Deborah Bachrach on Medicaid

Transforming Primary Healthcare for Women: The Path Forward

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

9/14/2020 / Department of Health and Human Services (HHS) , Diversity , Entrepreneurs , Gender Equity , Health Care Providers , Hospitals , Innovation , Medicaid , Telehealth , Women-Owned Businesses

Extending VBP Models Into Medicaid Drug Purchasing

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

6/7/2019 / Drug Pricing , Medicaid , Trump Administration , Value-Based Purchasing

Enhancing Access to Family Planning Services in Medicaid: A Toolkit for States

Medicaid is the primary source of family planning coverage in the United States, accounting for 75 percent of total public expenditures for family planning services; Title X and state and local governments also play an...more

5/22/2019 / Contraceptives , Eligibility , Family Planning Clinics , Medicaid

Monitoring and Evaluating Work and Community Engagement Requirements in Medicaid: Data Assets, Infrastructure and Other...

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

3/15/2019 / 1115 Waivers , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Medicaid

Medicaid Briefing Series: Priority Issues for State Policymakers

Issue 1 - The Issue - Medicaid is woven into the fabric of states’ health care systems and economies: it covers one in five Americans; is the single largest insurer in every state; and is the largest source of funding...more

3/11/2019 / Health Care Providers , Healthcare , Hospitals , Medicaid , Opioid

Establishing Connections to Healthcare for Justice-Involved Populations

With many states expanding Medicaid eligibility, individuals leaving jail or prison are now often able to enroll in health coverage upon release. It is increasingly clear, however, that coverage alone is insufficient to...more

1/11/2019 / Affordable Care Act , Health Insurance , Healthcare Reform , Medicaid , Medicaid Expansion

Manatt on Health: Medicaid Edition: CMS Releases Guidance Formalizing Budget Neutrality Policies

On August 22, 2018, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter (SMDL) memorializing its long-standing budget neutrality policies requiring that waivers under Section 1115 of...more

9/4/2018 / 1115 Waivers , Centers for Medicare & Medicaid Services (CMS) , Medicaid

Work and Community Engagement Requirements in Medicaid

In January 2018, the Centers for Medicare & Medicaid Services (CMS) issued guidance to states as to the circumstances under which CMS would approve Section 1115 demonstration waivers making work/community engagement (CE)...more

8/30/2018 / Centers for Medicare & Medicaid Services (CMS) , Enrollment , Health Care Providers , Medicaid , Medicare

Manatt on Health: Medicaid Edition - Virginia Expands Medicaid

On June 7, 2018, Virginia joined 32 other states and the District of Columbia in expanding Medicaid under the Affordable Care Act to adults with incomes at or below 138% of the federal poverty level (FPL). After rejecting...more

6/27/2018 / Affordable Care Act , Federal Poverty Line , Healthcare Reform , Medicaid , Medicaid Expansion

New Analyses Find Montana Medicaid Expansion Saving Millions of Dollars, Helping Thousands Access Preventive Care - Number of...

Bozeman, Mont. – According to two independent analyses released today, Montana’s 2015 bipartisan Medicaid legislation has saved more than $36 million in the state’s budget and helped more than 65,000 adults access preventive...more

6/22/2018 / Health Care Providers , Hospitals , Medicaid , Medicaid Expansion , State Budgets

Medicaid Work Requirements: Policy and Practical Considerations

In January 2018, the Centers for Medicare & Medicaid Services (CMS) issued guidance setting forth the standards it will apply in granting state waivers conditioning Medicaid eligibility on compliance with work and community...more

6/15/2018 / Centers for Medicare & Medicaid Services (CMS) , Medicaid , Medicaid Work Requirements , Medicare

Is Momentum for Medicaid Expansion on the Upswing?

To date, 32 states and the District of Columbia have expanded Medicaid under the Affordable Care Act (ACA) to adults with incomes at or below 138% of the federal poverty level (FPL)—newly covering more than 12 million...more

5/29/2018 / Affordable Care Act , Medicaid , Medicaid Expansion

Medicaid: Linchpin in State Strategies to Address Opioid Epidemic

The nation’s opioid epidemic claimed more than 42,000 lives in 2016, and more than 2 million people in the United States have an opioid use disorder (OUD). Yet only 1 in 5 people suffering from an OUD receive treatment. The...more

3/30/2018 / Drug & Alcohol Abuse , Medicaid , Medicaid Expansion , Opioid

Manatt on Health: Medicaid Edition - March 2018

Medicaid’s Critical Role in Addressing the Opioid Crisis - As the opioid crisis in the United States continues to deepen—with opioid overdoses claiming 42,000 lives in 2016—policymakers, providers, advocates and other...more

3/29/2018 / 1115 Waivers , Medicaid , Opioid

Manatt on Medicaid: 10 Trends to Watch in 2018

Medicaid has entered a period of volatile change, unprecedented in its 51-year history. With 74 million members nationwide,1 Medicaid provides health coverage to more than one in four Americans, ensuring access to...more

2/8/2018 / Health and Welfare Plans , Long Term Care Facilities , Managed Care Contracts , Medicaid , Medicaid Work Requirements , Prescription Drugs , Value-Based Purchasing

Manatt on Health: July 2017 #2

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

7/26/2017 / Affordable Care Act , American Health Care Act (AHCA) , Congressional Budget Office , Health Insurance , Healthcare Reform , Medicaid , Repeal

Can People Losing Medicaid Under BCRA Afford Marketplace Coverage?

Next steps regarding Congressional action on repeal and replace remain uncertain, with the President again supporting repeal coupled with replace, members attempting to bridge their differences over the Better Care...more

7/21/2017 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Congressional Budget Office , Health Insurance , Healthcare Reform , Medicaid , Medicaid Expansion

Manatt on Health: July 2017

BCRA Implications: Affordability of Coverage - In making the case for repealing and replacing the Affordable Care Act (ACA), the president and congressional leadership have cited “rising premiums,” “unaffordable...more

7/12/2017 / Affordable Care Act , American Health Care Act (AHCA) , Centers for Medicare & Medicaid Services (CMS) , Health Insurance , Healthcare Reform , Medicaid , Medicare Access and CHIP Reauthorization (MACRA)

Impact on Montana of the AHCA’s Medicaid Provisions

Overview of Findings - The Stakes for Montana - ..Montana is expected to lose $4.8 billion in federal Medicaid funds between federal FY* 2020 and 2026 due to the AHCA’s elimination of enhanced match for expansion and...more

6/29/2017 / American Health Care Act (AHCA) , Health Insurance , Healthcare Reform , Medicaid

Impact on Montana of Medicaid Provisions in the BCRA (June 26 Discussion Draft): Preliminary Analysis

Overview of Findings - The Stakes for Montana - ..Medicaid covers one in four people in Montana—more than 216,000 individuals, nearly half of whom are children. ..Under the Senate’s proposed Better Care...more

6/27/2017 / Health Insurance , Healthcare Reform , Medicaid

Manatt on Medicaid: Maine Releases Draft Waiver Request Proposing New Eligibility Requirements

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

Medicaid's Growing Role for SUD Services in Montana

Editor's Note: Montana's 2016 expansion of Medicaid provides an important opportunity to strengthen the state's substance use disorder (SUD) prevention and treatment system. In a new report for the Montana Healthcare...more

3/29/2017 / Affordable Care Act , Healthcare Reform , Medicaid , Substance Abuse

Medicaid’s Role in the Delivery and Payment of Substance Use Disorder Services in Montana

The State of Montana is grappling with a serious and growing public health problem in substance use disorders (SUDs)—including alcoholism, methamphetamine use and opioid abuse and overdose—as well as the related, profound...more

3/28/2017 / Affordable Care Act , Drug & Alcohol Abuse , Healthcare Reform , Medicaid , Medicaid Expansion , Substance Abuse

Health Update - March 2017

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

Repealing the Medicaid Expansion: Implications for Montana

Congress is currently debating whether and how to repeal and replace the Affordable Care Act (ACA). This report provides an analysis of the potential impact to the State of Montana of a possible repeal of one portion of the...more

3/9/2017 / Affordable Care Act , Health Care Providers , Health Insurance , Healthcare Reform , Medicaid , Medicaid Expansion

Deborah Bachrach

Manatt, Phelps & Phillips, LLP

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