Editor’s Note: An array of care gaps and structural barriers inhibits the U.S. primary healthcare system from fully meeting the needs of women across the life course. Recently, new models of technology-enabled primary...more
Under Section 1115 of the Social Security Act, the Secretary of Health and Human Services (HHS) is permitted to waive certain federal Medicaid requirements to allow a state to undertake an experimental, pilot or demonstration...more
Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary -
On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its...more
On April 25, 2017, the Maine Department of Health and Human Services released for public comment a draft Section 1115 waiver application to implement new eligibility and coverage requirements for MaineCare, the State’s...more
5/2/2017
/ 1115 Waivers ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Fee-for-Service ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicaid Work Requirements ,
Premiums
The Future of Essential Health Benefits -
Editor's Note: The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and...more
3/24/2017
/ Affordable Care Act ,
Antitrust Immunity ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Essential Health Benefits ,
False Claims Act (FCA) ,
Health Insurance ,
Healthcare Reform ,
Insurer Liability ,
Medicaid ,
Premiums ,
Repeal ,
Trump Administration
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
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
Abstract -
States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by...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