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Medicaid › Proposed Regulation

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 -
Foley & Lardner LLP

Medicare Overpayments: CMS Proposes Regulation Establishing Six Month Suspended Deadline for 60-Day Refund Rule

Foley & Lardner LLP on

The 60-day Refund Rule, created by the 2010 Affordable Care Act, requires providers to report and return Medicare and Medicaid overpayments within 60 days of identifying them. See Section 1128J(d) of the Social Security Act,...more

McDermott+

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

McDermott+ on

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

McDermott+

Looking Forward: Top Policy Areas for 2024

McDermott+ on

Happy New Year! As we enter 2024, we want to lay out some of the main regulatory issues (both new and old) that McDermott+Consulting will be tracking over the next year. While these may evolve, we think they are still...more

Manatt, Phelps & Phillips, LLP

State-Directed Payments: Overview, Trends and Proposed Changes

Manatt, Phelps & Phillips, LLP on

In 2020, Medicaid spent $220.8 billion on hospital care. Hospital care accounted for 33% of Medicaid spending. Supplemental payments are critical for closing the gap between hospital costs and Medicaid reimbursement,...more

McDermott+

The Comments are In! Responses to the Physician Fee Schedule Proposed Reg

McDermott+ on

Time’s up and pencils down! Comments on the calendar year (CY) 2024 physician fee schedule (PFS) proposed reg were due earlier this week. Now, the Centers for Medicare & Medicaid Services (CMS) will have to review them and...more

McDermott+

McDermottPlus Check-Up: May 19, 2023

McDermott+ on

The House and Senate were both in session this week, with significant healthcare activity at the committee level. The House Ways & Means Committee met to discuss healthcare price transparency, and the Ways & Means Health...more

Manatt, Phelps & Phillips, LLP

OMIG Proposes Omnibus Regulations Impacting Medicaid Providers’ and Plans’ Compliance Obligations

Manatt, Phelps & Phillips, LLP on

On July 13, 2022, the New York State Office of Medicaid Inspector General (OMIG) published proposed rules in the New York State Register to implement provisions of the State Fiscal Year 2020-2021 Enacted Budget and the...more

King & Spalding

CMS to Develop Regulations Requiring Nursing Home Staff Vaccinations

King & Spalding on

On August 18, 2021, President Biden announced that CMS would develop an emergency regulation to require nursing home staff vaccinations. This announcement comes after months of incentives and giveaways to increase the...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 14. News Briefs: April 2021 #2

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 30, no. 14 (April 12, 2021) - Doctors Care P.A., the largest urgent care provider network in South Carolina, and its management company, UCI Medical Affiliates of South Carolina Inc., will...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - September 2020

Manatt, Phelps & Phillips, LLP on

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more

Mintz - Health Care Viewpoints

CMS Proposes Rule to Pave the Way for Value-Based Drug Purchasing

Mintz - Health Care Viewpoints on

The Centers for Medicare & Medicaid Services (CMS) has taken another step to further the adoption of value-based purchasing within the health care industry. (Readers may recall the Department of Health & Human Services’ two...more

Arnall Golden Gregory LLP

CMS Proposes Regulations that Would Have Significant Financial Impact on CCRCs

Arnall Golden Gregory LLP on

In November 2019, the Centers for Medicare & Medicaid Services proposed the Medicaid Fiscal Accountability Regulation (MFAR), a set of regulations targeted at promoting financial integrity in state Medicaid programs. ...more

Foley Hoag LLP - Medicaid and the Law

Massachusetts Medicaid Proposes Changes to Hospital Acquisition of Costly Prescription Drugs

Foley Hoag LLP - Medicaid and the Law on

Earlier this year, we wrote about a lawsuit involving the 340B drug pricing program. We sometimes write about the 340B program because it is integrally linked to the Medicaid prescription drug rebate program. So today, we...more

Bricker Graydon LLP

CMS proposes new Stark Law exception for limited remuneration to a physician

Bricker Graydon LLP on

On October 9, 2019, the Centers for Medicare and Medicare Services (CMS) released proposed changes to the regulations interpreting the Physician Self-Referral Law (Stark Law), including a new proposed exception for limited...more

Bricker Graydon LLP

CMS proposes to recalibrate the scope and application of the Stark regulations

Bricker Graydon LLP on

As part of the long-awaited proposed changes “to modernize and clarify” the regulations that interpret the Physician Self-Referral Law (the “Stark Law”) released on October 9, 2019, the Centers for Medicare and Medicaid...more

Dorsey & Whitney LLP

Proposed Drug Rebate and PBM Service Fee Regulations Abandoned by Administration

Dorsey & Whitney LLP on

As reported here in February, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released two new significant proposed regulations that would have had a transformative effect on the drug...more

Sheppard Mullin Richter & Hampton LLP

The Military Health Care Fraud and Abuse Prevention Program: The Department of Defense Issues Proposed Regulations regarding...

Sheppard Mullin Richter & Hampton LLP on

The U.S. Department of Defense (“DOD”) claims that fraud and abuse is inhibiting the ability of the Defense Health Agency (“DHA”), the agency responsible for administering TRICARE, to support and deliver “integrated,...more

Baker Donelson

HHS Proposes Removing Anti-Kickback Safe Harbor Protection for PBM Rebates, Proposes Two New Safe Harbors

Baker Donelson on

On January 31, the Department of Health and Human Services (HHS) and HHS Office of Inspector General (OIG) issued for public display a proposed regulation that would subject certain pharmaceutical manufacturer rebates paid to...more

Chambliss, Bahner & Stophel, P.C.

Proposed New Medicare Payment System May Affect Beneficiaries

Chambliss, Bahner & Stophel, P.C. on

Medicare is proposing a new flat rate reimbursement system for doctors who treat Medicare patients. Some worry that the plan may reduce payments to specialists and cause fewer doctors to accept Medicare patients....more

Mintz - Health Care Viewpoints

CMS Focuses on a Modern Medicare

Mintz - Health Care Viewpoints on

Earlier this month, CMS proposed changes to the Medicare Physician Fee Schedule and Quality Payment Program with the goal of “modernizing Medicare and restoring the doctor-patient relationship.” The proposed changes achieve...more

Foley & Lardner LLP

Health Care Policy Newsletter - July 2018 pt 2

Foley & Lardner LLP on

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health Care policy news and legislation. *Please note that we...more

Baker Donelson

Maryland Telehealth Update: RPM, Store and Forward and Looking Ahead

Baker Donelson on

The Maryland Medicaid telehealth landscape saw some expansion in late 2017. The growth may not go as far as stakeholders desire, but it is movement nonetheless....more

Mintz - Employment Viewpoints

Proposed Regulations Issued Implementing Massachusetts Employer Medical Assistance Contribution (EMAC) Supplemental Contribution

Mintz - Employment Viewpoints on

In an earlier post, we reported on the passage of H. 3822, “An Act Further Regulating Employer Contributions to Health Care,” (the “Act”), the purpose of which is to shore up the finances of the Commonwealth’s Medicaid...more

Hogan Lovells

Republicans Release Much Anticipated ACA "Repeal and Replace" Bill, But Will it Fly Under the Byrd Rule?

Hogan Lovells on

On March 6, 2017, House Republicans in the Committee on Ways and Means and the Committee on Energy and Commerce introduced the American Health Care Act (AHCA), a bill that would repeal and replace key portions of the...more

Carlton Fields

Will “Trumpcare” Replace Obamacare by April?

Carlton Fields on

Monday, House Republicans revealed two bills collectively meant to repeal and replace the Affordable Care Act (ACA). House committees began reviewing the legislation yesterday. The bills do not contain any major surprises and...more

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