There is a critical need to increase access to evidence-based care for justice-involved pregnant people with a substance use disorder (SUD)—and connect them to continued coverage and care upon release—according to national...more
9/11/2023
/ American Medical Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Drug & Alcohol Abuse ,
Food and Drug Administration (FDA) ,
Health Insurance ,
Healthcare ,
Medicaid ,
New Guidance ,
Opioid ,
Patient Access ,
Pregnancy ,
Prisoners ,
Substance Abuse
On May 18, 2023, the CMS, in consultation with the DOE, released new guidance to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies (SMAs), state education agencies (SEAs), and local education...more
As the nation experiences unprecedented levels of behavioral health needs—even further exacerbated by the COVID-19 pandemic—state Medicaid programs have increasingly looked for flexibility to craft services and payment models...more
Editors’ Note: As COVID-19 rips through the country, an often-overlooked population at extraordinarily high risk is the nearly 2 million adults with opioid use disorder (OUD). This group faces a perfect storm of health and...more
6/2/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Controlled Substances ,
Coronavirus/COVID-19 ,
DEA ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Opioid ,
Prescription Drugs ,
Public Health ,
SAMHSA ,
State of Emergency
As the COVID-19 pandemic continues to progress, providers across the continuum of care are experiencing significant changes in utilization resulting in declining revenue and jeopardizing access to care. The federal government...more
On February 8, 2019, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) released the funding announcements for the Integrated Care for Kids Model (InCK Model) and...more
The Center for Medicare and Medicaid Innovation (CMMI) will fund a model of care, Integrated Care for Kids (InCK), that will test whether alternative payment models can promote closer integration across children’s physical...more
During 2018, the Center for Medicare & Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS) announced two new opportunities for state governments and their partners to improve their delivery...more
On October 6, the Centers for Medicare & Medicaid Services (CMS) approved West Virginia’s “Creating a Continuum of Care for Medicaid Enrollees with Substance Use Disorders” Section 1115 demonstration. West Virginia’s waiver,...more
Editor’s Note: With efforts to repeal and replace the Affordable Care Act (ACA) flagging, stakeholders are redirecting their attention toward Medicaid Section 1115 demonstrations. The Trump administration has encouraged...more
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
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
On January 5, 2016, New Hampshire secured a five-year, $150 million Medicaid 1115 waiver to transform the state's delivery system for Medicaid beneficiaries with mental health and substance use disorders. Known as the...more
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
Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure -
As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more
9/25/2015
/ Affordable Care Act ,
Amarin ,
Anti-Bribery ,
Anti-Competitive ,
Anti-Corruption ,
Audit Policies ,
Bribery ,
Centers for Medicare & Medicaid Services (CMS) ,
Class Action ,
Clinical Laboratories ,
Clinical Trials ,
Compensation Standards ,
Compliance ,
Corporate Integrity Agreement ,
Cost-Sharing ,
Damages ,
Department of Justice (DOJ) ,
Dodd-Frank ,
False Claims Act (FCA) ,
FERA ,
Food and Drug Administration (FDA) ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud Abuse and Waste ,
Government Investigations ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
HEAT ,
Hiring & Firing ,
Hospitals ,
KBR v ex rel Carter ,
Kickbacks ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reimbursements ,
Medicare ,
Medicare Advantage ,
Non-Compete Agreements ,
Nurses ,
Off-Label Promotion ,
OMIG ,
Penalties ,
Physician Compensation Arrangements ,
Public Health Insurance Marketplace ,
Qui Tam ,
Recordkeeping Requirements ,
Recruitment Policies ,
Relators ,
Required Documentation ,
SCOTUS ,
Self-Reporting ,
Tuomey ,
Value-Based Purchasing ,
Wage and Hour ,
Whistleblowers
Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace -
Editor's Note: As marketplaces prepare for the third open enrollment period, consumers are...more
7/23/2015
/ Admissions ,
Affordable Care Act ,
Anticompetitive Agreements ,
Attorney General ,
Biologics ,
Biosimilars ,
Caregivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Decision-Making Process ,
Department of Justice (DOJ) ,
DSRIP ,
FDA Approval ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Healthcare.gov ,
Home Health Care ,
Home Healthcare Workers ,
Hospitals ,
Long-Term Care ,
Medicaid ,
Medical Malpractice ,
Medicare ,
Medicare Part B ,
Nurses ,
Patient Rights ,
Physicians ,
Prescription Drug Coverage ,
Prescription Drugs ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
Settlement ,
Sherman Act ,
State Health Insurance Exchanges
On July 14 the Centers for Medicare & Medicaid Services (CMS) announced the Medicaid Innovation Accelerator Program (IAP), an initiative to provide $100 million in federal funding for technical assistance (TA) to states to...more
Even as the news media tries to untangle the latest data on Marketplace enrollment, an equally important and still-evolving story is playing out on the Medicaid side of the open enrollment equation. According to a Centers for...more
Manatt on Medicaid: New Strategy for Financing 12 Months of Continuous Coverage for Newly Eligible Adults -
The federal government recently issued sub-regulatory guidance that will allow states to receive 98.7 percent...more
Beginning January 1, 2014, millions of low-income parents and other adults will become newly eligible for coverage in states implementing the Affordable Care Act's (ACA's) expansion of Medicaid to adults with incomes at or...more