Medicaid, Provider Payments

Policy Update - CMS Releases Final Rule: Medicaid Program; Ensuring Access to Medicaid Services

McDermott+ on 4/29/2024

On April 22, 2024 the Centers for Medicare & Medicaid Services (CMS) published the Medicaid Program; Ensuring Access to Medicaid Services final rule. The rule has a particular focus on home- and community-based services...more

[Webinar] Final Medicaid Rules, Part Three: Home and Community Based Services - June 4th, 10:00 am - 11:00 am PT

Manatt, Phelps & Phillips, LLP on 4/18/2024

This program is part three of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

[Webinar] Final Medicaid Rules, Part Two: Managed Care Payments, Quality and Oversight - May 21st, 12:00 pm - 1:00 pm PT

Manatt, Phelps & Phillips, LLP on 4/16/2024

This program is part two of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

[Webinar] Final Medicaid Rules, Part One: Access, Enrollee Engagement and Provider Payment Transparency - May 14th, 12:00 pm -...

Manatt, Phelps & Phillips, LLP on 4/15/2024

This program is part one of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

CMS Issues Final Rule Impacting Prior Authorization Process

Cozen O'Connor on 1/24/2024

Last week CMS issued its final rule “CMS Interoperability and Prior Authorization” (CMS-0057-F), unchanged from its proposed rule in 2022, which addresses prior authorizations. Prior authorization, a “utilization management”...more

[Webinar] The Legal, Regulatory and Market Trends Transforming Health Care - October 5th, 9:30 am - 10:30 am PT

Manatt, Phelps & Phillips, LLP on 9/15/2023

From the end of the COVID-19 public health emergency (PHE) to the overturning of Roe v. Wade to the skyrocketing growth of virtual care, multiple forces are converging to remap the health care landscape. In a new webinar,...more

Overall Medicare Hospital Payments Will Increase in FY 2024, but Some Hospitals Could See a Decrease

McDermott+ on 8/10/2023

Congress may be on summer break, but reg season is in full swing. Last week, the Centers for Medicare & Medicaid Services (CMS) released a final reg that will impact Medicare hospital payments in fiscal year (FY) 2024, which...more

Federal District Court Grants Injunction Barring CMS from Implementing New Policy on Medicaid Funding Designed to Prevent...

King & Spalding on 7/17/2023

On June 30, 2023, the United States District Court for the Eastern District of Texas (the Court) granted the State of Texas’ preliminary injunction motion, enjoining CMS from implementing and enforcing its Informational...more

[Webinar] Proposed Rules on Medicaid Payments, Access and Quality: Implications for Health Care Stakeholders - June 20th, 1:00 pm...

Manatt, Phelps & Phillips, LLP on 6/9/2023

On Thursday, April 27, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated proposed rules... Together, these would reshape the federal regulatory landscape for Medicaid and the Children’s Health...more

Drastic Scheduled Cuts to Disproportionate Share Hospital Funding Would Increase Financial Distress for Safety Net Hospitals

ArentFox Schiff on 3/31/2023

Over 2500 hospitals across the country historically have relied upon Disproportionate Share Hospital (DSH) Medicaid payments for financial stability. These DSH payments, made in large measure to hospitals with high Medicaid...more

Takeaways From AHLA’s Institute on Medicare and Medicaid Payment Issues

Arnall Golden Gregory LLP on 4/6/2022

AGG Healthcare attorneys Lanchi Bombalier and Charmaine Mech recently attended the American Health Law Association (AHLA)’s Institute on Medicare and Medicaid Payment Issues in Baltimore, Maryland, from March 23-25, 2022. The...more

Payment Dispute with a Medicaid Health Plan? State Not Obligated to Help, According to Federal Court

Foley & Lardner LLP on 7/15/2021

Medicaid providers cannot sue the state to seek payment from a Medicaid health plan, according to a July 9 Illinois federal district court decision. The court’s holding is likely to be a disappointment to providers...more

[Webinar] Medicaid Managed Care Payment Policies to Support Pediatric Providers - December 7th, 3:30 pm - 4:30 pm ET

Manatt, Phelps & Phillips, LLP on 11/25/2020

What Actions Can State Medicaid Agencies and Medicaid Managed Care Organizations Take to Support Financial Stability for Pediatric and Other Primary Care Practices During the COVID-19 Pandemic? Find Out in a New Webinar From...more

HHS Issues Medicaid/CHIP Provider Relief Fund Payment Forms and Guidance

Jackson Walker on 6/23/2020

The U.S. Department of Health & Human Services (HHS) expects to distribute $15 billion to eligible Medicaid and CHIP providers. The payment to each provider will be at least 2% of reported gross revenue from patient care; the...more

HHS Announces Relief Fund Payments For Medicaid & CHIP Providers, Safety Net Hospitals And Enhanced Provider Relief Fund Portal

Fox Rothschild LLP on 6/12/2020

In a Press Release issued Tuesday afternoon, the U.S. Department of Health and Human Services (HHS) announced they will distribute approximately $15 billion to eligible providers that participate in state Medicaid and...more

CMS Pauses Advance Payments, Studies Accelerated Payments

Fox Rothschild LLP on 4/28/2020

The Centers for Medicare and Medicaid Services (CMS) announced that it has stopped accepting new applications for Advance Payments and is reevaluating pending and new applications for Accelerated Payments. In an April 26...more

Medicare and Medicaid Developments in Health Care Bankruptcies

Skadden, Arps, Slate, Meagher & Flom LLP on 4/6/2020

In 2019, the increased wave of distressed health care companies continued, and with downward pressure on reimbursement rates, regulatory changes, decreased occupancy rates and technological advances, this trend is unlikely to...more

Payment Advances For Medicare Providers, Suppliers May Ease Liquidity Issues – Six Key Points

McGuireWoods LLP on 3/31/2020

On March 28, 2020, the Centers for Medicare & Medicaid Services (CMS) released guidance expanding its Accelerated and Advanced Payment Program, which now allows most Medicare Part A and Part B providers and suppliers to...more

COVID-19: Expansion of Telemedicine Services and Rural Health Clinics

Butler Snow LLP on 3/28/2020

On March 17, 2020, in response to the COVID-19 emergency, Medicare announced that it will reimburse physicians and other certain healthcare providers for telehealth service visits at the same amount as in-person visits...more

A Flurry of Recent Activity Highlights Continued Interest in 340B Program Oversight

Baker Donelson on 1/30/2020

Four separate government releases coming over a three-week period have once again highlighted the intense interest in the 340B drug pricing program, with a federal agency and two government watchdog groups issuing guidance...more

CMS Proposes New Home Health Agency Rule Including Potential Changes to Reimbursement, Coverage, Quality, and More: CMS Accepting...

Sheppard Mullin Richter & Hampton LLP on 7/17/2019

On July 11, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced a proposed rule for home health agency Medicare reimbursement that would increase payments by an aggregate 1.3% for 2020, amounting to $250...more

Medicaid › Provider Payments