News & Analysis as of

Medicaid

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -

Virginia Health Care Legislation: 2018 Session Recap

by Williams Mullen on

To say the 2017 elections changed the dynamic of Virginia’s General Assembly would be an understatement. The Democratic party swept all three statewide elected offices and trimmed the Republican majority in the House of...more

North Carolina Update on Health Care Legislation in 2017

by Williams Mullen on

The North Carolina General Assembly considered several health care issues during the 2017 legislative session. Four of the more important of those issues are discussed below....more

America’s Opioid Crisis

The Genesis of the Opioid Crisis - The deaths caused by opioids in 2016 exceeded the total deaths in any single year from car accidents, gun violence and even HIV/AIDS at the height of that epidemic. Multiple factors have...more

Illinois Supreme Court Hears Oral Argument on Hospital Property Tax Exemptions

by Franczek Radelet P.C. on

Yesterday, the Illinois Supreme Court heard oral argument in Oswald v. Beard, a case challenging the constitutionality of the statute exempting most hospitals from paying any property taxes. ...more

State Action on Market Stabilization

During the open enrollment period for the 2018 plan year, approximately 11.8 million people enrolled in Marketplace coverage and 74 million people enrolled in Medicaid, leading to an uninsured rate in the U.S. of 12.2...more

Health Care Policy Newsletter - May 2018 pt 2

by Foley & Lardner LLP on

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly Health Care Newsletter” in which we compile the latest health care policy news and legislation.*Please note that we...more

Virginia, Maryland, and kids bear early brunt of partisan health care attacks

As the nation churns toward the midterm elections, the Trump Administration has sent stark messages to voters about how they may wish to respond to Republicans’ unceasing attacks on health care and health insurance for the...more

Trump Administration Drug Pricing Blueprint: Overview and Analysis

• The administration’s drug pricing Blueprint combines proposals that are already under way with new initiatives that may or may not be adopted. • Many of the more dramatic proposals would require federal rulemaking or...more

Medicaid Buy-In: State Options, Design Considerations and Section 1332 Waiver Implications

During the open enrollment period for the 2018 plan year, approximately 11.8 million people enrolled in marketplace coverage and 74 million people enrolled in Medicaid, bringing the United States’ uninsured rate to 12.2¹....more

UnitedHealthcare Wins Medicaid Bid Protest Case

by Alston & Bird on

On April 10, 2018, the Pennsylvania Commonwealth Court ruled in favor of our client, UnitedHealthcare, in their case against the state Department of Human Services (DHS) for violating the state’s procurement code during a...more

CMS Pushes for Hospital Price Transparency in Proposed Rule

On April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) announced a new proposed rule (CMS-1694-P) (“Proposed Rule”). In an attempt to “empower patients through better access to hospital price information,”...more

President Trump Delivers Much Anticipated Drug Pricing Speech

On Friday, after weeks of delay, the President finally delivered his Drug Pricing Speech and released the HHS Blueprint detailing the Trump Administration’s plan to lower drug prices and reduce out-of-pocket costs....more

Health Care Policy Newsletter

by Foley & Lardner LLP on

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our second “Public Policy Weekly* Health Care Newsletter” in which we compile the latest health care policy news and legislation. Please...more

Mental health provider faces False Claims Act lawsuit due to alleged unlicensed, untrained and unsupervised personnel

by Bricker & Eckler LLP on

After a federal judge denied its motion to dismiss the case, a Massachusetts mental health provider, formerly known as South Bay Mental Health Center, Inc. (South Bay), faces claims under the federal False Claims Act and the...more

Vermont Legislative Update 5-4-18 - An analysis from DRM's Government & Public Affairs Team

Medical Monitoring Bill Moves On - The House Judiciary Committee sent a version of S.197 to the Senate floor that eliminates the Senate-passed provisions creating strict, joint and several liability for release of harmful...more

States Increasingly Looking to Managed Care for Long-Term Care Services

More state Medicaid agencies are shifting to or considering managed care models to provide long-term care services, sparking a growing backlash from disability and elder rights advocates....more

CMS Releases Innovation Center New Direction RFI Feedback and Issues New RFI for Direct Provider Contracting

Last fall, the Centers for Medicare & Medicaid Services (CMS) announced a new direction for its Center for Medicare & Medicaid Innovation, CMS’s platform for testing innovative models for delivering high-quality care at lower...more

What Have We Learned About False Claims Act Litigation in the Two Years Since Universal Health Services, Inc. v. United States ex...

Summer is almost here. For some, that means planning vacations to the beach, hitting the gym to shed that winter weight, or perhaps hitting the golf course—but for us at the Sheppard Mullin Healthcare Law Blog and the False...more

Manatt on Health: Medicaid Edition - May 2018

As healthcare costs continue to rise and stakeholders maintain focus on improving quality of care and outcomes, payors for healthcare services are turning to value-based payment (VBP) as one tool to inject greater value into...more

K&L Gates Triage: ACO Improvements in the Bipartisan Budget Act of 2018

by K&L Gates LLP on

The Bipartisan Budget Act of 2018 recently introduced three noteworthy program improvements for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) aimed at increasing program...more

Will CMS Drive Further Changes to 340B?

There are now multiple proposals in the House and Senate for substantive changes to the 340B Drug Discount Program. The odds of a legislative “fix” to 340B are increasing. But independent of congressional action, is CMS...more

CMS Releases FY 2019 Medicare IPPS and LTCH PPS Proposed Rule, Proposes Significant Changes to Several Regulatory Requirements

by King & Spalding on

On April 24, 2018, CMS issued the annual Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System (PPS) Proposed Rule for FY 2019 (the Proposed Rule) which will...more

CMS Proposes Changes to Inpatient Admission Orders in 2019 IPPS Proposed Rule

by King & Spalding on

On April 24, 2018, the Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) Proposed Rule (CMS-1694-P). Among other changes, CMS proposes eliminating...more

Seeking Interoperability: Centers for Medicare & Medicaid Services

by Farrell Fritz, P.C. on

As we have discussed in an earlier blog post, the federal administrative agencies have been placing greater emphasis on being more transparent and promoting “interoperability”....more

OIG April 2018 Work Plan Update

by Baker Ober Health Law on

The OIG's April 2018 Work Plan update added six new items to its active list of scheduled audits, inspections, and evaluations. The OIG indicates its intention to review beneficiary access to drugs under Part D, as well as...more

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