News & Analysis as of


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 -

Continuing Resolution Creates Significant Changes to Medicare and Medicaid Policies

by Polsinelli on

The Bipartisan Budget Act of 2018, commonly referred to as the “Continuing Resolution,” was recently signed into law, creating a short-term fix to funding the federal government for six weeks while also raising the debt...more

Capitol Hill Healthcare Update

by BakerHostetler on

CONGRESS WORKS TO PASS BUDGET BEFORE FRIDAY’S SHUTDOWN DEADLINE - House leaders are pushing to schedule a vote this week on a $1.3 trillion budget agreement that would give the Senate enough time to pass it before a Friday...more

The State AG Report Weekly Update

by Cozen O'Connor on

Consumer Protection- Arizona Attorney General Announces Settlement with Auto Manufacturer Over Alleged Ignition Switch Defects- Arizona AG Mark Brnovich reached a settlement with auto manufacturer General Motors LLC...more

Healthcare Industry Beware: The Use of Statistical Sampling to Establish Damages and Liability Under the False Claims Act Remains...

The False Claims Act contains numerous requirements that are designed to prevent meritless cases from proceeding to discovery and trial. Among these provisions is the rule that, to establish liability, the government or a...more

CMS and Georgia DCH Representatives Discuss Current Topics in Medicaid at State Bar of Georgia Presentation

by Arnall Golden Gregory LLP on

On March 9, 2018, the Health Law Section of the State Bar of Georgia presented speakers from The Centers for Medicare and Medicaid Services (CMS) and the Georgia Department of Community Health (DCH) to discuss current topics...more

Healthcare Fraud & Abuse Review 2017

by Bass, Berry & Sims PLC on

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Health Care Weekly Preview from ML Strategies – March 2018 #2

This week, Congress returns to Washington with 11 days to finalize a government spending bill. House appropriators will be meeting throughout the week to finalize their respective packages which means we should expect to see...more

Window On Washington - Vol. 2, Issue 10

by Clark Hill PLC on

Outlook for This Week in the Nation's Capital - Omnibus. While negotiations on the Omnibus appropriations bill are said to be almost completed with the possibility of it being on the House floor next week, there are still a...more

Hospital, Cardiology Group Settle False Claims Act Allegations for $20.75 Million

by King & Spalding on

As reported previously, Hamot Medical Center (“Hamot”) and Medicor Associates, Inc. (“Medicor”) entered into a preliminary settlement agreement under which they agreed to pay $20.75 million to resolve kickback allegations...more

Medicaid Recipients Can Keep More of an Award Thanks to Recent Budget Deal

If you are injured due to medical malpractice or because of another person's negligence, you could receive care through your state's Medicaid program. In such cases, the state has a legal right to recover funds from your...more

CMS Revises National Coverage Determination for Implantable Cardioverter Defibrillators

On February 15, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a Decision Memo outlining revisions to its 2005 National Coverage Determination (NCD) for Implantable Automatic Defibrillators (ICDs) ....more

Advancing Access to Precision Medicine Act - A Bipartisan Bill

by Foley & Lardner LLP on

On February 15, 2018, representatives Eric Swalwell (CA-15), John Shimkus (IL-15), Scott Peters (CA-52), Erik Paulson (MN-03), and Juan Vargas (CA-51), introduced the Advancing Access to Precision Medicine Act (H.R....more

Have You Properly Prepared for a WPA Audit?

by FordHarrison on

Audits of compliance with the Wage Parity Act ("WPA") are on the rise. The NYS Attorney General's Medicaid Fraud Unit, Medicaid Inspector General ("OMIG"), and Department of Labor ("DOL") are all auditing home care agencies....more

Civil and Criminal Fraud and Abuse Penalties Increase and Stark Law Changes

by McGuireWoods LLP on

The Bipartisan Budget Act of 2018 (the Act) continues to ratchet up penalties for fraud and abuse violations under the Medicare and Medicaid programs. The Act doubles statutory civil fines and quadruples some criminal fines,...more

The Opioid Epidemic: Medicaid Funding for Residential and Inpatient SUD Treatment

by K&L Gates LLP on

Medicaid Funds Have Been Limited for Inpatient and Residential Treatment for Substance Use Disorder (“SUD”) - Until recently, Medicaid funds for inpatient or residential treatment of SUD have been restricted by a federal...more

Lifting the Limits on Physician-Owned Hospitals: Can Regulators Prevail Where Legislators Have Stalled?

We reported, in early 2017, on what was then the latest legislative effort to repeal the Affordable Care Act’s amendment to the Stark Law’s whole hospital exception, which amendment has effectively prevented new...more

Health Care Weekly Preview from ML Strategies – March 2018

Congress kicks off this week with three weeks to go before the March 23 omnibus spending deadline. At this point it’s still not entirely clear what will be tacked on to this spending package, but immigration, market...more

K&L Gates Triage: Opioid Epidemic: Update on Policy Issues in Washington, DC.

by K&L Gates LLP on

In the third episode of our series on the national opioid crisis, Amanda Makki and Corbin Santo provide an overview of how the Trump Administration and Congress may address the opioid epidemic this year....more

CMS Expands Reimbursement for Telehealth Services

Despite telehealth’s significant expansion over the past ten years, it has been plagued by a historically unstable regulatory and reimbursement landscape....more

Efforts to Cut Drug Prices in Medicaid

Over the past five years, the budgets of state Medicaid programs have been challenged by the introduction of new high-cost drugs into the marketplace. Many of these drugs have important clinical benefits, and some are even...more

CMS Extends Hospital and CAH Attestation Deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the eligible hospital and critical access hospital (CAH) attestation deadline from February 28, 2018 to March 16, 2018....more

Health Care Weekly Preview from ML Strategies – February 2018 #3

This week, Congress is back in session and will continue its role in addressing the opioid epidemic. While fighting the epidemic is going to be a top priority in Congress this work period, a renewed push for gun control and...more

The President’s Budget and Shifting Policy on Prescription Drugs

On February 12, the Trump administration released the President’s Budget (or “the Budget”), outlining spending priorities for FY 2019. The Budget—though an important annual milestone and barometer of the administration’s...more

Significant New Medicare, Medicaid, and Other Health Policy and Payment Provisions Adopted in Bipartisan Budget Act

by Reed Smith on

The Bipartisan Budget Act of 2018 (the Act), signed into law by President Trump on February 9, 2018, includes extensive and far-reaching Medicare, Medicaid, and other health policy and payment provisions. Many of these...more

The Trump Administration Proposes a Budget Increase to Fight Healthcare Fraud

by Dickinson Wright on

The Trump administration proposed a budget increase of 19 million to aid in the fight against health care fraud. This showcases the continued (and heightened) importance of anti-fraud programs, especially compared to the...more

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