Since its inception, Medicaid has been fi nanced jointly by the federal and state governments. There are no caps on the federal government’s fi nancial obligations; federal funding is guaranteed as a share (known as a...more
President-elect Donald Trump and Republican congressional leadership have called for a repeal of the Affordable Care Act (ACA) and a fundamental overhaul of the Medicaid program that would include imposing caps on federal...more
As the incoming Congress and administration develop plans to “repeal and replace” the Affordable Care Act (ACA), analysis of five earlier repeal and replace proposals provides insights into the key features likely to appear...more
Section 1332 Waivers: Will We See More State Innovation? -
Editor's Note: In a new essay for the National Institute of Health Care Management (NIHCM), summarized below, Manatt Health examines Section 1332 waivers and the...more
8/25/2016
/ 1332 Waiver ,
Assisted Suicide ,
Customer-Loyalty Programs ,
Department of Health and Human Services (HHS) ,
Discounts ,
Dispute Resolution ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Long Term Care Facilities ,
Medicaid ,
Off-Label Promotion ,
Patient Privacy Rights ,
PHRMA ,
Prescription Drug Coverage ,
Section 340B ,
Unfair or Deceptive Trade Practices
Editor's Note: This Manatt on Medicaid is the third in a series of updates focused on CMS's new Medicaid/CHIP managed care regulations. In the coming weeks, Manatt will be exploring key provisions of the regulations and...more
Better Late Than Never: CMS Provides Much-Needed Clarity on the 60-Day Overpayment Refund Requirements -
On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the long-awaited final rule (Final...more
2/26/2016
/ 60-Day Rule ,
ACOs ,
Affordable Care Act ,
Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
Certificate of Need ,
Health IT ,
Interstate Commerce ,
Knox Keene ,
License Agreements ,
Look-Back Measurement Period ,
Medicaid ,
Medicare Shared Savings Program ,
Overpayment Recovery Time Limits ,
Risk Allocation ,
Telehealth
In a 5-4 ruling in Obergefell v. Hodges released on June 26, 2015, the Supreme Court held that same-sex marriage is a fundamental right guaranteed by the 14th Amendment of the United States Constitution, expanding the right...more
8/14/2015
Examining Fee Splitting Statutes in the Context of Value-Based Healthcare -
Editor’s note: One of the goals of the Affordable Care Act (ACA) is to align incentives among provider communities and their patients and...more
6/23/2015
/ Affordable Care Act ,
Cardinal Health ,
Federal Trade Commission (FTC) ,
Fee-Splitting ,
Hospital Mergers ,
Hospitals ,
Licensing Boards ,
Medicare Shared Savings Program ,
Mergers ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
Radiopharmaceuticals ,
SCOTUS ,
Value-Based Fees
Policyholder Can Keep Selected Counsel, Court Rules; Insurers’ Objection Too Late -
Why it matters: A policyholder was able to maintain its selected defense counsel after a federal court judge ruled that the insurers’...more
4/23/2015
/ Class Action ,
Commercial General Liability Policies ,
Duty to Defend ,
Insurance Litigation ,
Mortgage Lenders ,
Policy Limits ,
Property Damage ,
TCPA ,
Unsolicited Faxes ,
Vacant Properties ,
Vandalism
Supporting Informed Decision Making in the Health Insurance Marketplace: A Progress Report -
Editor’s note: As Affordable Care Act (ACA) implementation moves forward and the marketplace continues to evolve, there is a...more
Sharing Clinical Trial Data: Maximizing Benefits, Minimizing Risk -
Editor’s note: At the request of 23 public and private sector sponsors—including major life sciences companies, as well as U.S. and international...more
In a highly anticipated speech on January 22, 2015, the newly inaugurated Governor of Arkansas, Asa Hutchinson, laid out his vision for charting the future of Medicaid in Arkansas. Governor Hutchinson outlined a plan that...more
“Healthcare-Related” Calls: Ambiguity at the Intersection of HIPAA and TCPA -
Editor’s Note: The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer...more
11/21/2014
/ Business Associates ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Draft Guidance ,
Electronic Medical Records ,
FCC ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Hospitals ,
PHI ,
Physicians ,
Standard of Care ,
TCPA ,
Text Messages ,
Voicemail
The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer Protection Act (TCPA) for health care messages regulated under the Health Insurance Portability and...more
Avoiding the Regulatory Land Mines of Commercial ACOs -
While providers are showing great interest in creating ACOs to participate in the Medicare Shared Savings Program (MSSP), they are showing even greater enthusiasm...more
7/23/2014
/ ACOs ,
EHR ,
Halifax Hospital ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Medicare ,
Medicare Shared Savings Program ,
Regulatory Standards ,
Reporting Requirements ,
Social Networks ,
Stark Law
Removing Regulatory Barriers to Accelerate EHR Adoption -
Recognizing the potential long-term value of EHRs for improving care and reducing costs, many hospitals considered offering physicians financial support to...more
Litigation Arising from the Affordable Care Act: The Blessing and Curse of Interesting Times -
The Affordable Care Act (ACA) has brought the most sweeping changes to the healthcare delivery and payment systems in the...more
Assessing the Medicare Shared Savings Program: Diverse Participants, Diverse Results -
Rising healthcare costs and declining reimbursements have placed immense pressure on providers and health systems to manage the...more
On February 19, 2014, Pennsylvania submitted to CMS an application requesting approval under Section 1115 of the Social Security Act to implement the Affordable Care Act (ACA) Medicaid expansion effective January 1, 2015....more
On December 30, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Michigan’s request to amend an existing waiver to implement the Affordable Care Act (ACA) Medicaid expansion effective April 1, 2014 through...more
On December 10, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Iowa’s waivers to implement the Affordable Care Act (ACA) Medicaid expansion. The state plans to provide coverage for the new adult group...more
On September 27, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Arkansas’s waiver to implement the Affordable Care Act (ACA) Medicaid expansion by using premium assistance to purchase QHPs in the Health...more
How Does the DOMA Defeat Impact Healthcare Reform and Health Insurance Access? -
NOTE: The Supreme Court's 5-4 decision to invalidate the Defense of Marriage Act (DOMA) will affect more than 1,000 federal statutes—and...more
7/16/2013
/ Affordable Care Act ,
Delays ,
Department of Health and Human Services (HHS) ,
DOMA ,
Employee Benefits ,
Employer Mandates ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Pay or Play ,
Pharmacies ,
Same-Sex Marriage ,
SCOTUS ,
Shared Responsibility Rule ,
U.S. Treasury
Originally published in Health IT Law & Industry Report, on January 23, 2013.
On Jan. 17, 2013, the Office for Civil Rights of the U.S. Department of Health and Human Services (‘‘HHS’’) issued a long-awaited omnibus rule...more