Medicaid has seen significant increases in enrollment across all states since the outbreak of the COVID-19 pandemic. According to the latest data from the Centers for Medicare and Medicaid Services (CMS), total Medicaid...more
Editor’s Note: In a recent issue brief for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, summarized below, Manatt Health describes the provision in the American Rescue Plan Act of 2021 (ARP)...more
As much of the nation’s economic activity ground to a halt at the beginning of the COVID-19 pandemic, millions of people lost jobs and many also lost their job-based healthcare coverage. Based on the experience in other...more
The Trump administration has issued sweeping new Medicaid guidance, continuing its efforts to cap federal Medicaid funding. The new policy relies on untested legal theories to implement the fundamental “bargain” of block...more
3/9/2020
/ 1115 Waivers ,
Affordable Care Act ,
Block Grants ,
Centers for Medicare & Medicaid Services (CMS) ,
Consumer Price Index ,
Long-Term Care ,
Medicaid ,
Medicaid Work Requirements ,
New Guidance ,
Prescription Drugs ,
State Medicaid Programs
Lawmakers across the country are proposing legislation to stabilize the Affordable Care Act (ACA) insurance market, make coverage more affordable for consumers, and improve access to care by leveraging the bargaining power...more
In November 2017, Maine voters approved a referendum to implement expansion of MaineCare under the Affordable Care Act (ACA) to adults with incomes up to 138 percent of the federal poverty level (FPL). As Maine’s legislature...more
The Senate is poised to vote today, July 25, 2017, on a motion to proceed (MTP) to debate on repealing and possibly replacing the Affordable Care Act (ACA). The MTP allows the Senate to consider the House repeal and replace...more
Editor’s Note: While the American Health Care Act (AHCA)—the bill that would replace the Affordable Care Act—does not include explicit changes to Medicare, it could have a profound impact on the 11 million Medicare...more
In a new chart pack commissioned by the Blue Cross Blue Shield of Massachusetts Foundation for the Massachusetts Coalition for Coverage and Care, Manatt Health provides an overview of proposals to cap federal Medicaid funding...more
Securing the Safety Net for America's Vulnerable Populations -
Editor's Note: America's population is aging rapidly. By 2029, 75 million baby boomers will have reached age 65 and older, and older adults will represent...more
2/22/2017
/ Aetna ,
Affordable Care Act ,
Anthem Insurance ,
Antitrust Provisions ,
Caregivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
CIGNA ,
Department of Justice (DOJ) ,
FMAP ,
HCQIA ,
Health Insurance ,
Humana ,
Lead Poisoning ,
Medicaid ,
Medicare Advantage ,
Mergers ,
Opioid ,
Private Sector ,
Substance Abuse ,
Whistleblower Protection Policies ,
Whistleblowers
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
Balancing Gene Therapy’s Promise and Price -
Editor’s Note: Exciting advances in science have led to developing treatment breakthroughs, such as gene scripting therapies, that could represent the first potential cures...more
12/20/2016
/ Affordable Care Act ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
Final Rules ,
Healthcare Reform ,
Hospice ,
MCOs ,
Medicaid ,
Medicare ,
Non-Discrimination Rules ,
OCR ,
OIG ,
Safe Harbors ,
Telehealth
President-elect Trump and leaders in Congress have proposed a major restructuring of the Medicaid program, but very significant changes to Medicaid coverage and financing could be adopted even before that debate begins as...more
Real-Time Data Analytics in Government Investigations and Reducing Exposure -
It is not every day that the words “innovative” and “nimble” are used when referring to an agency of the federal government bureaucracy. Yet,...more
6/24/2016
/ ACOs ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Federal Trade Commission (FTC) ,
Government Investigations ,
Healthcare Fraud ,
HEAT ,
Hospital Mergers ,
IRS ,
MCOs ,
Medi-Cal ,
Medicaid ,
Medicare Advantage ,
OIG ,
Section 340B
Medicaid continues to gain scale and importance nationally – as both the leading source of health coverage for Americans, and as a change agent within the healthcare marketplace.
With the number of Americans obtaining...more
On December 30, 2015, the Centers for Medicare and Medicaid Services (CMS) approved California's request to renew its waiver under Section 1115 of the Social Security Act. A significant component of the waiver is the Delivery...more
Key Findings -
The cost of Medicaid expansion in Kansas is projected to average just over $50 million annually between 2016 and 2020. Based on publicly available data and the experiences of states that expanded in 2014,...more
Editor’s note: Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs into the nation’s largest health insurer. Medicaid’s 50th birthday is a fitting time to...more
10/27/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Eligibility ,
Enrollment ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance ,
Healthcare ,
Healthcare Costs ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Tax Credits ,
Value-Based Purchasing ,
Waivers
Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs to the nation’s largest health insurer. The occasion of Medicaid’s 50th birthday is a fitting time to...more
9/30/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Enrollment ,
Health Insurance ,
Information Technology ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Public Health Insurance Marketplace ,
State Medicaid Programs ,
Waivers
Five Lessons From 2015 Healthcare Deals -
In 2015, we already have seen a great deal of activity in healthcare transactions that is attracting antitrust scrutiny, with mixed results. Among the winners have been Cabell...more
8/21/2015
/ Affordable Care Act ,
Antitrust Provisions ,
Certificate of Need ,
FTC v. Phoebe Putney Health System ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Hospital Mergers ,
Medicaid ,
Medicaid Expansion ,
Palmyra ,
Security and Privacy Controls ,
St. Luke's ,
TCPA
CMS Proposes Permanent Enhanced Funding for Medicaid Eligibility Systems and Stronger Framework for Medicaid IT -
Editor’s Note: On April 16, 2015, the Centers for Medicare and Medicaid Services (CMS) issued the...more