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 -

CMS Summit on Potential Behavioral Health Innovative Payment Model (Sept. 8, 2017)

by Reed Smith on

The CMS Center for Medicare and Medicaid Innovation is holding a public summit on September 8, 2017 to explore creating a behavioral health innovative payment model intended to improve health care quality and access, while...more

CMS Issues Corrections to Medicare/Medicaid LTC Conditions of Participation

by Reed Smith on

CMS has made numerous technical and typographical corrections to its October 4, 2016 final rule revising the requirements that long-term care facilities must meet to participate in the Medicare and Medicaid programs. ...more

Health Care Weekly Preview from ML Strategies – July 2017 #3

We head into the last week of July with the Findings of the Senate Parliamentarian in hand, who ruled late Friday that several provisions in the Better Care Reconciliation Act (BCRA) released on June 26th would be subject to...more

Special Edition: Key BCRA Policy Concerns

Congressional action on repeal and replace took a number of significant turns in the past few days, and next steps still remain uncertain. On Monday evening, Senators Mike Lee (R-UT) and Jerry Moran (R-KS) joined Senators...more

Vermont’s New Telemedicine Law Expands Insurance Coverage, Bans Recording

by Foley & Lardner LLP on

Vermont health care providers and patients can now enjoy a revamped, and significantly improved, telehealth commercial insurance coverage law. Vermont Governor Phil Scott signed S. 50 into law on June 7, 2017, expanding...more

Can People Losing Medicaid Under BCRA Afford Marketplace Coverage?

Next steps regarding Congressional action on repeal and replace remain uncertain, with the President again supporting repeal coupled with replace, members attempting to bridge their differences over the Better Care...more

State Releases Medicaid Managed Care Invitation to Negotiate

Last Friday, July 14, 2017, the Florida Agency for Health Care Administration (AHCA) released its long awaited Invitation to Negotiate (ITN) for State Wide Medicaid Managed Care services. The ITN, one for each of the 11...more

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

Home health agencies (HHAs) can breathe a sigh of relief now that the Centers for Medicare & Medicaid Services (CMS) have published a Final Rule delaying the effective date of the revised Medicare Conditions of Participation...more

Blog: OIG Work Plan Will Now Be Updated Monthly; 14 New Items Added for July

by Cooley LLP on

The Office of Inspector General (OIG) for Health and Human Services (HHS) recently announced that it will begin updating its Work Plan initiatives monthly rather than its previous twice-yearly publications, which was most...more

Establishing a Medicaid Per Capita Cap: Implications for California - Presentation

Both the House-passed American Health Care Act (AHCA) and the Senate’s draft Better Care Reconciliation Act (BCRA) of 2017 propose major changes to Medicaid’s financing structure. These include caps on federal funding for...more

Senate Health Care Bill 2.0: Implications for Health Care Stakeholders

by Epstein Becker & Green on

The new version of the Senate Republicans’ draft bill to repeal and replace the Affordable Care Act (ACA), known as the Better Care Reconciliation Act (BCRA), was released July 13. This second pass includes changes meant to...more

Issue 110: Senate Efforts at Health Care Reform

by Seyfarth Shaw LLP on

Seyfarth Synopsis: The epicenter of the health care repeal and replace effort has moved from the House of Representatives to the Senate. After several weeks of drafting behind closed doors, the Senate introduced the Better...more

Medicaid Edition: Establishing a Medicaid Per Capita Cap: Implications for California

Both the House-passed American Health Care Act (AHCA) and the Senate’s draft Better Care Reconciliation Act (BCRA) of 2017 propose major changes to Medicaid’s financing structure. These include caps on federal funding for...more

California Court Upholds Expansive Definition of Recoupment

The Bankruptcy Court for the Central District of California examined the scope of the doctrine of recoupment for Medicaid and related payments, allowing the deduction by the state. The court held that the California...more

Manatt on Health: July 2017

BCRA Implications: Affordability of Coverage - In making the case for repealing and replacing the Affordable Care Act (ACA), the president and congressional leadership have cited “rising premiums,” “unaffordable...more

New Massachusetts Employer Assessment Intended to Deter MassHealth Enrollment

by Foley Hoag LLP on

Since the beginning of this year’s legislative session, Governor Baker has expressed concern over the growth in enrollment in MassHealth, the state’s Medicaid program. A look at the numbers explains why. Prior to the...more

Achievements You Don’t List on Your Resume

by Faegre Baker Daniels on

A physician immigrated to the United States in 1991 and established a medical practice called Compassionate Doctors. By 2013 the practice and its related health care entities boasted some 44 employees and contractors,...more

CMS Finalizes Changes to Payment Error Rate Measurement (PERM) & Medicaid Eligibility Quality Control (MEQC) Programs

by Reed Smith on

CMS has published a final rule that modifies PERM and MEQC regulations to align with changes to how states adjudicate Medicaid and CHIP eligibility under the Affordable Care Act (ACA). According to CMS, the policy revisions...more

STATE BUDGET UPDATE: In A Historic Move, House Votes To Override 11 of the Governor's Vetoes From State Budget

by Roetzel & Andress on

The last time the Legislature voted to override multiple state budget vetoes was exactly forty (40) years ago to this day on July 6, 1977 under then Governor James Rhodes (R) and former longtime House Speaker Vern Riffe (D)....more

CBO Scores Senate ACA Repeal and Replace Bill; Senate Postpones Legislative Action Until After July 4

by King & Spalding on

On June 27, 2017, Senate Republican leaders postponed a planned vote on the motion to proceed to debate on the Better Care Reconciliation Act of 2017 (BCRA), legislation to repeal and replace the Affordable Care Act, until...more

Over 4th, GOP senators seek independence from their health care jam

Republicans in the U.S. Senate will spend a long Fourth of July break trying to figure if they can repeal and replace the Affordable Care Act, aka Obamacare, with their Better Care Reconciliation Act, aka Trumpcare. Their...more

State Budget Wrap-Up: Extensive Public Policy And Funding Changes - What You Need To Know

by Roetzel & Andress on

Just before the midnight deadline on Friday, Governor John R. Kasich signed the state’s two-year operating budget into law. The Governor first released his budget proposal in January 2017 and the Legislature has spent the...more

CMS Actuary Predicts an Additional 13 Million Uninsured Under the ACA Repeal Legislation

by King & Spalding on

In a report published on June 13, 2017, the independent chief actuary of CMS estimated that an additional 13 million people will be uninsured in ten years if the American Health Care Act of 2017 (ACHA), the latest ACA repeal...more

Manatt on Medicaid: Monthly Expansion Recap - June 2017

Manatt Health Introduces Two New Publications: Ongoing Insights into the Latest Healthcare Issues and Actions In this time of uncertainty for healthcare, real-time, insightful information on key developments is more...more

Part VII: The Senate’s Response to the American Health Care Act

Caveat: As of the date of this writing, there are indications that revisions to the Better Care Reconciliation Act of 2017 (“BCRA”) are in the works and may be issued as soon as Friday, June 30, 2017. If a revised BCRA is...more

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