Foley Hoag LLP - Medicaid and the Law

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Seaport West
155 Seaport Boulevard
Boston, MA 02210-2600, United States
Phone: 617-832-1000
Fax: 617-832-7000
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Publications About Authors

Haider David Andazola

A Deeper Dive into CMS’ Multiple Best Prices Policy

As my colleague Tom wrote about in a recent post, the Centers for Medicare & Medicaid Services (CMS) has finally responded to a growing chorus of stakeholders that government price reporting requirements, particularly Medicaid…more

Anti-Kickback Statute, Centers for Medicare & Medicaid Services (CMS), Coronavirus/COVID-19, Drug Pricing, Medicaid

See all updates »

Thomas Barker

CMS Issues Rule Implementing Medicaid Redetermination Policies

We’ve written recently about the process that states are undertaking to begin to wind down the Medicaid enrollment expansion that was necessitated by the enactment of the Families First Coronavirus Response Act in March of 2020…more

Beneficiaries, Centers for Medicare & Medicaid Services (CMS), Consolidated Appropriations Act (CAA), Corrective Action Plans (CAPs), Eligibility

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Michelle Youngmin Choi

HHS Ordered to Correct Medicare Payments to 340B Hospitals for Remainder of 2022

We have noted before the link between the Medicaid prescription drug rebate program and the 340B program. As we wrote in an earlier Client Alert, in June 2022, the U.S. Supreme Court struck down HHS’s Medicare payment cuts to…more

Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS), Drug Pricing, Health Care Providers, Hospitals

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Kristyn Bunce DeFilipp

D.C. Circuit Reverses District Court in DSH Case

We have long covered the handful of lawsuits that have been filed over the past several years concerning Medicaid disproportionate share hospital (“DSH”) payment policies. These lawsuits all revolve around some steps that CMS…more

Centers for Medicare & Medicaid Services (CMS), DSH, Health Care Providers, Hospitals, Medicaid

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Regina DeSantis

CMS Rings in the New Year with Updated Guidance on ‘In Lieu of Services and Settings’ (ILOS) in Medicaid Managed Care

Welcome back! We hope everyone had a great start to 2023. A new year provides an opportunity to look back on previous successes and identify areas for growth (this said, we certainly don’t expect everyone to make—let alone…more

Centers for Medicare & Medicaid Services (CMS), Managed Care Contracts, MCOs, Medicare, Medicare Advantage

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Erin Estey Hertzog

Gang of Six Introduces Historic 340B “Discussion Draft” Legislation

On February 2, 2024, the “gang of six”—a bipartisan group of six senators who have traditionally championed reforms to the 340B program1 —introduced a discussion draft of a bill that would modify the program that provides safety…more

Drug Pricing, Legislative Agendas, New Legislation, Pharmaceutical Industry, Pharmacies

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Tyrus Jackson

CMMI Introduces New Multi-State Initiative Focused on Enhancing Primary Care Delivery

CMMI was established to test innovative payment and service delivery models expected to reduce expenditures and preserve or enhance care quality under Medicare, Medicaid, and the Children’s Health Insurance Program. Over the…more

Centers for Medicare & Medicaid Services (CMS), Children's Health Insurance Program (CHIP), CMMI, Health Insurance, Healthcare

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Ross Margulies

Gang of Six Introduces Historic 340B “Discussion Draft” Legislation

On February 2, 2024, the “gang of six”—a bipartisan group of six senators who have traditionally championed reforms to the 340B program1 —introduced a discussion draft of a bill that would modify the program that provides safety…more

Drug Pricing, Legislative Agendas, New Legislation, Pharmaceutical Industry, Pharmacies

See all updates »

Alexander Somodevilla

CMS Issues Rule Implementing Medicaid Redetermination Policies

We’ve written recently about the process that states are undertaking to begin to wind down the Medicaid enrollment expansion that was necessitated by the enactment of the Families First Coronavirus Response Act in March of 2020…more

Beneficiaries, Centers for Medicare & Medicaid Services (CMS), Consolidated Appropriations Act (CAA), Corrective Action Plans (CAPs), Eligibility

See all updates »

Colin Zick

New Developments in HIPAA and Related Issues in Health Information Law

Halloween or HIPAA: Which is Scarier? HIPAA and the Pandemic - Telehealth: - On Friday, March 20, 2020, OCR announced it will “exercise its enforcement discretion and will not impose penalties for noncompliance with the…more

Breach Notification Rule, California Consumer Privacy Act (CCPA), Centers for Medicare & Medicaid Services (CMS), Coronavirus/COVID-19, Disclosure

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