News & Analysis as of

Medicaid Healthcare

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 -

Value-based health care: the role of payors

by Ropes & Gray LLP on

Bill Knowlton, Ropes & Gray health care partner, examines the critically important role of payors in value-based health care programs. ____________ Payors are critically important to value-based health care because they're...more

K&L Gates Triage: 340B Eligibility - Hospital Covered Entities

by K&L Gates LLP on

This podcast focuses on the eligibility requirements for hospitals participating in the 340B Drug Pricing Program. Factors affecting eligibility include a hospital’s licensure status, patient population, and Medicare...more

Manatt on Health Reform: Weekly Highlights - February 2017

HealthCare.gov enrollment is down, while State-based Marketplace enrollment is up at the end of 2017 open enrollment; Hawaii, Massachusetts and Oregon introduce legislation to codify ACA reforms in state law in case of...more

CMS Issues Final Rule on New Medicare and Medicaid Conditions of Participation for Home Health Agencies

by Stinson Leonard Street on

The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, 42 C.F.R. pt. 484, implementing significant changes to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to...more

Participating in New York's CDPAP Is Necessary to Maintain Your Caseload

by FordHarrison on

Radio, newspaper, and subway ads are driving Medicaid home care clients and home care workers to abandon traditional home care agency programs for the greater flexibility and freedom of choice of New York’s Consumer Directed...more

21st Century Cures Act Includes Several Noteworthy Mental Health and Substance Use Provisions

by Stinson Leonard Street on

The 21st Century Cures Act (Act), enacted in December 2016, has received widespread coverage for funding biomedical research and streamlining the drug approval process. The Act also includes the Helping Families in Mental...more

Manatt on Health Reform: Weekly Highlights - January 2017 #4

The National Governors Association and National Association of Insurance Commissioners weigh in on ACA repeal and replace; CBO releases new Medicaid and Marketplace enrollment estimates; and Massachusetts proposes reinstating...more

Potential Implications to the ACA Under the Incoming Republican Administration – Part IV: Pharmacies

The Affordable Care Act (ACA), as a whole, did not have a significant impact on pharmacy services per se. However, a complete repeal would likely impact certain areas of pharmacy services including the drug benefit for the...more

Under the Dome: Inside the Maine State House

by Pierce Atwood LLP on

Under the Dome: Inside the Maine State House provides a high-level overview of recent activity at the Maine State House. LePage Presents Priorities at Biddeford Town Hall Forum - On Wednesday, January 25, Governor...more

Manatt on Medicaid: Monthly Expansion Recap - January 2017 #2

National News and Reports - Governors Voice Support for Maintaining the Medicaid Expansion - Democratic Governors, joined by some of their Republican colleagues, are actively making the case to Congress for...more

The Affordable Care Act: On the Fast Track to Repeal

by Carlton Fields on

On January 20, hours after his inauguration, President Donald Trump issued an executive order directing the heads of all executive departments and agencies to “waive, defer, grant exemptions from, or delay the implementation...more

Potential Implications to the ACA Under the Incoming Republican Administration – Part II: Physicians

In contemplating the ways in which physicians may be affected by the possible repeal of the Affordable Care Act (ACA)—and certain features of any legislation that may replace it—a good place to start is with the person...more

Post-Inauguration Outlook: ACA, Fiduciary Rule and Retirement-Related Tax Provisions

by Holland & Knight LLP on

President Donald Trump took the oath of office on Jan. 20, 2017, officially ushering in Republican control of the executive and legislative branches of government. With Republican control of both houses of Congress, and a new...more

Potential Implications to the ACA Under the Incoming Republican Administration – Part I: the Insurance Industry

In the uncertain atmosphere surrounding the process of ‘repealing’ and replacing the Affordable Care Act (ACA), there are some clues as to what we can expect to come next, at least with regard with the health insurance...more

Government Affairs Insights - Obamacare: Charting the Shoals Ahead

by Murtha Cullina on

This nation’s latest effort to lower the rate of uninsured health care recipients and improve health outcomes was launched with President Obama’s approval in 2010 of the Patient Protection and Affordable Care Act (ACA or...more

Texas Court Enjoins Enforcement of Regulation that Would Forbid Discrimination in Healthcare on the Basis of Gender Identity and...

by FordHarrison on

As LGBTQ rights have taken center stage in political and social issues, FordHarrison has been following ground-breaking litigation related to LGBTQ rights and providing updates. In the latest decision, a federal judge in...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 New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

by Carlton Fields on

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

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

by Reminger Co., LPA on

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

Healthcare Law Update: December 2016

by Holland & Knight LLP on

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

OIG Recognizes New Local Transportation Safe Harbor and Exceptions to CMP in Updated Fraud and Abuse Regulations

by Robinson & Cole LLP on

On December 7, 2016, the Department of Health and Human Services Office of Inspector General (OIG) issued a long-awaited final rule (Final Rule) that expands the safe harbor regulations under the Anti-Kickback Statute (AKS)...more

Under the Dome: Inside the Maine State House

by Pierce Atwood LLP on

Under the Dome: Inside the Maine State House provides a high-level overview of recent activity at the Maine State House. New Legislature Sworn In, Governor Shares Initial Priorities - On Wednesday, December 7,...more

Obama Signs 21st Century Cures Act, Adding $6.3 Billion For Medical Research

by Ballard Spahr LLP on

The Cures Act aims to increase the speed by which new drugs are brought to market by streamlining clinical trials, allowing the use of patient data in the regulatory review process, and modernizing U.S. Food and Drug...more

HHS OIG Adopts NewAnti-Kickback Safe Harbor and Civil Monetary Penalty Exceptions

by Proskauer Rose LLP on

On December 7, 2016, the Department of Health and Human Services (HHS), Office of Inspector General (OIG), issued a final rule that will have a widespread impact on health care service providers, medical transport providers,...more

Are Recommendations of the White House Task Force on Behavioral Health Parity Trumped by the Election?

by Akerman LLP - Health Law Rx on

Recently the White House Behavioral Health Parity Task Force issued guidance on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (Parity Law). The Task Force could not have known, though,...more

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