia. Reforming or Repealing Virginia’s Certificate of Public Need Program - The study of the COPN process continues -...more

Final Policies on Encounter Data and the Star Ratings Released

by McDermott Will & Emery on

The Centers for Medicare and Medicaid Services recently finalized meaningful Medicare Advantage policy changes in response to industry concerns, including those regarding data integrity, the Star Ratings and encounter data....more

CMS Revises the Self-Referral Disclosure Protocol Requiring the Use of Prescribed Forms for Disclosure of Stark Law Violations

by McDermott Will & Emery on

The Centers for Medicare and Medicaid Services (CMS) recently posted revisions to the Voluntary Self-Referral Disclosure Protocol (SRDP). In an attempt to streamline the self-disclosure process, CMS requires the use of new...more

House Pulls Vote on ACA Repeal and Replace, Future Uncertain

by King & Spalding on

Following a week of amendments and last-minute deal making, and after postponing a scheduled March 23 vote, the House leadership cancelled a vote on H.R. 1628, the American Health Care Act (AHCA), legislation to repeal and...more

Manatt on Health Reform: Weekly Highlights - April 2017

Consumers could use Marketplace subsidies to purchase off-Marketplace plans under proposed Senate bill; Oklahoma and Massachusetts will pursue Medicaid and Marketplace waivers; and a Medicaid expansion bill fails in Kansas...more

CMS Clarifies Medicaid DSH Rules for Treatment of Third Party Payments in Calculating Uncompensated Care Costs

by Reed Smith on

CMS has published a final rule intended to codify its existing interpretation of how third-party payments are considered in the calculation of Medicaid uncompensated care costs for the purpose of making Medicaid...more

CMS Encourages Providers/Suppliers Not To Put Off Emergency Preparedness Training Exercises; Educational Call Scheduled for April...

by Reed Smith on

CMS is reminding Medicare- and Medicaid-participating providers and suppliers that they will be expected to comply with training and testing requirements included in a September 2016 emergency preparedness final rule by...more

GOP turns from failed blitzkrieg to trench fighting in war against Obamacare

Now that the blitzkrieg assault on Obamacare is over, the battle to repeal and replace the Affordable Care Act hasn’t gone totally up in smoke. It just has fallen, for now, into lots of still critical bits and pieces....more

Strike One on Health Care Reform: Where Do We Go from Here?

As reported in our January 23, 2017 Clients & Friends Memorandum entitled “Status of the Affordable Care Act Repeal Efforts,” one of the first priorities of the Trump administration was the repeal of the Patient Protection...more

Manatt on Medicaid: Monthly Expansion Recap, March 2017 #2

Arkansas - Governor Proposes Changes to Medicaid Expansion Waiver as House Passes Bill to Cap Expansion Enrollment - Governor Asa Hutchinson (R) released a proposal to amend the State's Medicaid expansion waiver by...more

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