On July 1, Oregon launched a Basic Health Program (BHP) that offers comprehensive health care coverage, including medical, dental, and behavioral health care, with zero premiums and zero cost-sharing for eligible individuals...more
The Affordable Care Act (ACA) Marketplaces have nearly tripled their enrollment in their first decade of operation, from eight million people in 2014 to 21.4 million in 2024. At the national level, the ACA has helped cut the...more
Editor’s Note: Welcome to the Manatt State Cost Containment Update, a digital publication produced with generous support from the Robert Wood Johnson Foundation and developed in coordination with the Peterson-Milbank Program...more
On April 5, President Biden held an event at the White House celebrating coverage gains since the enactment of the Affordable Care Act (ACA). Joined by Vice President Harris and former President Obama, President Biden...more
In-home evaluations (IHEs) are an integral component of Medicare Advantage (MA) plans, giving MA plans a cost-effective way to identify and meet the medical and nonmedical needs of vulnerable beneficiaries in their own homes...more
Editor’s Note: Welcome to the latest edition of the Manatt State Cost Containment Update, a digital publication produced with generous support from the Robert Wood Johnson Foundation and in collaboration with the...more
President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more
2/16/2022
/ Alternative Payment Models (APM) ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Beneficiaries ,
Physicians ,
Public Health Emergency ,
Public Health Insurance Marketplace ,
Surprise Medical Bills ,
Telehealth ,
Webinars
In July 2021, Governor Kate Brown signed into law HB 2010, which charges the Oregon Health Authority (OHA), in collaboration with the Department of Consumer and Business Services (DCBS), with developing a potential path for a...more
Oregon is committed to closing the remaining gap in health insurance coverage and doing so in a way that helps the State meet its goal of eliminating health inequities. According to the Oregon Health Insurance Survey,...more
In December 2021, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters for 2023. This proposal kicks off the annual rulemaking cycle for the Marketplaces and the...more
Executive Summary -
While most stakeholders agree on the need for more transparency in our health care system, there is substantial debate about how to make meaningful progress toward this goal in specific cases. This...more
Executive Summary -
Employers sponsoring group health plans face the ever-growing challenge of rising health care costs, and the increasing expenses they place on the plans and their enrollees alike. To respond to these...more
In a new “Expert Perspective” prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health provides a midyear update on the public option at the federal and state levels. ...more
The Big Picture -
The Biden Administration is just two weeks old, and President Biden has already issued more than two dozen Executive Orders on racial justice, health equity, strengthening Medicaid and the Affordable...more
Section 9 of Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of...more
Technological innovation has always been at the center of the Affordable Care Act (ACA) Marketplaces and has never been more important than it is now. Changes brought on by the coronavirus pandemic have clearly illustrated a...more
After a tumultuous four days, Joe Biden crossed the electoral college threshold to become the 46th President of the United States, a result that the Trump Campaign is challenging with recounts and litigation in several...more
As Election Day approaches, the outcomes of many federal and state races remain unclear, with the future of health reform hanging in the balance. In this newsletter, we examine how the election—including 36 gubernatorial...more
1332 Waivers Under Review at CMS -
The Trump administration has approved one 1332 waiver to date, but four more are pending, including a sweeping Iowa waiver. Here is where things stand today...more
Mapping the Healthcare M&A Landscape Under the New Administration -
Editor’s Note: The healthcare M&A market continues to be among the most active sectors. In a recent webinar, Manatt examined how the policies and goals of...more
5/25/2017
/ Acquisitions ,
Affordable Care Act ,
American Health Care Act (AHCA) ,
Antitrust Provisions ,
Centers for Medicare & Medicaid Services (CMS) ,
DSH ,
Food and Drug Administration (FDA) ,
Health Insurance ,
Healthcare Reform ,
Hospitals ,
Mergers ,
Trump Administration
CMS Issues Self-Referral Disclosure Protocol for Stark Law Violations -
On March 28, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a new voluntary self-referral disclosure protocol (SRDP) for disclosing...more
4/25/2017
/ Affordable Care Act ,
Anti-Steering Rules ,
Antitrust Provisions ,
Centers for Medicare & Medicaid Services (CMS) ,
Deceptive Intent ,
Department of Justice (DOJ) ,
Drug Pricing ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmacist ,
Self-Referral ,
Stark Law ,
Telehealth ,
Trump Administration
Editor's Note: In a dramatic conclusion to the heated debate surrounding the American Health Care Act (AHCA), the bill was withdrawn after it became clear that House leadership did not have enough votes to pass it. There is...more
4/25/2017
/ Administrative Authority ,
Affordable Care Act ,
Discrimination ,
Executive Orders ,
Gender Identity ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmaceutical Industry ,
Pregnancy Discrimination ,
Section 1557 ,
Trump Administration
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
As the incoming Congress and administration develop plans to “repeal and replace” the Affordable Care Act (ACA), analysis of five earlier repeal and replace proposals provides insights into the key features likely to appear...more
Post-Election Analysis: Healthcare Antitrust in a Trump Administration -
In a Republican sweep of all the elected branches of the federal government, Donald Trump won the presidential election and Republicans retained...more
11/23/2016
/ Affordable Care Act ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Covered Entities ,
Data Collection ,
Data Security ,
Enforcement ,
Federal Trade Commission (FTC) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
Internal Revenue Code (IRC) ,
IRS ,
Marketing ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Presidential Elections ,
Public Concern ,
Reinsurance ,
Section 501r ,
Trump Administration