In the United States, individuals are eligible for Medicare because they are aged 65 or older or because of their long-term disability status, and they are typically eligible for Medicaid because they have low income and few...more
Editor’s Note: In a new white paper, summarized below, Manatt Health discusses emerging reimbursement models for cell and gene therapies. The paper provides an overview of current Medicaid, Medicare and commercial coverage,...more
7/26/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
DNA ,
Food and Drug Administration (FDA) ,
Genetic Materials ,
Health Insurance ,
Healthcare ,
Life Sciences ,
Medicaid ,
Medicare ,
Pharmaceutical Industry ,
Value-Based Payments
Over the past five years, cell and gene therapies have increasingly moved from the R&D pipeline to the health care setting, putting lifesaving treatments for certain cancers and genetic diseases within patients’ reach. Over...more
7/20/2023
/ Clinical Trials ,
Food and Drug Administration (FDA) ,
Health Insurance ,
Healthcare ,
Human Genes ,
Life Sciences ,
Medicaid ,
Medical Devices ,
Medical Reimbursement ,
Medical Research ,
Medicare ,
Pharmaceutical Industry
Over 12 million Americans are eligible for both Medicare and Medicaid, including roughly 7.5 million adults aged 65 and over and roughly 4.5 million people with disabilities under age 65. Many of these dual-eligible...more
Editor’s Note: Over the past decade, both public and private payers have sought to develop payment policies that emphasize the value of the services provided instead of the quantity. These value-based purchasing (VBP)...more
The Search for Savings and Value: The Federal Perspective -
President Trump’s “American Patients First” blueprint outlines several initiatives to lower drug prices and reduce patients’ out-of-pocket costs. Shortly after...more
Editor’s Note: State Medicaid programs continue to balance serving eligible beneficiaries and controlling costs. In an environment sharply focused on the cost of drugs, it is increasingly critical to understand the Medicaid...more
Editor’s Note: In the past four months, the Government Accountability Office (GAO) and Office of the Inspector General (OIG) have issued a barrage of reports scrutinizing Medicaid programs and their oversight of program...more
Editor's Note: This “Manatt on Medicaid” is the fourth 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
On February 9, 2016, the Centers for Medicare and Medicaid Services (CMS) approved Alabama's request for a waiver under Section 1115 of the Social Security Act. The waiver enables the transition of the State's Medicaid...more
States have long relied on Section 1115 Medicaid waivers to advance payment and delivery reforms in their Medicaid programs, including far-reaching managed care programs and innovative provider-led care management...more