As previously reported by Sheppard, the Centers for Medicare & Medicaid Services (“CMS”) has announced several program integrity actions to combat health care fraud. Among these actions was the issuance of a Request for...more
3/26/2026
/ Beneficial Owner ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Comment Period ,
Health Care Providers ,
Health Insurance ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
New Regulations ,
Proposed Rules ,
Regulatory Oversight ,
Request For Information
Regulators are making meaningful changes to Certificate of Need (CON) programs across the country to strengthen the oversight of material expansions in the healthcare market while reducing unnecessary regulatory friction....more
As New York’s FY 2026-27 budget process moves from joint legislative hearings that concluded last month into March negotiations, Governor Hochul’s proposal to expand oversight of “material transactions” involving healthcare...more
3/17/2026
/ Healthcare ,
Healthcare Facilities ,
Hospital Mergers ,
Merger Reviews ,
New York ,
Proposed Legislation ,
Public Health ,
Regulatory Oversight ,
Regulatory Requirements ,
Reporting Requirements ,
State and Local Government ,
State Budgets ,
State Health Departments
Welcome to Health-e Law, Sheppard’s podcast exploring the fascinating health tech topics and trends of the day. In this episode, partner and host Michael Orlando welcomes Adam Herbst, a partner in Sheppard’s Healthcare...more
The University of Miami Herbert Business School’s Business of Healthcare conference on February 6, 2026, brought together payers, providers, clinical leadership, pharmaceutical executives, and federal policymakers. The agenda...more
Governor Hochul’s 2026 State of the State Agenda, released in January, and the FY 2027 Executive Budget are best understood as two parts of a single healthcare strategy. The Agenda sets the direction; the Budget supplies the...more
2/10/2026
/ 1115 Waivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Certificate of Need ,
HCBS Waivers ,
Healthcare Reform ,
Healthcare Workers ,
Home and Community Based Services (HCBS) ,
Home Health Care ,
Hospitals ,
Medicaid ,
Nursing Homes ,
Prescription Drugs ,
State and Local Government ,
State Budgets
The One Big Beautiful Bill Act (OBBBA), enacted in July 2025, is no longer a policy debate or a future concern. It is already changing how coverage works, how Medicaid dollars flow, and how much operational friction health...more
1/15/2026
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Medicaid Reimbursements ,
New Legislation ,
Regulatory Reform ,
Regulatory Requirements ,
Reimbursements ,
Risk Management ,
Rural Health Care Providers ,
Section 340B ,
Waivers
The California Department of Health Care Services (“DHCS”) announced via a Policy Letter that the state has paused the application process for Program of All-Inclusive Care for the Elderly (“PACE”) organizations for a minimum...more
12/5/2025
/ Acquisitions ,
California ,
Centers for Medicare & Medicaid Services (CMS) ,
Government Agencies ,
Health Care Providers ,
Healthcare ,
Medicaid ,
New Guidance ,
Regulatory Oversight ,
Regulatory Requirements ,
State and Local Government
On August 6, 2025, the New York State Department of Health (DOH) finalized amendments to its Certificate of Need (CON) regulations in 10 N.Y.C.R.R. Part 710, raising the financial thresholds for full review, expanding...more
8/13/2025
/ Certificate of Need ,
Final Rules ,
Healthcare ,
Healthcare Facilities ,
New Regulations ,
New York ,
Public Health ,
Regulatory Oversight ,
Regulatory Reform ,
Regulatory Requirements ,
State and Local Government
Among the many sweeping changes to the Medicaid program included in the One Big Beautiful Bill Act (“OBBBA”), Congress established new statutory caps on state-directed payments (“SDPs”) in Medicaid managed care. SDPs have...more
8/4/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
New Legislation ,
One Big Beautiful Bill Act ,
Regulatory Oversight ,
State Medicaid Programs ,
Value-Based Care
Following Sheppard Mullin’s recent webinar on Health Equity Impact Assessments (HEIAs), one thing is clear: providers and investors cannot afford to treat equity requirements as an afterthought in the Certificate of Need...more
7/28/2025
/ Certificate of Need ,
Compliance ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Investors ,
New York ,
Public Health ,
Regulatory Requirements ,
State and Local Government
Last month, New York State began a formal review of its Certificate of Need (CON) process for nursing homes, launching a timely conversation about how best to align regulatory oversight with evolving system needs. A new...more
7/17/2025
/ Certificate of Need ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
Healthcare Reform ,
Medicaid ,
New York ,
Nursing Homes ,
Public Health ,
Regulatory Reform ,
Skilled Nursing Facility ,
State and Local Government
On June 30, 2025, New York State released its long-anticipated Master Plan for Aging (MPA), a 10-year strategic framework designed to improve the way the state supports older adults, individuals with disabilities, and family...more
In June 2025, the U.S. House of Representatives introduced a budget reconciliation bill titled the One Big Beautiful Bill Act (OBBBA). The legislation proposes a number of administrative changes to existing federal health...more
6/25/2025
/ Beneficiaries ,
Budget Reconciliation ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Budget Office ,
Government Agencies ,
Medicaid ,
Medicare ,
New Legislation ,
New Regulations ,
Proposed Legislation ,
Proposed Rules ,
Regulatory Reform
New York’s Medicaid financing strategy—particularly its use of a managed care organization (MCO) tax—has come under renewed federal scrutiny amid recent legislative proposals and regulatory developments. The federal...more
6/19/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Federal Budget ,
Federal Funding ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
MACPAC ,
MCOs ,
Medicaid ,
New York ,
Proposed Legislation ,
Regulatory Reform ,
Regulatory Requirements ,
State Taxes ,
Tax Planning
On May 15, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule, entitled “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole” to address a...more
5/30/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Federal Funding ,
Government Agencies ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
New Regulations ,
Proposed Rules ,
Regulatory Reform ,
State and Local Government ,
State Taxes
In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services (“CMS”) recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct...more
4/17/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Federal Funding ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Public Health ,
State and Local Government ,
Telehealth
As legal and policy developments continue to evolve, hospitals and health care professionals that provide gender-affirming care face new uncertainties regarding federal funding, compliance, and patient access. While these...more
2/24/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Department of Health and Human Services (HHS) ,
Executive Orders ,
Federal Funding ,
Gender Identity ,
Health Care Providers ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Medicare ,
Regulatory Agenda ,
Trump Administration
As budget negotiations heat up in Washington, Medicaid has emerged as a key target for cost-cutting measures. With policymakers looking to trim federal spending while maintaining commitments to Social Security and Medicare,...more
The recent U.S. election has had profound implications for the healthcare industry, prompting industry leaders to reexamine their strategies and day-to-day operations. At the Miami Herbert Business School’s annual “The...more
2/5/2025
/ Artificial Intelligence ,
Data Privacy ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Medicare ,
Medicare Advantage ,
Public Health ,
Trump Administration ,
Value-Based Care
The proposed New York Health Information Privacy Act (NYHIPA), currently awaiting Governor Kathy Hochul’s signature, represents a major step in the state’s approach to protecting personal health data in the digital age. At...more
1/31/2025
/ Consumer Privacy Rights ,
Data Privacy ,
Data Protection ,
Data Security ,
Digital Health ,
Federal Trade Commission (FTC) ,
Health Information Technologies ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
New Legislation ,
New York ,
Privacy Laws ,
State Privacy Laws
In January 2025, New York Governor Kathy Hochul proposed legislation within her FY 2026 Executive Budget that could significantly reshape healthcare transactions in the state. This legislation introduces a “Cost Market Impact...more
New York State has a long-standing commitment to supporting its most vulnerable populations through Medicaid-funded services for older adults and those requiring long-term care. However, rising costs and an increasingly...more
The rising cost of prescription drugs under Medicare continues to pose significant challenges for seniors, a population that relies heavily on consistent and affordable access to medications. This issue underscores broader...more