Medicaid, Medicaid Reform

Emerging Opportunities for State-Based Marketplaces (SBMs)

Manatt, Phelps & Phillips, LLP on 4/23/2024

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

OMIG Proposes Omnibus Regulations Impacting Medicaid Providers’ and Plans’ Compliance Obligations

Manatt, Phelps & Phillips, LLP on 7/14/2022

On July 13, 2022, the New York State Office of Medicaid Inspector General (OMIG) published proposed rules in the New York State Register to implement provisions of the State Fiscal Year 2020-2021 Enacted Budget and the...more

Medicaid Reform and Cuomo’s Budget: Why They Matter to Municipalities

Harris Beach PLLC on 1/30/2020

The Medicaid system in New York state has received a great deal of attention over the past few months – pinpointed as cause for over $2 billion of New York State’s staggering $6 billion deficit. While Governor Cuomo blamed...more

Cuomo's Proposed Medicaid Reform Yields Insight for New York State Municipalities, Health Care Providers

Harris Beach PLLC on 1/28/2020

Governor Cuomo’s plan to reform Medicaid has given local governments, municipalities and healthcare providers a little glimpse into how he plans to address issues related to New York state’s budget deficit. First, the...more

CMS Delays Price Transparency, Doubles Down on Site-Neutral and 340B Payment Policies in CY 2020 OPPS Final Rule

Polsinelli on 11/6/2019

Late last week, the Centers for Medicare & Medicaid Services (“CMS”) released the CY 2020 Hospital Outpatient Prospective Payment System (“OPPS”) final rule [CMS-1717-FC]. While many hospitals had hoped for relief from recent...more

Medicaid Reform Beyond the AHCA

Mintz - Health Care Viewpoints on 4/10/2017

While we continue to monitor Congressional efforts to repeal and replace the ACA, we are also monitoring CMS’s efforts to implement the administration’s Medicaid program goals without Congressional action. The future of the...more

Medicaid Reform: It’s All About Paying Providers

Mintz - Health Care Viewpoints on 2/22/2017

Health care services cost money. Often times, a lot of money. This fundamental truism captures the challenge facing Congressional Republicans as they consider coverage of low income populations as part of their so-called...more

Manatt on Health Reform: Weekly Highlights - August 2016 #4

Manatt, Phelps & Phillips, LLP on 8/24/2016

HealthCare.gov plans an open enrollment pilot that will let consumers compare provider network breadth; new Medicaid enrollees reduce out-of-pocket spending on prescription drugs by nearly 60%; and Kansas’s Governor announces...more

Manatt on Health Reform: Weekly Highlights - August 2016 #3

Manatt, Phelps & Phillips, LLP on 8/17/2016

CMS’s risk adjustment program data signals an improving risk pool while the agency announces plans to modify the program; California enrolls 134,000 undocumented immigrant children into Medicaid; and Oregon approves increases...more

Manatt on Health Reform: Weekly Highlights - July 2016 #3

Manatt, Phelps & Phillips, LLP on 7/20/2016

Massachusetts’s Marketplace eliminates cost-sharing for addiction treatment in subsidized QHPs; Montana cuts its uninsurance rate in half; and a Kaiser report identifies the 50 most costly drugs for Medicaid....more

Medicaid in Iowa: What's Next

Dentons on 6/22/2016

In my previous blog post, I provided a brief history of Medicaid in Iowa, including sharing details on it’s current modernization and challenges. In this post, we’ll cover what’s next for Medicaid members with the move to...more

Manatt on Medicaid: 10 Trends to Watch in 2016

Manatt, Phelps & Phillips, LLP on 2/24/2016

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

Medicaid Update - January 2016

Manatt, Phelps & Phillips, LLP on 1/29/2016

Welcome to the inaugural issue of "Manatt on Medicaid: Monthly Expansion Recap," a new companion publication to Manatt's weekly health reform highlights newsletter. For those of you laser-focused on Medicaid expansion, the...more

Manatt on Health Reform: Weekly Highlights - November 2015 #2

Manatt, Phelps & Phillips, LLP on 11/11/2015

With the election of a new Governor, the future of Kentucky’s Marketplace and Medicaid expansion is uncertain; CMS questions Iowa on its Medicaid managed care transition timeline; and the Supreme Court agrees to hear a case...more

Manatt on Health Reform: Weekly Highlights - November 2015

Manatt, Phelps & Phillips, LLP on 11/5/2015

Montana receives approval to expand Medicaid beginning 2016; California’s $6.2 billion Medicaid waiver receives pre-approval; and HHS proposes broadening circumstances under which states receive enhanced federal matching...more

Manatt on Medicaid: Medicaid at 50—The Program’s Evolution and Future

Manatt, Phelps & Phillips, LLP on 10/27/2015

Editor’s note: Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs into the nation’s largest health insurer. Medicaid’s 50th birthday is a fitting time to...more

Manatt on Health Reform: Weekly Highlights - October 2015 #3

Manatt, Phelps & Phillips, LLP on 10/21/2015

Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more

Manatt on Health Reform: Weekly Highlights - October 2015

Manatt, Phelps & Phillips, LLP on 10/7/2015

Congress passes a bill to give states greater flexibility in defining “small businesses”; South Dakota seeks to offset Medicaid expansion costs in part with increased use of the fully federally-funded Indian Health Service;...more

Medicaid at 50: The Program’s Evolution and Future

Manatt, Phelps & Phillips, LLP on 9/30/2015

Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs to the nation’s largest health insurer. The occasion of Medicaid’s 50th birthday is a fitting time to...more

Manatt on Health Reform: Weekly Highlights - September 2015 #5

Manatt, Phelps & Phillips, LLP on 9/30/2015

New study shows Marketplace premiums parallel the employer market; Montana likely to select a private insurer to administer benefits to its Medicaid expansion population; and Washington’s Exchange customers will begin paying...more

NC Legislative Update for September 2015 #3

Nexsen Pruet, PLLC on 9/29/2015

This Week - After passing the State’s biennial budget into law last week, the legislature turned its focus towards adjournment. The Senate unveiled an adjournment resolution which would adjourn the session on Tuesday,...more

Manatt on Health Reform: Weekly Highlights - September 2015 #4

Manatt, Phelps & Phillips, LLP on 9/23/2015

The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more

North Carolina General Assembly Week in Review

McGuireWoods LLP on 9/21/2015

The House went into session at 5 pm on Thursday, to start debate on the budget bill. The House debated the bill for 5 hours. In the end, 9 Democrats voted with 71 Republicans in favor of the budget, Rep. Gale Adcock (D-Wake),...more

Manatt on Medicaid: Arizona Releases Draft Waiver Request for Approval to Implement Reforms to ACA Medicaid Expansion

Manatt, Phelps & Phillips, LLP on 9/21/2015

Overview - On August 18, 2015, Arizona released the Modernizing Arizona Medicaid proposal for a new 1115 waiver to implement coverage and delivery system reforms in its Medicaid program, the Arizona Health Care Cost...more

Manatt on Health Reform: Weekly Highlights - August 2015 #4

Manatt, Phelps & Phillips, LLP on 8/26/2015

Arkansas's “Private Option” is projected to have a net impact of $438 million on state funds 2017-2021; Iowa selects MCOs for proposed Medicaid managed care transition; and, the DC Marketplace launches a robust dual-language...more

Medicaid › Medicaid Reform

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